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Min K, Bosma ML, John G, McGuire JA, DelSasso A, Milleman J, Milleman KR. Quantitative analysis of the effects of brushing, flossing, and mouthrinsing on supragingival and subgingival plaque microbiota: 12-week clinical trial. BMC Oral Health 2024; 24:575. [PMID: 38760758 PMCID: PMC11102210 DOI: 10.1186/s12903-024-04362-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 05/10/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Translational microbiome research using next-generation DNA sequencing is challenging due to the semi-qualitative nature of relative abundance data. A novel method for quantitative analysis was applied in this 12-week clinical trial to understand the mechanical vs. chemotherapeutic actions of brushing, flossing, and mouthrinsing against the supragingival dental plaque microbiome. Enumeration of viable bacteria using vPCR was also applied on supragingival plaque for validation and on subgingival plaque to evaluate interventional effects below the gingival margin. METHODS Subjects with gingivitis were enrolled in a single center, examiner-blind, virtually supervised, parallel group controlled clinical trial. Subjects with gingivitis were randomized into brushing only (B); brushing and flossing (BF); brushing and rinsing with Listerine® Cool Mint® Antiseptic (BA); brushing and rinsing with Listerine® Cool Mint® Zero (BZ); or brushing, flossing, and rinsing with Listerine® Cool Mint® Zero (BFZ). All subjects brushed twice daily for 1 min with a sodium monofluorophosphate toothpaste and a soft-bristled toothbrush. Subjects who flossed used unflavored waxed dental floss once daily. Subjects assigned to mouthrinses rinsed twice daily. Plaque specimens were collected at the baseline visit and after 4 and 12 weeks of intervention. Bacterial cell number quantification was achieved by adding reference amounts of DNA controls to plaque samples prior to DNA extraction, followed by shallow shotgun metagenome sequencing. RESULTS 286 subjects completed the trial. The metagenomic data for supragingival plaque showed significant reductions in Shannon-Weaver diversity, species richness, and total and categorical bacterial abundances (commensal, gingivitis, and malodor) after 4 and 12 weeks for the BA, BZ, and BFZ groups compared to the B group, while no significant differences were observed between the B and BF groups. Supragingival plaque vPCR further validated these results, and subgingival plaque vPCR demonstrated significant efficacy for the BFZ intervention only. CONCLUSIONS This publication reports on a successful application of a quantitative method of microbiome analysis in a clinical trial demonstrating the sustained and superior efficacy of essential oil mouthrinses at controlling dental plaque compared to mechanical methods. The quantitative microbiological data in this trial also reinforce the safety and mechanism of action of EO mouthrinses against plaque microbial ecology and highlights the importance of elevating EO mouthrinsing as an integral part of an oral hygiene regimen. TRIAL REGISTRATION The trial was registered on ClinicalTrials.gov on 31/10/2022. The registration number is NCT05600231.
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Affiliation(s)
- Kyungrok Min
- Johnson & Johnson Consumer Inc, 199 Grandview Rd, Skillman, NJ, USA.
| | - Mary Lynn Bosma
- Johnson & Johnson Consumer Inc, 199 Grandview Rd, Skillman, NJ, USA
| | - Gabriella John
- Johnson & Johnson Consumer Inc, 199 Grandview Rd, Skillman, NJ, USA
| | - James A McGuire
- Johnson & Johnson Consumer Inc, 199 Grandview Rd, Skillman, NJ, USA
| | - Alicia DelSasso
- Johnson & Johnson Consumer Inc, 199 Grandview Rd, Skillman, NJ, USA
| | - Jeffery Milleman
- Salus Research, Inc, 1220 Medical Park Drive, Building 4, Fort Wayne, IN, USA
| | - Kimberly R Milleman
- Salus Research, Inc, 1220 Medical Park Drive, Building 4, Fort Wayne, IN, USA
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Buonavoglia A, Camero M, Lanave G, Catella C, Trombetta CM, Gandolfi MG, Palazzo G, Martella V, Prati C. Virucidal activity in vitro of mouthwashes against a feline coronavirus type II. Oral Dis 2022; 28 Suppl 2:2492-2499. [PMID: 34739171 PMCID: PMC9788155 DOI: 10.1111/odi.14067] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 10/12/2021] [Accepted: 11/01/2021] [Indexed: 12/30/2022]
Abstract
Transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can occur through saliva and aerosol droplets deriving from the upper aerodigestive tract during coughing, sneezing, talking, and even during oral inspection or dental procedures. The aim of this study was to assess in vitro virucidal activity of commercial and experimental mouthwashes against a feline coronavirus (FCoV) strain. Commercial and experimental (commercial-based products with addition of either sodium dodecyl sulfate (SDS) or thymus vulgaris essential oil (TEO) at different concentrations) mouthwashes were placed in contact with FCoV for different time intervals, that is, 30 s (T30), 60 s (T60), and 180 s (T180); subsequently, the virus was titrated on Crandell Reese Feline Kidney cells. An SDS-based commercial mouthwash reduced the viral load by 5 log10 tissue culture infectious dose (TCID)50 /50 µl at T30 while a cetylpyridinium (CPC)-based commercial mouthwash was able to reduce the viral titer of 4.75 log10 at T60. Furthermore, five experimental mouthwashes supplemented with SDS reduced the viral titer by 4.75-5 log10 according to a dose- (up to 4 mM) and time-dependent fashion.
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Affiliation(s)
- Alessio Buonavoglia
- Dental SchoolDepartment of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - Michele Camero
- Department of Veterinary MedicineUniversity of BariValenzanoItaly
| | - Gianvito Lanave
- Department of Veterinary MedicineUniversity of BariValenzanoItaly
| | | | | | - Maria Giovanna Gandolfi
- Dental SchoolDepartment of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
| | - Gerardo Palazzo
- Department of Chemistry, and CSGI (Center for Colloid and Surface Science)University of BariBariItaly
| | - Vito Martella
- Department of Veterinary MedicineUniversity of BariValenzanoItaly
| | - Carlo Prati
- Dental SchoolDepartment of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
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3
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Buonavoglia A, Lanave G, Marchi S, Lorusso P, Montomoli E, Martella V, Camero M, Prati C, Trombetta CM. In vitro
virucidal activity of mouthwashes on SARS‐CoV‐2. Oral Dis 2022; 28 Suppl 2:2509-2515. [PMID: 35398970 PMCID: PMC9115502 DOI: 10.1111/odi.14205] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 11/29/2022]
Abstract
Objectives Materials and Methods Results Conclusions
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Affiliation(s)
- Alessio Buonavoglia
- Dental School Department of Biomedical and Neuromotor Sciences University of Bologna 40126 Bologna Italy
| | - Gianvito Lanave
- Department of Veterinary Medicine University of Bari 70010 Valenzano Italy
| | - Serena Marchi
- Department of Molecular and Developmental Medicine University of Siena 53100 Siena Italy
| | - Pantaleo Lorusso
- Section of Anesthesia and Intensive Care Department of Emergency and Organ Transplantation Aldo Moro University of Bari 70121 Bari Italy
| | - Emanuele Montomoli
- Department of Molecular and Developmental Medicine University of Siena 53100 Siena Italy
- VisMederi srl 53100 Siena Italy
- VisMederi Research srl 53100 Siena Italy
| | - Vito Martella
- Department of Veterinary Medicine University of Bari 70010 Valenzano Italy
| | - Michele Camero
- Department of Veterinary Medicine University of Bari 70010 Valenzano Italy
| | - Carlo Prati
- Dental School Department of Biomedical and Neuromotor Sciences University of Bologna 40126 Bologna Italy
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Kőhidai Z, Takács A, Lajkó E, Géczi Z, Pállinger É, Láng O, Kőhidai L. The effects of mouthwashes in human gingiva epithelial progenitor (HGEPp) cells. Clin Oral Investig 2022; 26:4559-4574. [PMID: 35257248 PMCID: PMC9203393 DOI: 10.1007/s00784-022-04422-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/17/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The gingiva epithelium accounts for a significant proportion of the surface around the tooth. An inflammatory reaction occurs in the presence of bacterial biofilm, adhesion is reduced, and the depth of the sulcus gingivalis increases. The most common antiseptic agents in oral rinses are chlorhexidine digluconate (CHX) and cetylpyridinium chloride. We examined long-lasting effects of residual concentrations of eight commercially available rinses. Our main goals were (i) to analyze the effect of different chemical compositions on cell proliferation, (ii) to examine apoptosis, and (iii) cell morphology on human epithelial progenitor cell line (HGEPp). MATERIALS AND METHODS Cell proliferation was measured in a real-time system (0-48 h) by impedimetry (xCELLigence). Apoptosis was measured with labeled Annexin-V (BD-FACScalibur). RESULTS Changes in proliferation were measured at certain concentrations: (i) H2O2 proved to be cytotoxic at almost all concentrations; (ii) low concentrations of CHX (0.0001%; 0.0003%) were proliferation inducers, while higher concentrations were cytotoxic; (iii) for ClO2, advantageous proliferative effect was observed over a broad concentration range (0.06-6 ppm). In mouthwashes, additives in the formulation (e.g., allantoin) appeared to influence cellular responses positively. Apoptosis marker assay results suggested a low-level activation by the tested agents. CONCLUSIONS Mouthwashes and their reference compounds proved to have concentration-dependent cytotoxic effects on human gingival epithelial cells. CLINICAL RELEVANCE A better understanding of the effects of mouthwashes and their reference compounds is particularly important. These concentration-dependent effects (cytotoxic or proliferation inducing) interfere with human cells physiology while being used in the fight against the pathogenic flora.
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Affiliation(s)
- Zsófia Kőhidai
- Department of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, Hungary.
- Department of Oral Diagnostics, Semmelweis University, Budapest, Hungary.
| | - Angéla Takács
- Department of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, Hungary
| | - Eszter Lajkó
- Department of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, Hungary
| | - Zoltán Géczi
- Department of Prosthodontics, Semmelweis University, Budapest, Hungary
| | - Éva Pállinger
- Department of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, Hungary
| | - Orsolya Láng
- Department of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, Hungary
| | - László Kőhidai
- Department of Genetics, Cell- and Immunobiology, Semmelweis University, Budapest, Hungary
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Buonavoglia A, Leone P, Solimando AG, Fasano R, Malerba E, Prete M, Corrente M, Prati C, Vacca A, Racanelli V. Antibiotics or No Antibiotics, That Is the Question: An Update on Efficient and Effective Use of Antibiotics in Dental Practice. Antibiotics (Basel) 2021; 10:550. [PMID: 34065113 PMCID: PMC8151289 DOI: 10.3390/antibiotics10050550] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/02/2021] [Accepted: 05/06/2021] [Indexed: 12/17/2022] Open
Abstract
The antimicrobial resistance (AMR) phenomenon is an emerging global problem and is induced by overuse and misuse of antibiotics in medical practice. In total, 10% of antibiotic prescriptions are from dentists, usually to manage oro-dental pains and avoid postsurgical complications. Recent research and clinical evaluations highlight new therapeutical approaches with a reduction in dosages and number of antibiotic prescriptions and recommend focusing on an accurate diagnosis and improvement of oral health before dental treatments and in patients' daily lives. In this article, the most common clinical and operative situations in dental practice, such as endodontics, management of acute alveolar abscesses, extractive oral surgery, parodontology and implantology, are recognized and summarized, suggesting possible guidelines to reduce antibiotic prescription and consumption, maintaining high success rates and low complications rates. Additionally, the categories of patients requiring antibiotic administration for pre-existing conditions are recapitulated. To reduce AMR threat, it is important to establish protocols for treatment with antibiotics, to be used only in specific situations. Recent reviews demonstrate that, in dentistry, it is possible to minimize the use of antibiotics, thoroughly assessing patient's conditions and type of intervention, thus improving their efficacy and reducing the adverse effects and enhancing the modern concept of personalized medicine.
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Affiliation(s)
- Alessio Buonavoglia
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Patrizia Leone
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Antonio Giovanni Solimando
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Rossella Fasano
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Eleonora Malerba
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Marcella Prete
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | | | - Carlo Prati
- Endodontic Clinical Section, Department of Biomedical and NeuroMotor Sciences, Dental School, University of Bologna, 40125 Bologna, Italy;
| | - Angelo Vacca
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
| | - Vito Racanelli
- Unit of Internal Medicine “Guido Baccelli”, Department of Biomedical Sciences and Human Oncology, University of Bari Medical School, 70124 Bari, Italy; (A.B.); (P.L.); (A.G.S.); (R.F.); (E.M.); (M.P.); (A.V.)
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Van Dijck C, Tsoumanis A, Rotsaert A, Vuylsteke B, Van den Bossche D, Paeleman E, De Baetselier I, Brosius I, Laumen J, Buyze J, Wouters K, Lynen L, Van Esbroeck M, Herssens N, Abdellati S, Declercq S, Reyniers T, Van Herrewege Y, Florence E, Kenyon C. Antibacterial mouthwash to prevent sexually transmitted infections in men who have sex with men taking HIV pre-exposure prophylaxis (PReGo): a randomised, placebo-controlled, crossover trial. THE LANCET. INFECTIOUS DISEASES 2021; 21:657-667. [PMID: 33676596 DOI: 10.1016/s1473-3099(20)30778-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 09/09/2020] [Accepted: 09/24/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Bacterial sexually transmitted infections (STIs) are highly prevalent among men who have sex with men who use HIV pre-exposure prophylaxis (PrEP), which leads to antimicrobial consumption linked to the emergence of antimicrobial resistance. We aimed to assess use of an antiseptic mouthwash as an antibiotic sparing approach to prevent STIs. METHODS We invited people using PrEP who had an STI in the past 24 months to participate in this single-centre, randomised, double-blind, placebo-controlled, AB/BA crossover superiority trial at the Institute of Tropical Medicine in Antwerp, Belgium. Using block randomisation (block size eight), participants were assigned (1:1) to first receive Listerine Cool Mint or a placebo mouthwash. They were required to use the study mouthwashes daily and before and after sex for 3 months each and to ask their sexual partners to use the mouthwash before and after sex. Participants were screened every 3 months for syphilis, chlamydia, and gonorrhoea at the oropharynx, anorectum, and urethra. The primary outcome was combined incidence of these STIs during each 3-month period, assessed in the intention-to-treat population, which included all participants who completed at least the first 3-month period. Safety was assessed as a secondary outcome. This trial is registered with Clinicaltrials.gov, NCT03881007. FINDINGS Between April 2, 2019, and March 13, 2020, 343 participants were enrolled: 172 in the Listerine followed by placebo (Listerine-placebo) group and 171 in the placebo followed by Listerine (placebo-Listerine) group. The trial was terminated prematurely because of the COVID-19 pandemic. 151 participants completed the entire study, and 89 completed only the first 3-month period. 31 participants withdrew consent, ten were lost to follow-up, and one acquired HIV. In the Listerine-placebo group, the STI incidence rate was 140·4 per 100 person-years during the Listerine period, and 102·6 per 100 person-years during the placebo period. In the placebo-Listerine arm, the STI incidence rate was 133·9 per 100 person-years during the placebo period, and 147·5 per 100 person-years during the Listerine period. We did not find that Listerine significantly reduced STI incidence (IRR 1·17, 95% CI 0·84-1·64). Numbers of adverse events were not significantly higher than at baseline and were similar while using Listerine and placebo. Four serious adverse events (one HIV-infection, one severe depression, one Ludwig's angina, and one testicular carcinoma) were not considered to be related to use of mouthwash. INTERPRETATION Our findings do not support the use of Listerine Cool Mint as a way to prevent STI acquisition among high-risk populations. FUNDING Belgian Research Foundation - Flanders (FWO 121·00).
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Affiliation(s)
- Christophe Van Dijck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Medical Microbiology, University of Antwerp, Belgium
| | - Achilleas Tsoumanis
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Department of Medical Sciences, University of Antwerp, Belgium
| | - Anke Rotsaert
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Bea Vuylsteke
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Elke Paeleman
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Irith De Baetselier
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Isabel Brosius
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jolein Laumen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Jozefien Buyze
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Kristien Wouters
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Lutgarde Lynen
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Marjan Van Esbroeck
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Natacha Herssens
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Said Abdellati
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Steven Declercq
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Thijs Reyniers
- Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium
| | - Yven Van Herrewege
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Eric Florence
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium
| | - Chris Kenyon
- Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium; Division of Infectious Diseases and HIV Medicine, University of Cape Town, Cape Town, South Africa.
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Verma T, Sharma P, Kumar P, Tyagi K, Bhatnagar S, Raza M. Evaluation of antimicrobial property of modified acrylic resin-containing cetylpyridinium chloride. J Orthod Sci 2020; 9:1. [PMID: 32166080 PMCID: PMC7041310 DOI: 10.4103/jos.jos_6_19] [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: 02/08/2019] [Revised: 08/24/2019] [Accepted: 09/26/2019] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To evaluate the antimicrobial property of cetylpyridinium chloride (CPC) when polymerized with cold cure acrylic and to assess the duration of its release from modified acrylic. MATERIALS AND METHODS CPC was added in different concentrations (0%, 2.5%, 5%, and 10%) to cold cure acrylic resin and 180 acrylic discs were prepared. These were divided into four groups of 45 each depending on the concentration of CPC. The antimicrobial property of the modified acrylic for Streptococcus mutans was tested using disc diffusion assay in agar. The duration of release of CPC from self-cure acrylic was tested with optical density reading of solutions by ultraviolet spectrophotometer. The effect of addition of CPC on diametral tensile strength (DTS) of acrylic was tested using UTM (Instron) and the effect of water aging on modified acrylic was compared with unaged specimens. RESULTS AND CONCLUSION The normality of the data was checked by Shapiro-Wilktest, and as the data failed to show normal distribution, inferential statistics were performed using nonparametric tests of significance. Antimicrobial activity of modified acrylic increased with increase in CPC concentration. Greatest CPC release was observed on the seventh day with a decrease in release from 7 to 180 days. There was a decrease in the diametral strength of the modified resin and water aging had a significant effect on the DTS of the modified resin.
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Affiliation(s)
- Tanvi Verma
- Department of Orthodontics and Dentofacial Orthopaedics, I.T.S. Center for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Payal Sharma
- Department of Orthodontics and Dentofacial Orthopaedics, I.T.S. Center for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Piush Kumar
- Department of Orthodontics and Dentofacial Orthopaedics, I.T.S. Center for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Kirti Tyagi
- Department of Orthodontics and Dentofacial Orthopaedics, I.T.S. Center for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Shalaj Bhatnagar
- Department of Orthodontics and Dentofacial Orthopaedics, I.T.S. Center for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
| | - Monis Raza
- Department of Orthodontics and Dentofacial Orthopaedics, I.T.S. Center for Dental Studies and Research, Muradnagar, Ghaziabad, Uttar Pradesh, India
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Katsaros T, Mayer E, Palaiologou A, Romero-Bustillos M, Evans GH, Lallier TE, Maney P. Effect of different concentrations of commercially available mouthwashes on wound healing following periodontal surgery: a randomized controlled clinical trial. Clin Oral Investig 2020; 24:3587-3595. [PMID: 32076866 DOI: 10.1007/s00784-020-03232-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 01/29/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The purpose of this study was to evaluate the effect of chlorhexidine and essential oils containing mouth rinses on oral wound healing after periodontal flap surgery. MATERIALS AND METHODS Eighty subjects participated in the study and were randomly assigned to use water, 0.12% chlorhexidine (CHX), essential oils (EO), 5% CHX, and 10% EO. Subjects were examined at 1, 2, and 3 weeks postoperatively. Plaque index (PI) and the modified gingival index (GI) were recorded, while wound epithelialization was measured to evaluate the healing process. Numerical data were analyzed with parametric test for multiple comparisons (ANOVA) with Bonferroni correction. Categorical data were analyzed using Chi-square test/fisher exact test. RESULTS All groups demonstrated a gradual GI reduction from first to third visit. Patients in the CHX group presented statistically significant lower PI scores than patients in the water group at the all-time points of the study. Wound epithelialization analysis demonstrated that 100% of the sites in the CHX group were healing by secondary intention at visit 1. This finding was statistically significant. CONCLUSION Full strength concentrations of CHX and EO did not show any detrimental effects on healing after traditional periodontal surgery at the end of the observation period. CLINICAL RELEVANCE The use of chlorhexidine and EO containing mouthwashes does not appear to delay wound healing. Diluting these commercial mouthwashes may present an approach that could possibly reduce the adverse effects (such as tooth staining) associated with their use, while maintaining their antibacterial properties.
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Affiliation(s)
- Theodoros Katsaros
- Department of Periodontics, University of Iowa College of Dentistry and Dental Clinics, 801 Newton Rd., S447, Iowa City, IA, 52241, USA.
| | - Elizabeth Mayer
- Department of Periodontics, Louisiana State University Health Sciences Center School of Dentistry, New Orleans, LA, USA
| | - Archontia Palaiologou
- Department of Periodontics, UT Health San Antonio School of Dentistry, San Antonio, TX, USA
| | - Miguel Romero-Bustillos
- Department of Periodontics, University of Iowa College of Dentistry and Dental Clinics, 801 Newton Rd., S447, Iowa City, IA, 52241, USA
| | - Gerald H Evans
- Department of Periodontics, Louisiana State University Health Sciences Center School of Dentistry, New Orleans, LA, USA
| | - Thomas E Lallier
- Department of Cell Biology and Anatomy, Louisiana State University Health Sciences Center, New Orleans, LA, 70119, USA
| | - Pooja Maney
- Department of Periodontics, Louisiana State University Health Sciences Center School of Dentistry, New Orleans, LA, USA
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9
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Lafaurie GI, Zaror C, Díaz-Báez D, Castillo DM, De Ávila J, Trujillo TG, Calderón-Mendoza J. Evaluation of substantivity of hypochlorous acid as an antiplaque agent: A randomized controlled trial. Int J Dent Hyg 2018; 16:527-534. [PMID: 29608039 DOI: 10.1111/idh.12342] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND Hypochlorous acid (HOCl) is a non-antibiotic antimicrobial substance with significant effects on pathogenic oral micro-organisms. The effects of HOCl as an antiplaque agent have not been studied. OBJECTIVE The aim of this study was to evaluate the substantivity of HOCl mouthwashes compared with chlorhexidine (CHX) rinses and a placebo. MATERIALS AND METHODS A double-blind randomized controlled trial with 75 participants was conducted. Participants were divided into five groups using block randomization: 0.025% HOCl, 0.05% HOCl, 0.12% CHX, 0.2% CHX, and sterile water as a placebo. Participants were instructed to use each rinse solution for 30 seconds after dental prophylaxis. Samples of saliva were taken at baseline and after 30 seconds, 1, 3, 5 and 7 hours to assess substantivity, and bacterial viability was established by the fluorescence method. Visible plaque in all participants was assessed with the Turesky index at baseline and at 7 hours, and adverse events were also assessed. RESULTS HOCl led to a 33% reduction in bacterial counts in the saliva after 30 seconds compared with a 58% reduction by CHX. HOCl has no substantivity, and bacterial counts returned to baseline after 1 hour. Placebo treatment led to the highest plaque count after 7 hours compared with the CHX and HOCl groups, although the differences were not significant. HOCl rinsing induced the highest percentages of unpleasant taste and dryness sensations. CONCLUSIONS HOCl rinses have an initial effect on bacterial viability in saliva but have no substantivity. Other mechanisms may explain its antiplaque effect.
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Affiliation(s)
- G I Lafaurie
- Unit of Basic Oral Investigation-UIBO, School of Dentistry, El Bosque University, Bogotá, Colombia
| | - C Zaror
- Centre for Research in Epidemiology, Economics and Oral Public Health (CIEESPO), Faculty of Dentistry, Universidad de La Frontera, Temuco, Chile.,Centro de Excelencia CIGES, Faculty of Medicine, Universidad de La Frontera, Temuco, Chile
| | - D Díaz-Báez
- Unit of Basic Oral Investigation-UIBO, School of Dentistry, El Bosque University, Bogotá, Colombia
| | - D M Castillo
- Unit of Basic Oral Investigation-UIBO, School of Dentistry, El Bosque University, Bogotá, Colombia
| | - J De Ávila
- Unit of Basic Oral Investigation-UIBO, School of Dentistry, El Bosque University, Bogotá, Colombia
| | - T G Trujillo
- Unit of Basic Oral Investigation-UIBO, School of Dentistry, El Bosque University, Bogotá, Colombia
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Naiktari RS, Dharmadhikari C, Gurav AN, Kakade S. Determining the antibacterial substantivity of Triphala mouthwash and comparing it with 0.2% chlorhexidine gluconate after a single oral rinse: A crossover clinical trial. J Indian Soc Periodontol 2018; 22:498-502. [PMID: 30631228 PMCID: PMC6305101 DOI: 10.4103/jisp.jisp_265_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Context: Triphala has been extensively used in dentistry as a mouthwash because of its antiplaque and antigingivitis properties. Aim: The present study is designed to determine the duration of its antibacterial substantivity after a single oral rinse and to compare it with the substantivity of 0.2% chlorhexidine gluconate (CHX). Materials and Methods: In this clinical crossover trial, unstimulated saliva from 30 individuals was collected 2 h after routine oral hygiene procedures but not rinsing (pre-sample) with randomly selected mouthwash, (10% Triphala mouthwash, 0.2% CHX, and normal saline) and 5 min after rinsing (postsample). A washout period of 1 week was kept between two rinses. The sampling was repeated after every 2 h for 12 h (post 1, post 2, post 3, post 4, post 5, and post 6) and was checked for microbial count. Statistical Analysis Used: Friedman test, Kruskal–Wallis test, and post hoc analysis were used to assess the effect of different mouthrinses on colony forming units at different times. Results: Ten percent Triphala showed statistically significant results when the antibacterial effect at post, post 1 and post 2 were compared to pre-assessment count (P < 0.05). After which the effect was at par with normal saline (P > 0.05). The results for CHX were statistically significant at all times when compared to pre-assessment count (P < 0.05) and it showed the maximum substantivity of 7 h. Conclusion: After a single rinse with no eating and drinking restrictions over the day, 10% Triphala mouthwash had an antibacterial effect for 3–4 h. It can be used three times daily for its maximum antibacterial effect.
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Affiliation(s)
| | - Chandrakant Dharmadhikari
- Department of Microbiology, Tatyasaheb Kore Dental College and Research Centre, Kolhapur, Maharashtra, India
| | - Abhijit Ningappa Gurav
- Department of Periodontics, Tatyasaheb Kore Dental College and Research Centre, Kolhapur, Maharashtra, India
| | - Satish Kakade
- Department of Preventive and Social Medicine, Krishna Institute of Dental Sciences, Karad, Maharashtra, India
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11
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Ali A, Farooq U, Uzair S, Patel R. Conductometric and tensiometric studies on the mixed micellar systems of surface-active ionic liquid and cationic surfactants in aqueous medium. J Mol Liq 2016. [DOI: 10.1016/j.molliq.2016.08.082] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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12
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Antibacterial and antiplaque efficacy of a commercially available octenidine-containing mouthrinse. Clin Oral Investig 2015; 20:1469-76. [PMID: 26556571 DOI: 10.1007/s00784-015-1643-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 10/26/2015] [Indexed: 01/19/2023]
Abstract
OBJECTIVES The purpose of this clinical study was to determine the antibacterial and antiplaque efficacy of a recently introduced octenidine-containing mouthrinse (Octenidol®) in comparison with established antiseptic mouthrinses. MATERIALS AND METHODS In a 4-day plaque-regrowth study employing a four-replicate cross-over design, a 0.1 % octenidine mouthrinse (Octenidol®/OCT-MR) was compared with a 0.12 % chlorhexidine mouthrinse (Paroex®/CHX-MR), an essential oil mouthrinse (Listerine®/EO-MR), and a placebo mouthrinse/P-MR. Plaque regrowth was assessed with a modified Quigley-Hein plaque index. The antibacterial effect was assessed by taking bacterial counts from the tooth surface and oral mucosa after professional tooth cleaning and after first rinsing with the allocated mouthrinse on days 1 and 5. Sixteen volunteers suspended tooth cleaning and rinsed twice daily with the allocated mouthrinse for 4 days. RESULTS All tested antiseptic mouthrinses were significantly more effective than the placebo mouthrinse in inhibiting plaque, but no significant differences were observed between OCT-MR and CHX-MR, OCT-MR and EO-MR, and CHX-MR and EO-MR. After 4 days, comparable bacterial count levels were found on both the tooth surface and mucosa applying OCT-MR and CHX-MR, which were significantly lower than that of EO-MR and P-MR. CONCLUSION Octenidol® and Paroex® showed comparable antibacterial and antiplaque efficacy in the human oral cavity. CLINICAL RELEVANCE The recently introduced octenidine-containing mouthrinse Octenidol® may become a suitable alternative to 0.12 % chlorhexidine-containing mouthrinses such as Paroex®.
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14
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In situ neutralisation of the antibacterial effect of 0.2% Chlorhexidine on salivary microbiota: Quantification of substantivity. Arch Oral Biol 2015; 60:1109-16. [DOI: 10.1016/j.archoralbio.2015.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 04/11/2015] [Accepted: 04/13/2015] [Indexed: 11/24/2022]
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15
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Marya CM, Chopra M, Oberoi SS, Nagpal R, Dhingra C. Comparison of Antimicrobial Efficacy of Brazilian Propolis With Chlorhexidine and Sodium Fluoride Against Common Oral Pathogens: An In Vitro Study. Jundishapur J Nat Pharm Prod 2015. [DOI: 10.17795/jjnpp-19069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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16
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Lee HO, Park JY. Antibacterial Effect and Cytotoxicity of Desensitizer Containing Antimicrobial. ACTA ACUST UNITED AC 2015. [DOI: 10.17135/jdhs.2015.15.2.238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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17
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Tomás I, Alvarez M, Limeres J, Tomás M, Medina J, Otero JL, Diz P. Effect of a Chlorhexidine Mouthwash on the Risk of Postextraction Bacteremia. Infect Control Hosp Epidemiol 2015; 28:577-82. [PMID: 17464918 DOI: 10.1086/516663] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Accepted: 08/22/2006] [Indexed: 11/03/2022]
Abstract
Objective.
To investigate the prevalence, duration, and etiology of bacteremia following dental extractions performed after a single administration of Chlorhexidine mouthwash.
Design and Setting.
A randomized, controlled trial performed in a university hospital.
Methods.
A series of 106 patients with mental and behavioral disabilities who underwent dental extractions under general anesthesia were randomly assigned to a control group or Chlorhexidine group. The exclusion criteria applied were use of antibiotics in the previous 3 months, use of oral antiseptics, any type of congenital or acquired immunodeficiency, and disease that predisposes the patient to infections or bleeding. The Chlorhexidine group had 0.2% Chlorhexidine mouthwash administered for 30 seconds before any dental manipulation. Blood samples were collected at baseline, 30 seconds, 15 minutes, and 1 hour after the dental extractions. Subculture and further identification of the isolated bacteria were performed by conventional microbiological techniques.
Results.
The prevalence of bacteremia after dental extraction in the control and Chlorhexidine groups were 96% and 79%, respectively, at 30 seconds (P = .008), 64% and 30% at 15 minutes (P <.001), and 20% and 2% at 1 hour (P = .005). The most frequently identified bacteria were Streptococcus species in both the control and Chlorhexidine groups (64% and 68%, respectively), particularly viridans group streptococci.
Conclusion.
We recommend the routine use of a 0.2% Chlorhexidine mouthwash before dental extractions to reduce the risk of postextraction bacteremia.
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Affiliation(s)
- I Tomás
- Department of Special Needs, School of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela, Spain
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18
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Tonon CC, Paschoal MA, Correia M, Spolidório DMP, Bagnato VS, Giusti JSM, Santos-Pinto L. Comparative effects of photodynamic therapy mediated by curcumin on standard and clinical isolate of Streptococcus mutans. J Contemp Dent Pract 2015; 16:1-6. [PMID: 25876942 DOI: 10.5005/jp-journals-10024-1626] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM The aim of this study was investigate the effect of photodynamic therapy (PDT) using curcumin (C) as a photosensitizing agent irradiated with an LED (L) in the blue wavelength as a light source on a standard and clinical isolate of Streptococcus mutans (S. mutans) in a planktonic suspension model. MATERIALS AND METHODS Suspensions of both strains were divided into 4 groups as follows: absence of C and L (control group: C-L-), with C and without L (C group: C+L-), absence of C with L (L group: C-L+) and presence of C and L (PDT group: C+L+). Three different concentrations of curcumin (0.75 mg/ml, 1.5 mg/ml and 3 mg/ml) and three light fluences of studied light source (24, 48 and 72 J cm(-2)) were tested. Aliquots of each studied group was plated in BHI agar and submitted to colony forming units counting (CFU/ml) and the data transformed into logarithmical scale. RESULTS A high photoinactivation rate of more than 70% was verified to standard S. mutans strain submitted to PDT whereas the clinical isolate showed a lower sensitivity to all the associations of curcumin and LED. A slight bacterial reduction was verified to C+L- and C-L+, demonstrating no toxic effects to the isolated application of light and photosensitizer to both S. mutans strains tested. CONCLUSION Photodynamic therapy using a combination of curcumin and blue LED presented a substantial antimicrobial effect on S. mutans standard strain in a planktonic suspension model with a less pronounced effect on its clinical isolate counterparts due to resistance to this alternative approach. CLINICAL SIGNIFICANCE Alternative antimicrobial approaches, as photodynamic therapy, should be encouraged due to optimal results against cariogenic bacteria aiming to prevent or treat dental caries.
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Affiliation(s)
- Caroline C Tonon
- Araraquara Dental School, Universidade Estadual Paulista Araraquara, São Paulo, Brazil
| | | | - Marilia Correia
- Department of Pediatric Dentistry, Araraquara Dental School Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Denise M P Spolidório
- Department of Pathology and Physiology, Araraquara Dental School, Universidade Estadual Paulista, Araraquara, São Paulo, Brazil
| | - Vanderlei S Bagnato
- São Carlos Institute of Physics, University of São Paulo, São Carlos, São Paulo, Brazil
| | - Juçaíra S M Giusti
- São Carlos Institute of Physics, University of São Paulo, São Carlos, São Paulo, Brazil
| | - Lourdes Santos-Pinto
- PhD, Department of Pediatric Dentistry, Araraquara Dental School Universidade Estadual Paulista, Araraquara, São Paulo, Brazil, Rua Humaité, 1680 Araraquara, São Paulo 14801-903, Brazil Phone: 55 16 33016330, Fax: 55 16 33016328, e-mail:
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19
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Paschoal MA, Moura CMZ, Jeremias F, Souza JF, Bagnato VS, Giusti JSM, Santos-Pinto L. Longitudinal effect of curcumin-photodynamic antimicrobial chemotherapy in adolescents during fixed orthodontic treatment: a single-blind randomized clinical trial study. Lasers Med Sci 2014; 30:2059-65. [PMID: 25543296 DOI: 10.1007/s10103-014-1700-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 12/14/2014] [Indexed: 11/30/2022]
Abstract
White spot lesions are one of the concerns during the fixed orthodontic treatment. Thus, the aim of the present study was to evaluate the antimicrobial/anti-inflammatory effect of curcumin-photodynamic antimicrobial chemotherapy (c-PACT) and chlorhexidine varnish on the plaque accumulation and gingival bleeding in adolescents under fixed orthodontic treatment. A randomized clinical trial was performed with an initial number of 45 patients being distributed into three groups: group I-chlorhexidine varnish 2%, group II-placebo varnish, and group III-c-PACT (curcumin at 1.5 mg.mL(-1)) exposed to blue Light-emitting diode (LED) light at 450 nm (power density = 165 mW.cm(-2), fluency = 96 J.cm(-2), total dose = 150.7 J). The treatments were performed for four consecutive times with an interval of 1 week each. After the interventions, two calibrated examiners (Kappa value = 0.75) analyzed the dental plaque accumulation by plaque index (PI) and gingivitis condition by gingival bleeding index (GBI) with 1 and 3 months of follow-up after the treatments comprised a final sample of 35 patients. No significant difference was found to PI between the groups during baseline and 1-month period. Group III (1.52 ± 0.51) presented significance difference from group I (0.91 ± 0.75) and group II (1.03 ± 0.51) at 3 months of follow-up. In this same period, there was more plaque accumulation with significant statistical difference (P ≤ 0.05) in comparison to the other periods to all studied groups. There was a GBI reduction statistically significant to groups I and III at 1-month follow-up in comparison to other periods. No effect was verified to dental plaque accumulation after the photodynamic application mediated with curcumin activated with a blue LED light.
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Affiliation(s)
| | - Cíntia Maria Zanin Moura
- Araraquara Dental School, UNESP - Univ Estadual Paulista, Rua Humaitá, 1680, Araraquara, SP, 14801-903, Brazil.
| | - Fabiano Jeremias
- Department of Pediatric Dentistry, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, 14801-903, Brazil.
| | - Juliana Feltrin Souza
- Master's Program in Clinical Dentistry, School of Dentistry, Positivo University - UP, Curitiba, PR, 81280-330, Brazil.
| | - Vanderlei S Bagnato
- São Carlos Institute of Physics, University of São Paulo, USP, São Carlos, São Paulo, Brazil.
| | - Juçaíra S M Giusti
- São Carlos Institute of Physics, University of São Paulo, USP, São Carlos, São Paulo, Brazil
| | - Lourdes Santos-Pinto
- Department of Pediatric Dentistry, Araraquara Dental School, UNESP - Univ Estadual Paulista, Araraquara, SP, 14801-903, Brazil.
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20
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Ugwumba CU, Adeyemo WL, Odeniyi OM, Arotiba GT, Ogunsola FT. Preoperative administration of 0.2% chlorhexidine mouthrinse reduces the risk of bacteraemia associated with intra-alveolar tooth extraction. J Craniomaxillofac Surg 2014; 42:1783-8. [DOI: 10.1016/j.jcms.2014.06.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2013] [Revised: 06/03/2014] [Accepted: 06/06/2014] [Indexed: 10/25/2022] Open
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21
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Pedrazzi V, Escobar EC, Cortelli JR, Haas AN, Andrade AKPD, Pannuti CM, Almeida ERD, Costa FO, Cortelli SC, Rode SDM. Antimicrobial mouthrinse use as an adjunct method in peri-implant biofilm control. Braz Oral Res 2014; 28 Spec No:S1806-83242014000200301. [PMID: 25003787 DOI: 10.1590/1807-3107bor-2014.vol28.0022] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2014] [Accepted: 04/11/2014] [Indexed: 01/23/2023] Open
Abstract
Great possibilities for oral rehabilitation emerged as a result of scientific consolidation, as well as a large number of dental implant applications. Along with implants appeared diseases such as mucositis and peri-implantitis, requiring management through several strategies applied at different stages. Biofilm accumulation is associated with clinical signs manifest by both tooth and implant inflammation. With this in mind, regular and complete biofilm elimination becomes essential for disease prevention and host protection. Chemical control of biofilms, as an adjuvant to mechanical oral hygiene, is fully justified by its simplicity and efficacy proven by studies based on clinical evidence. The purpose of this review was to present a consensus regarding the importance of antimicrobial mouthrinse use as an auxiliary method in chemical peri-implant biofilm control. The active ingredients of the several available mouthrinses include bis-biguanide, essential oils, phenols, quaternary ammonium compounds, oxygenating compounds, chlorine derivatives, plant extracts, fluorides, antibiotics and antimicrobial agent combinations. It was concluded that there is strong clinical evidence that at least two mouthrinses have scientifically proven efficacy against different oral biofilms, i.e., chlorhexidine digluconate and essential oils; however, 0.12% chlorhexidine digluconate presents a number of unwanted side effects and should be prescribed with caution. Chemical agents seem beneficial in controlling peri-implant inflammation, although they require further investigation. We recommend a scientifically proven antiseptic, with significant short and long term efficacy and with no unwanted side effects, for the prevention and/or treatment of peri-implant disease.
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Affiliation(s)
- Vinicius Pedrazzi
- Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
| | - Elaine Cristina Escobar
- Periodontology Department, School of Dentistry, Faculdades Metropolitanas Unidas, São Paulo, SP, Brazil
| | - José Roberto Cortelli
- Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Alex Nogueira Haas
- Periodontology Department, School of Dentistry, Universidade Federal do Rio Grande do Sul, Rio Grande do Sul, RS, Brazil
| | | | - Claudio Mendes Pannuti
- Periodontology Department, School of Dentistry, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Eliete Rodrigues de Almeida
- Epidemiology and Pediatric Dentistry Department, School of Dentistry, Universidade Cruzeiro do Sul, São Paulo, SP, Brazil
| | - Fernando Oliveira Costa
- Periodontology Department, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Sheila Cavalca Cortelli
- Periodontology Department, School of Dentistry, Universidade de Taubaté, Taubaté, SP, Brazil
| | - Sigmar de Mello Rode
- Dental Materials and Prosthesis Department, Instituto de Ciência e Tecnologia, Univ Estadual Paulista, São José dos Campos, SP, Brazil
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22
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Quintas V, Prada-López I, Prados-Frutos JC, Tomás I. In situ antimicrobial activity on oral biofilm: essential oils vs. 0.2 % chlorhexidine. Clin Oral Investig 2014; 19:97-107. [DOI: 10.1007/s00784-014-1224-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 03/03/2014] [Indexed: 11/28/2022]
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Chlorhexidine substantivity on salivary flora and plaque-like biofilm: an in situ model. PLoS One 2013; 8:e83522. [PMID: 24386220 PMCID: PMC3873939 DOI: 10.1371/journal.pone.0083522] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Accepted: 11/05/2013] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To evaluate the in situ antibacterial activity of a mouthrinse with 0.2% Chlorhexidine (M-0.2% CHX) on undisturbed de novo plaque-like biofilm (PL-biofilm) and on salivary flora up to 7 hours after its application. METHODS A special acrylic appliance was designed, with 3 inserted glass disks on each buccal side, allowing for PL-biofilm growth. Fifteen healthy volunteers wore the appliance for 48 hours and then performed an M-0.2% CHX; disks were removed at 30 seconds and 1, 3, 5 and 7 hours after the mouth-rinsing. Applying a washout period, saliva samples were collected from each volunteer at 30 seconds and 1, 3, 5 and 7 hours after performing an M-0.2% CHX. The PL-biofilm and saliva samples were analysed by confocal laser scanning and epifluorescence microscopes, respectively. RESULTS At 30 seconds after M-0.2% CHX, the levels of viable bacteria detected in saliva were significantly lower than those observed in PL-biofilm. The difference in the percentage of live bacteria detected in saliva was significantly higher than that observed in PL-biofilm at 5 and 7 hours after M-0.2% CHX. CONCLUSION After a single mouthrinse of the 0.2% CHX formulation tested in the present study, the 2-day PL-biofilm presented a significantly higher resistance to this antiseptic in situ than that observed in salivary flora. However, this 0.2% CHX formulation showed a higher substantivity on PL-biofilm than on salivary flora at 5 and 7 hours after mouth-rinsing, which could be related to the slower growth rate of PL-biofilm and the possible reservoir function for antimicrobial agents associated with the undisturbed de novo PL-biofilm.
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Müller W, Déjugnat C, Diat O, Zemb T. Effects of Alkaline Cations on Self-assembly of Cetylpyridinium Surfactants. TENSIDE SURFACT DET 2013. [DOI: 10.3139/113.110102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
Here we study the influence of alkaline cations on the self-assembly of cetylpyridinium chloride and cetylpyridinium nitrate. It is known that the anionic counterions have a strong influence on the solubility and self-assembly properties of cationic surfactants. However, in this paper we will show that monovalent cations have also an influence which is weaker but detectable. Scattering techniques (X-Ray, light) were used to obtain structural information about the aggregation as a function of the temperature and the ionic strength. The results are interpreted in terms of ion pair adsorption at the micellar interface, depending on the ionic strength.
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Affiliation(s)
- W. Müller
- ICSM – UMR 5257 (CEA, CNRS, UM2, ENSCM), Bagnols-sur-Cèze, France
| | - Ch. Déjugnat
- ICSM – UMR 5257 (CEA, CNRS, UM2, ENSCM), Bagnols-sur-Cèze, France
- IMRCP – UMR 5623, Université Paul Sabatier, Toulouse, France
| | - O. Diat
- ICSM – UMR 5257 (CEA, CNRS, UM2, ENSCM), Bagnols-sur-Cèze, France
| | - Th. Zemb
- ICSM – UMR 5257 (CEA, CNRS, UM2, ENSCM), Bagnols-sur-Cèze, France
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25
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Müller W, Déjugnat C, Zemb T, Dufrêche JF, Diat O. How Do Anions Affect Self-Assembly and Solubility of Cetylpyridinium Surfactants in Water. J Phys Chem B 2013; 117:1345-56. [DOI: 10.1021/jp3093622] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Wolfram Müller
- Institut de Chimie Séparative
de Marcoule (ICSM),
UMR 5257 (CEA/CNRS/UM2/ENSCM), Bagnols-sur-Cèze, France
| | - Christophe Déjugnat
- Institut de Chimie Séparative
de Marcoule (ICSM),
UMR 5257 (CEA/CNRS/UM2/ENSCM), Bagnols-sur-Cèze, France
| | - Thomas Zemb
- Institut de Chimie Séparative
de Marcoule (ICSM),
UMR 5257 (CEA/CNRS/UM2/ENSCM), Bagnols-sur-Cèze, France
| | - Jean-François Dufrêche
- Institut de Chimie Séparative
de Marcoule (ICSM),
UMR 5257 (CEA/CNRS/UM2/ENSCM), Bagnols-sur-Cèze, France
| | - Olivier Diat
- Institut de Chimie Séparative
de Marcoule (ICSM),
UMR 5257 (CEA/CNRS/UM2/ENSCM), Bagnols-sur-Cèze, France
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Tomás I, García-Caballero L, López-Alvar E, Suárez-Cunqueiro M, Diz P, Seoane J. In situ chlorhexidine substantivity on saliva and plaque-like biofilm: influence of circadian rhythm. J Periodontol 2013; 84:1662-72. [PMID: 23327586 DOI: 10.1902/jop.2013.120475] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND The aim of the present study is to assess in situ substantivity of a single mouthrinse with 0.2% chlorhexidine (CHX) on saliva and on undisturbed de novo plaque-like biofilm (PL-biofilm), differentiating between two times of application: 1) CHX mouthrinse in the morning; and 2) CHX mouthrinse at night. METHODS The study participants were 10 healthy volunteers who wore an individualized splint with glass disks for 48 hours to boost the growth of PL-biofilm. Saliva samples were collected, and two disks were removed from each volunteer's splint at 8, 10, and 12 hours after performing a mouthrinse with 0.2% CHX at 7:00 am (M-0.2% CHX-diurnal) and 1:00 am (M-0.2% CHX-nocturnal). The saliva and plaque samples were analyzed by epifluorescence and confocal laser scanning microscopy, respectively, using a green fluorescent nucleic acid stain/propidium iodide staining. RESULTS With M-0.2% CHX-diurnal, the frequency of vital bacteria in saliva was significantly higher than in the PL-biofilm at 8, 10, and 12 hours after mouthrinse. After M-0.2% CHX-nocturnal, the frequency of vital bacteria in saliva was significantly lower than in the PL-biofilm at 8 hours and higher than in the PL-biofilm at 12 hours after mouthrinse. CONCLUSION These results support the more active physiologic dynamics of the salivary flora and the possible reservoir function associated with the structure of undisturbed de novo PL-biofilm.
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Affiliation(s)
- Inmaculada Tomás
- Oral Sciences Research Group, Department of Stomatology, School of Medicine and Dentistry, University of Santiago de Compostela, Santiago de Compostela, Spain
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Corrosion Response of Ti6Al4V and Ti15Mo Dental Implant Alloys in the Presence of Listerine Oral Rinse. INTERNATIONAL JOURNAL OF CORROSION 2013. [DOI: 10.1155/2013/739841] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The influence of a commonly used antibacterial mouth rinse, Listerine, on the corrosion behavior of one of the commonly used titanium alloys Ti6Al4V (two-phase structure, i.e.,αandβ) and a newer Ti15Mo (singleβphase) in normal saline solution has been investigated using electrochemical techniques. Interfacial electrochemical changes occurring at the oxide-solution interface have been analysed using EIS circuit modeling. Listerine acts as a corrosion inhibitor for Ti15Mo alloy and a corrosion promoter for Ti6Al4V alloy.
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Satpathy A, Ravindra S, Porwal A, C. Das A, Kumar M, Mukhopadhyay I. Effect of alcohol consumption status and alcohol concentration on oral pain induced by alcohol-containing mouthwash. J Oral Sci 2013; 55:99-105. [DOI: 10.2334/josnusd.55.99] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Tsourounakis I, Palaiologou-Gallis AA, Stoute D, Maney P, Lallier TE. Effect of essential oil and chlorhexidine mouthwashes on gingival fibroblast survival and migration. J Periodontol 2012; 84:1211-20. [PMID: 23106509 DOI: 10.1902/jop.2012.120312] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Chemical plaque control is the most commonly recommended means of oral hygiene after periodontal surgery. Commercially available mouthwashes contain a variety of active ingredients that have bactericidal properties but may potentially be toxic to the host cells. The goal of this in vitro study is to investigate the effect of commercially available mouthwashes on the survival and migratory capacity of human fibroblasts. METHODS Human gingival and periodontal ligament (PDL) fibroblasts were treated with commercially available mouthwashes that contained either chlorhexidine (CHX) or essential oils (EO) as the active ingredient. Each mouthwash was tested over a range of concentrations for its ability to affect fibroblast survival and migration, as well as long-term effects on cell viability. RESULTS Undiluted mouthwashes induced near-complete cell death 24 hours after only a 60-second treatment. Dilutions of 15% to 20% for both CHX and EO mouthwashes resulted in 50% cell death. When diluted to 10% to 15%, EO did not reduce cell migration, whereas similar dilutions of CHX resulted in reduced cell migration. Concentrations of 10% of both EO and CHX mouthwashes retained most of their antibacterial capacity. Treatment with EO did not result in gingival fibroblast death, whereas 5% CHX resulted in near-complete gingival fibroblast death 7 days after exposure. CONCLUSIONS The results of this in vitro study indicate that diluted EO displayed no detectable detrimental effects on human gingival and PDL fibroblasts, whereas diluted CHX reduced both cell migration and long-term survival. Both solutions retained their antimicrobial activity in lower concentrations.
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Affiliation(s)
- Ioannis Tsourounakis
- Department of Periodontics, School of Dentistry, Louisiana State University Health Science Center, New Orleans, LA 70119, USA
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Alves D, Costa AL, Almeida RF, Carvalho JF, Felino A. Cloreto de cetilpiridínio - revisão da literatura. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.rpemd.2011.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Ramalingam K, Amaechi BT, Ralph RH, Lee VA. Antimicrobial activity of nanoemulsion on cariogenic planktonic and biofilm organisms. Arch Oral Biol 2011; 57:15-22. [PMID: 21807359 DOI: 10.1016/j.archoralbio.2011.07.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 06/30/2011] [Accepted: 07/05/2011] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Nanoemulsions (NE) are a unique class of disinfectants produced by mixing a water immiscible liquid phase into an aqueous phase under high shear forces. NE have antimicrobial properties and are also effective anti-biofilm agents. MATERIALS AND METHODS The effectiveness of nanoemulsion and its components was determined against Streptococcus mutans and Lactobacillus casei by live/dead staining. In vitro antimicrobial effectiveness of nanoemulsion against planktonic S. mutans, L. casei, Actinomyces viscosus, Candida albicans and mixed culture was determined by a serial dilution technique to obtain minimum inhibitory concentration and minimum bactericidal concentration (MIC/MBC). In addition, efficacy was investigated by kinetics of killing, adherence and biofilm assays. RESULTS Compared to its components, nanoemulsion showed notable antimicrobial activity against biofilm organisms, up to 83.0% kill within 1min. NE dilutions ranging from 243 to 19683 were effective against planktonic S. mutans, L. casei, A. viscosus, C. albicans and mixed culture of these four strains as shown through MIC/MBC assays. NE showed antimicrobial activity against planktonic cells at high dilutions, confirmed by time kill studies. The level of adhesion on glass surface was reduced by 94.2-99.5% in nanoemulsion treated groups (p<0.001). 4-Day-old S. mutans, L. casei, A. viscosus, C. albicans and mixed cultures biofilms treated with NE showed reductions of bacterial counts with decreasing dilutions (p<0.001). CONCLUSION These results suggest that nanoemulsion has effective anti-cariogenic activity against cariogenic microorganisms and may be a useful medication in the prevention of caries.
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Affiliation(s)
- Karthikeyan Ramalingam
- Department of Comprehensive Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229-3900, USA.
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Duss C, Lang NP, Cosyn J, Persson GR. A randomized, controlled clinical trial on the clinical, microbiological, and staining effects of a novel 0.05% chlorhexidine/herbal extract and a 0.1% chlorhexidine mouthrinse adjunct to periodontal surgery. J Clin Periodontol 2010; 37:988-97. [DOI: 10.1111/j.1600-051x.2010.01609.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Tomás I, Cousido M, García-Caballero L, Rubido S, Limeres J, Diz P. Substantivity of a single chlorhexidine mouthwash on salivary flora: Influence of intrinsic and extrinsic factors. J Dent 2010; 38:541-6. [DOI: 10.1016/j.jdent.2010.03.012] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2009] [Revised: 03/23/2010] [Accepted: 03/30/2010] [Indexed: 11/16/2022] Open
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Lee VA, Karthikeyan R, Rawls HR, Amaechi BT. Anti-cariogenic effect of a cetylpyridinium chloride-containing nanoemulsion. J Dent 2010; 38:742-9. [PMID: 20600554 DOI: 10.1016/j.jdent.2010.06.001] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2009] [Revised: 06/07/2010] [Accepted: 06/11/2010] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this pilot study was to investigate the anticaries activity of a nanoemulsion composed of soybean oil, water, Triton X-100 and cetylpyridinium chloride. METHODS Tooth blocks (3 mm length x 3 mm width x 2 mm thickness) were cut from smooth surfaces of selected molar teeth using a water-cooled diamond wire saw. The blocks were randomly assigned to three experimental groups: (A) nanoemulsion, (B) 0.12% chlorhexidine gluconate, and (C) no treatment. The formation of dental caries in human tooth enamel was tested using a continuous flow dual-organism (Streptococcus mutans and Lactobacillus casei), biofilm model, which acts as an artificial mouth and simulates the biological and physiological activities observed within the oral environment. Experimental groups A and B were treated with their respective solutions once daily for 30 s on each occasion, while group C received no treatment. 10% sucrose was supplied every 6 h for 6 min to simulate meals and pH cycling. The experiment lasted for 5 days, and the tooth blocks were harvested and processed for demineralization assessment using transverse microradiography (TMR). RESULTS For both lesion depth and mineral loss, statistical analysis indicated that Emulsion was significantly lower than Control and Chlorhexidine, and Chlorhexidine was significantly lower than Control. CONCLUSIONS We conclude that cetylpyridinium-containing nanoemulsions appear to present a feasible means of preventing the occurrence of early caries.
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Affiliation(s)
- Valerie A Lee
- University of Texas Health Science Center at San Antonio, San Antonio, TX, United States.
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Menezes SMS, Cordeiro LN, Viana GSB. Punica granatum(Pomegranate) Extract Is Active Against Dental Plaque. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/j157v06n02_07] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Cousido MC, Tomás Carmona I, García-Caballero L, Limeres J, Alvarez M, Diz P. In vivo substantivity of 0.12% and 0.2% chlorhexidine mouthrinses on salivary bacteria. Clin Oral Investig 2009; 14:397-402. [PMID: 19662444 DOI: 10.1007/s00784-009-0320-2] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2009] [Accepted: 07/21/2009] [Indexed: 11/30/2022]
Abstract
The in vivo antimicrobial activity of 0.12% and 0.2% chlorhexidine (CHX) on the salivary flora up to 7 h after its application, using epifluorescence microscopy with the SYTO 9/propidium iodide dual staining, was evaluated. Fifteen volunteers performed a single mouthrinse with sterile water (SM-water), a single mouthrinse with 0.12% CHX (0.12% SM-CHX) and a single and double mouthrinse with 0.2% CHX (0.2% SM-CHX and 0.2% DM-CHX). Samples of saliva were taken at 30 s, and 1, 3, 5, and 7 h after each application. In comparison with SM-water, 0.2% CHX (SM and DM) showed a significant antibacterial effect up to 7 h after the mouthrinse, whereas this effect only persisted up to 5 h after the 0.12% SM-CHX mouthrinse. On comparing the two concentrations of CHX, significantly higher percentages of bacterial vitality were observed in all the saliva samples after the use of 0.12% CHX than after 0.2% CHX. On comparison of the 0.2% SM-CHX and 0.2% DM-CHX, significantly higher percentages of live bacteria were observed in the saliva samples taken at 1, 3, 5, and 7 h after the single mouthrinse compared with the double mouthrinse. The 0.2% CHX mouthrinse had the greatest antimicrobial activity on the salivary flora up to 7 h after its application, with a progressive recovery in bacterial vitality. The differences observed with respect to the 0.12% CHX mouthrinse demonstrate the influence of the concentration on its immediate antimicrobial activity and substantivity.
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Affiliation(s)
- Maria Consuelo Cousido
- School of Medicine and Dentistry, Santiago de Compostela University, Calle Entrerrios s/n, Santiago de Compostela 15782, Spain.
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Louise Doran A, Greenman J, Verran J. A clinical study on the antimicrobial and breath-freshening effect of zinc-containing lozenge formulations. MICROBIAL ECOLOGY IN HEALTH AND DISEASE 2009. [DOI: 10.1080/08910600701521188] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Anna Louise Doran
- School of Biology, Chemistry and Health Science, Manchester Metropolitan University, Manchester
| | - John Greenman
- Faculty of Applied Sciences, School of Biomedical Sciences, University of the West of England, Bristol, UK
| | - Joanna Verran
- School of Biology, Chemistry and Health Science, Manchester Metropolitan University, Manchester
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Tomás I, García-Caballero L, Cousido MC, Limeres J, Alvarez M, Diz P. Evaluation of chlorhexidine substantivity on salivary flora by epifluorescence microscopy. Oral Dis 2009; 15:428-33. [PMID: 19413678 DOI: 10.1111/j.1601-0825.2009.01570.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the in vivo antimicrobial activity of chlorhexidine (CHX) in saliva 7 h after its application using an epifluorescence microscopy technique. SUBJECTS AND METHODS Fifteen volunteers performed a single mouthrinse with sterile water (SM-water) and with 0.2% CHX (SM-0.2% CHX). Saliva samples were taken at 30 s and 1, 3, 5 and 7 h after each application. The bacterial suspension was mixed with the SYTO 9/propidium iodide staining and observed using an Olympus BX51 microscope. The mean percentage of viable bacteria was calculated for each sample. RESULTS In comparison with baseline values, the frequency of viable bacteria decreased significantly at 30 s after the SM-0.2% CHX (P < 0.001) and presented significant antibacterial activity up to 7 h after the mouthrinse (P < 0.001). In comparison with SM-water, the prevalence of viable bacteria was significantly lower at 30 s after the SM-0.2% CHX (P < 0.001) and showed a significant antibacterial effect up to 7 h after the mouthrinse (P < 0.001). CONCLUSIONS Epifluorescence microscopy permits evaluating the antimicrobial activity of CHX on the salivary flora in real-time. Fluorescence assays could be particularly useful to analyse simultaneously the effect of antimicrobials that alter the cytoplasmic membrane integrity on different oral ecosystems.
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Affiliation(s)
- I Tomás
- School of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela, Spain.
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Preoperative antiseptics in clean/contaminated maxillofacial and oral surgery: prospective randomized study. Int J Oral Maxillofac Surg 2009; 38:160-5. [DOI: 10.1016/j.ijom.2008.11.023] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2006] [Revised: 07/25/2008] [Accepted: 11/24/2008] [Indexed: 11/23/2022]
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Tomás I, Cousido M, Tomás M, Limeres J, García-Caballero L, Diz P. In vivo bactericidal effect of 0.2% chlorhexidine but not 0.12% on salivary obligate anaerobes. Arch Oral Biol 2008; 53:1186-91. [DOI: 10.1016/j.archoralbio.2008.07.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2008] [Revised: 06/09/2008] [Accepted: 07/26/2008] [Indexed: 11/24/2022]
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Cousido M, Tomás M, Tomás I, Limeres J, García-Caballero L, Diz P. Effect of a neutralising agent on the evaluation of the antimicrobial activity of chlorhexidine on the bacterial salivary flora. Arch Oral Biol 2008; 53:981-4. [DOI: 10.1016/j.archoralbio.2008.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2008] [Revised: 03/24/2008] [Accepted: 04/23/2008] [Indexed: 11/25/2022]
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Abstract
BACKGROUND This article reviews the rationale for incorporating effective antimicrobial mouthrinses into a daily oral hygiene regimen along with mechanical plaque control methods. TYPES OF STUDIES REVIEWED The author reviewed studies demonstrating the essential etiologic role of a pathogenic dental plaque biofilm in the development of gingivitis, as well as studies indicating that most people fail to maintain a level of mechanical plaque control sufficient to prevent disease. In addition, he did a brief review of studies of oral microbial ecology that identified the oral mucosal tissues as a reservoir of bacteria that colonize tooth surfaces, and he summarized six-month clinical studies of marketed antimicrobial mouthrinse ingredients and products. CONCLUSIONS There is a twofold rationale for daily use of antimicrobial mouthrinses: first, given the inadequacy of mechanical plaque control by the majority of people, as a component added to oral hygiene regimens for the control and prevention of periodontal diseases; second, as a method of delivering antimicrobial agents to mucosal sites throughout the mouth that harbor pathogenic bacteria capable of recolonizing supragingival and subgingival tooth surfaces, thereby providing a complementary mechanism of plaque control. The efficacy of several mouthrinse ingredients and products is supported by published six-month clinical trials. CLINICAL IMPLICATIONS The daily use of an effective antiplaque/antigingivitis antimicrobial mouthrinse is well-supported by a scientific rationale and can be a valuable component of oral hygiene regimens.
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Affiliation(s)
- Michael L Barnett
- Department of Periodontics/Endodontics, School of Dental Medicine, University at Buffalo, State University of New York, USA.
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Abstract
This paper reviews the benefits of the use of antimicrobial mouthrinses for controlling dental biofilm. It is currently known that the human oral cavity is inhabited by approximately 600 to 700 different species of microorganisms, including bacteria, fungi and viruses, organized in biofilms. Biofilm accumulation represents the principal etiologic agent of oral diseases including caries and periodontal diseases. For that reason, prevention of biofilm accumulation has been shown to be associated with the control of diseases. Patient motivation and oral hygiene instruction are claimed to be a major factor influencing the degree of biofilm control. Therefore, mechanical home-care methods, including toothbrushing and flossing, represent the best way for patients to remove biofilm. For many patients, however, the elimination of all biofilm present in the oral cavity through home-care methods could be tedious and time-consuming. Additionally, some local conditions, including malpositioned teeth, presence of bridge-work or orthodontic appliances, among others, may render the mechanical control of biofilm especially difficult. Chemotherapeutic agents, including mouthrinses, could have a key role as adjuncts to daily home care, preventing and controlling supragingival plaque, gingivitis and oral malodor. Indeed, according to the ADA, the active ingredients of mouthwashes must demonstrate a therapeutic effect in vivo and in vitro to be classified as drugs. Several studies included in the present review have demonstrated the effectiveness of mouthrinses containing active ingredients such as chlorhexidine and essential oils in preventing and controlling both supragingival plaque and gingivitis, especially when used adjunctively to regular toothbrushing and flossing procedures.
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Kozlovsky A, Artzi Z, Moses O, Kamin-Belsky N, Greenstein RBN. Interaction of chlorhexidine with smooth and rough types of titanium surfaces. J Periodontol 2006; 77:1194-200. [PMID: 16805682 DOI: 10.1902/jop.2006.050401] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Chlorhexidine (CHX) digluconate exerts plaque inhibitory efficacy in the natural dentition environment due to a superior degree of persistence at the tooth surface. The purpose of the present study was to assess the interaction of CHX with titanium surfaces to estimate its antiplaque potential in the peri-implant environment. METHODS Saliva-coated machined smooth (S) and sand-blasted acid-etched rough (R) titanium disks were soaked in either 0.1% or 0.2% CHX solution. After 24 hours, CHX amounts that were adsorbed, washed out, and desorbed from the titanium surfaces were determined spectrophotometrically at 230 nm. The antibacterial activity of CHX-treated titanium disks was assessed by measuring bacterial inhibition zones on Streptococcus mutans lawns. RESULTS Titanium disks adsorbed 3% to 8% of the available CHX, which was significantly higher with 0.2% CHX (P<0.001) than with 0.1% CHX and two-fold higher on the R titanium disks compared to S titanium surface (P<0.001). After rinsing with water, 2.2% of the adsorbed CHX was washed out. Over 24 hours, S- and R-type disks released 1.1% and 0.6% of the adsorbed agent, respectively. Larger bacterial inhibition zones were obtained with 0.2% CHX and in R disks compared to S disks. CONCLUSIONS CHX displayed persistence at the titanium surface. The adsorption level and bacterial growth inhibition were affected by CHX concentration and titanium surface characteristics, with higher levels of adsorption and antibacterial activity with 0.2% CHX and rough titanium surface. The slow CHX release rate suggests persistence of this agent at the titanium-pellicle surface, which can provide a long-term antiplaque effect.
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Affiliation(s)
- Avital Kozlovsky
- Department of Periodontology, The Maurice and Gabriela Goldschleger School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel.
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Al-Musallam TA, Evans CA, Drummond JL, Matasa C, Wu CD. Antimicrobial properties of an orthodontic adhesive combined with cetylpyridinium chloride. Am J Orthod Dentofacial Orthop 2006; 129:245-51. [PMID: 16473717 DOI: 10.1016/j.ajodo.2005.10.015] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2004] [Revised: 10/01/2004] [Accepted: 10/01/2004] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Patients undergoing fixed appliance treatment are at greater risk for increases in salivary and plaque levels of Streptococcus mutans and an elevated risk of dental caries. Cetylpyridinium chloride (CPC) is known to be an effective antiplaque agent. The purpose of this study was to investigate whether incorporating CPC into a commercially available orthodontic adhesive would impart antimicrobial properties without altering the diametral tensile strength of the material. METHODS CPC was added to a commercially available, filled, photo-activated bracket adhesive (Transbond XT, Unitek 3M, Monrovia, Calif) in varying amounts, to obtain specimens with CPC concentrations of 0% (control), 2.5%, 5.0%, and 10.0% by weight. Adhesive discs 2 mm thick and 4 mm in diameter were incubated with Streptococcus mutans for 48 hours. The diameters of the zones of bacterial inhibition were measured in an agar disc diffusion assay; specimens of each concentration were tested every other week for 196 days. Other discs were soaked in distilled water for 180 days. The amount of CPC released into the water from the modified discs was measured and recorded on days 7, 15, 30, 60, and 180 by using a spectrophotometer at 254 nm. Diametral tensile strength of the modified adhesive discs was measured with a universal testing machine, and the effect of water aging was also evaluated. RESULTS The measured zone of bacterial inhibition increased as CPC content increased. All CPC-adhesive specimens maintained antimicrobial activity up to 196 days. No zone of bacterial inhibition was measured around the control specimens. CPC release was observed through the end of 180-day period, but the greatest release was recorded in the first week. There was no significant difference (P < .05) in diametral tensile strength between the 2.5% CPC-adhesive group and the control; there were significant differences among the 5.0% and 10.0% CPC-adhesive groups and the control. Water aging had no significant effect on diametral tensile strength other than decreasing it for the test group containing 10.0% CPC. CONCLUSIONS The incorporation of 2.5% CPC in adhesive material imparted antimicrobial activity without altering diametral tensile strength.
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Affiliation(s)
- Tahani A Al-Musallam
- Department of Orthodontics, College of Dentistry, University of Illinois, Chicago, IL 60612-7211, USA
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Almas K, Skaug N, Ahmad I. An in vitro antimicrobial comparison of miswak extract with commercially available non-alcohol mouthrinses. Int J Dent Hyg 2006; 3:18-24. [PMID: 16451373 DOI: 10.1111/j.1601-5037.2004.00111.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The aim of this study was to assess the antimicrobial activity of eight commercially available mouthrinses and 50% miswak extract against seven microorganisms. Corsodyl, Alprox, Oral-B advantage, Florosept, Sensodyne, Aquafresh Mint, Betadine and Emoform mouthrinses were used while 50% aqueous extract of miswak (Salvadora persica) was used against Streptococcus faecalis, Streptococcus pyogenis, Streptococcus mutans, Candida albicans, Staphylococcus aureus and Staphylococcus epidermidis. The ditch plate method was used to test the antimicrobial activity. Inhibition zones of microorganisms around ditches were measured in millimetres. Range, mean and standard deviations were used for comparison of antimicrobial activity. Mouthrinses containing chlorhexidine was with maximum antibacterial activity, while cetylpyridinium chloride mouthrinses were with moderate and miswak extract was with low antibacterial activity. Further research is needed for the substantivity of these mouthrinses and further in vivo/in vitro studies are needed using Biofilm model to substantiate present findings. Dental professionals must exercise caution and provide guidance in assisting their patients in making informed choices regarding their use of mouthrinses for clinical efficacy.
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Affiliation(s)
- K Almas
- Department of Periodontics, New York University, College of Dentistry, New York, NY 10010-4086, USA.
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Netuschil L, Hoffmann T, Brecx M. How to select the right mouthrinses in periodontal prevention and therapy. Part I. Test systems and clinical investigations. Int J Dent Hyg 2005; 1:143-50. [PMID: 16451514 DOI: 10.1034/j.1601-5037.2003.00033.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The use of mouthrinses is increasing, especially as adjuncts to the daily mechanical oral hygiene. Different test systems may and can be used to test their antibacterial and clinical effects: bacteriology in vitro, substantivity in vivo, 4-day plaque re-growth, experimental gingivitis and long-term use. The plaque re-growth investigations of a few days are not only of limited use but may also be dangerous because often too extensive conclusions have been drawn from their design. The 'gold standard' test is the experimental gingivitis model to reveal the antiplaque as well as the antigingivitis effects of any mouthrinse preparation during 3 weeks. The last kind of investigations are of several months' duration, where the substances are used as supplements to mechanical oral hygiene measures.
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Affiliation(s)
- L Netuschil
- Department of Conservative Dentistry, Medical Faculty Carl Gustav Carus, University of Technology, Dresden, Germany
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Abstract
Taking into account the limitations of the daily self-performed oral hygiene the use of chemical agents that can be incorporated in dentifrice or mouth rinse formulations has been advocated. The present review deals with randomized controlled clinical trials of >or=6 months in duration, on the use of those agents and their effects on plaque and gingival inflammation.
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Affiliation(s)
- S Paraskevas
- Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
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Sekino S, Ramberg P. The effect of a mouth rinse containing phenolic compounds on plaque formation and developing gingivitis. J Clin Periodontol 2005; 32:1083-8. [PMID: 16174272 DOI: 10.1111/j.1600-051x.2005.00793.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The clinical effect of Listerine, a mouth rinse containing a mixture of phenolic compounds, is ascribed to its bactericidal properties. However, phenolic compounds are also known to interfere with the inflammatory process. OBJECTIVE The purpose of this clinical trial was to evaluate the effect of regular mouth rinsing with Listerine on plaque and gingivitis during a 2-week period of no mechanical oral hygiene. MATERIAL AND METHODS Twenty-one subjects were recruited for the study. On Day 0 of each 2-week experimental period, the participants were told to abstain from all mechanical plaque-control measures but to rinse twice a day with 10 ml of the assigned solution (test: Listerine, positive control:0.1% chlorhexidine (CHX), negative control: saline) for 60 s. Each experimental period was preceded by a 2-week period including oral hygiene instruction, scaling and professional mechanical tooth cleaning. Examinations included assessments of plaque and gingivitis (Days 0 and 14), sampling of plaque and collection of gingival crevicular fluid (GCF) (Days 0, 7 and 14). From the supragingival plaque samples, six different morphotypes of bacteria were counted using dark-field microscopy. The GCF collected was analysed with respect to the content of lactoferrin and albumin. RESULTS During the experimental periods, it was observed that significantly less plaque formed and less gingivitis developed when the participants rinsed with the Listerine mouthwash than with saline solution. However, significantly more plaque formed during the Listerine than during the CHX rinse period, while there was no significant difference in the development of gingival bleeding between the Listerine and the CHX rinse regimens. Significantly smaller proportions of motile rods and fusiforms were found in the List and CHX groups than in the control (Ctrl) group. The increase of the lactoferrin/albumin ratio in the List group was significantly smaller than that in the Ctrl group but significantly larger than in the CHX group. CONCLUSION It was suggested that the effect of Listerine on gingivitis is more pronounced than on plaque formation. This indicates that the phenolic compound may have anti-inflammatory effects.
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Affiliation(s)
- Satoshi Sekino
- Faculty of Odontology, Department of Periodontology, The Sahlgrenska Academy at Göteborg University, Göteborg, Sweden
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Quirynen M, Soers C, Desnyder M, Dekeyser C, Pauwels M, van Steenberghe D. A 0.05% cetyl pyridinium chloride/0.05% chlorhexidine mouth rinse during maintenance phase after initial periodontal therapy. J Clin Periodontol 2005; 32:390-400. [PMID: 15811057 DOI: 10.1111/j.1600-051x.2005.00685.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Chlorhexidine (CHX) mouth rinse/spray can still be considered the gold standard in the chemical prevention of plaque formation and development of gingivitis. The product unfortunately has some side effects, such as extrinsic tooth staining, poor taste, taste disturbance, sensitivity changes in tongue, pain and irritation because of the alcohol content. These side effects led to the search of new formulations. METHODS In this double-blind, randomized, long-term, parallel study, 48 moderate periodontitis patients rinsed for 6 months (starting immediately after a "one-stage, full-mouth" disinfection) with one of the following products: CHX 0.2%+alcohol (Corsodyl), CHX 0.05%+ cetyl pyridinium chloride (CPC) 0.05% and no alcohol (Perio-Aid Maintenance, a new formulation), or the placebo of the latter. After 1, 3 and 6 months a series of clinical and microbiological parameters were recorded for the supra- and subgingival area as well as for saliva. RESULTS Although there was a significant treatment impact (mechanical debridement) in all groups, both CHX solutions further decreased both plaque and gingivitis indices (p<0.001 and p<0.05, respectively), when compared with placebo. This was also reflected by additional reductions in the number of CFU/ml of aerobic and especially anaerobic species and by a suppression of Streptococcus mutans (versus an overgrowth for the placebo), in all niches. Differences between both CHX solutions were never encountered. The subjective ratings were slightly in favour of the new CHX-CPC formulation when compared with the other CHX-alcohol formulation, especially for taste of the product (p<0.05), but less impressive for the staining of teeth and tongue. CONCLUSIONS The results of this study demonstrated the potential of a new CHX 0.05%+CPC 0.05% non-alcoholic formulation as an effective antiplaque agent for long-term use with reduced subjective side effects.
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Affiliation(s)
- Marc Quirynen
- Department of Periodontology, Oral Pathology and Maxillo-Facial Surgery, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
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