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Sjödin T, Diogo Löfgren C, Glantz PO, Christersson C. Delmopinol - adsorption to and absorption through the oral mucosa. Acta Odontol Scand 2020; 78:572-579. [PMID: 32348171 DOI: 10.1080/00016357.2020.1758772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To investigate the surface chemical changes in dynamic interactions of delmopinol on salivary films on oral mucosa in healthy participants after rinsing with an unbuffered water solution of delmopinol, and to examine the oral tissue disposition of delmopinol in rats after local administration. MATERIAL AND METHODS The contact angle technique was used to monitor the interaction of delmopinol with the salivary film coating the upper labial mucosa of 10 healthy participants through a 4 h period. The tissue disposition of 14C-labelled delmopinol was examined in rats by autoradiography. RESULTS Rinsing with delmopinol increased the polarity of the saliva coated mucosa during the time of observation. The binding of delmopinol was verified in the autoradiograms showing that radioactivity remained in the rat oral mucosa after 24 h. Delmopinol was however not irreversibly bound. CONCLUSIONS The findings indicate that delmopinol interacts with the salivary film of the upper labial mucosa and affects its polarity. It appears that delmopinol assists in the maintenance of the hydrophilicity of the mucosal pellicle and thereby also reinforcing hydration of the mucosa. The rat autoradiograms, showed that radioactivity remains in the oral mucosa after 24 h, but diffuses through the mucosal membranes into the systemic circulation.
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Affiliation(s)
- Torgny Sjödin
- Faculty of Odontology, Department of Oral Biology, Malmö University, Malmö, Sweden
| | | | - Per Olof Glantz
- Faculty of Odontology, Department of Prosthodontics, Malmö University, Malmö, Sweden
| | - Cecilia Christersson
- Faculty of Odontology, Department of Dental Materials Science, Malmö University, Malmö, Sweden
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Philip J, Laine ML, Wismeijer D. Adjunctive effect of mouthrinse on treatment of peri-implant mucositis using mechanical debridement: A randomized clinical trial. J Clin Periodontol 2020; 47:883-891. [PMID: 32315444 PMCID: PMC7317778 DOI: 10.1111/jcpe.13295] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 04/16/2020] [Indexed: 11/30/2022]
Abstract
Aim To study effect of delmopinol hydrochloride (DEL) in comparison with chlorhexidine digluconate (CHX) and a placebo (PLA) in addition to non‐surgical mechanical debridement in patients with peri‐implant mucositis. Materials and methods Eighty‐nine patients with at least one implant diagnosed with peri‐implant mucositis were randomly assigned to one of three study groups (DEL, CHX and PLA). Professional non‐surgical mechanical debridement was performed at baseline. Mouth rinsing was carried out by the patients twice a day in addition to their regular oral hygiene practices. Assessments of efficacy were performed for the primary outcome ‐ Implant bleeding on probing (IBOP%) and secondary outcomes ‐ modified Bleeding Index (mBI) and modified Plaque Index (mPI) at 1 and 3 months. Results At 3 months, there was statistically significant reduction in IBOP% and mBI within the study groups compared to baseline. However, there was no statistically significant difference between the study groups at 3 months follow‐up. Moreover, there was a statistically significant difference according to mPI at 1 month between the chlorhexidine and placebo group (p = .004). Conclusions This study confirms that mechanical debridement combined with oral hygiene instruction is effective in treatment of peri‐implant mucositis. The clinical effects between groups were comparable.
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Affiliation(s)
- Juliana Philip
- Department of Oral Implantology and Prosthetic Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Marja L Laine
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Daniël Wismeijer
- Department of Oral Implantology and Prosthetic Dentistry, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Sjödin T. The pH-dependent effect of cationic and non-ionic delmopinol on planktonic and biofilm bacteria. Arch Oral Biol 2019; 102:101-105. [DOI: 10.1016/j.archoralbio.2019.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 03/16/2019] [Accepted: 03/19/2019] [Indexed: 10/27/2022]
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Levin L, Barbu H, Kurgan S, Comăneanu RM, Referendaru D, Lorean A. Evaluation of 0.2% delmopinol mouth rinse for prevention of peri-implant mucositis and peri-implantitis: A randomized controlled canine study. Clin Implant Dent Relat Res 2019; 21:46-51. [PMID: 30444075 DOI: 10.1111/cid.12692] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 09/25/2018] [Accepted: 10/14/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To evaluate the effectiveness of 0.2% delmopinol mouth rinse in maintenance of peri-implant tissue health and prevention or inhibition of peri-implant mucositis and peri-implantitis. MATERIALS AND METHODS Four weeks following tooth extraction, eight titanium dental implants, were placed in six dogs' mandibles. Three dogs were assigned to the test or placebo mouth rinse. Eight weeks following implant installation (T2) ligature was placed to induce peri-implant disease. Clinical and radiographic assessment was performed during the study period as well as micro-CT analysis and histologic assessment to evaluate Bone-Implant Contact at the end of the follow-up (T4). RESULTS Plaque at implant sites before ligature placement (T2) was lower for the test group (0.7 ± 1.0 vs 1.5 ± 1.3, P < .05). The ratio of affected implant (PD ≧4 mm) at T2 and T4 in the test group was significantly smaller than that of the placebo group (T2, 17% vs 47%, P < .01; T4, 67% vs 83%, P < .05). The test agent also seemed to be effective in partially preventing bone loss induced by ligature placement according to the Computed Tomography and histologic analysis (test, 1.1 ± 0.8 mm; placebo, 1.5 ± 0.9 mm). CONCLUSIONS Within the limits of this animal model study, the results of the study indicate that the 0.2% delmopinol rinse might play a role in prevention of peri-implant disease development.
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Affiliation(s)
- Liran Levin
- Faculty of Medicine and Dentistry, Division of Periodontology, University of Alberta, Canada
| | - Horia Barbu
- Faculty of Dental Medicine, Department of Implantology, Titu Maiorescu University, Bucharest, Romania
| | - Sivge Kurgan
- Faculty of Dentistry, Department of Periodontology, Ankara University, Ankara, Turkey
| | - Raluca Monica Comăneanu
- Faculty of Dental Medicine, Department of Implantology, Titu Maiorescu University, Bucharest, Romania
| | - Daniel Referendaru
- Faculty of Dental Medicine, Department of Implantology, Titu Maiorescu University, Bucharest, Romania
| | - Adi Lorean
- Faculty of Dental Medicine, Department of Implantology, Titu Maiorescu University, Bucharest, Romania
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Gkatzonis AM, Vassilopoulos SI, Karoussis IK, Kaminari A, Madianos PN, Vrotsos IA. A randomized controlled clinical trial on the effectiveness of three different mouthrinses (chlorhexidine with or without alcohol and C31G), adjunct to periodontal surgery, in early wound healing. Clin Oral Investig 2018; 22:2581-2591. [PMID: 29396643 DOI: 10.1007/s00784-018-2357-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 01/23/2018] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The use of chlorhexidine (CHX) with or without alcohol has been recommended for a number of clinical applications. On the other hand, there is a plethora of widely subscribed antiseptics, such as agent C31G (alkyl dimethyl glycine/alkyl dimethyl amine oxide), which has not yet been evaluated postsurgically. The effectiveness of three different mouthrinses (CHX with and without alcohol, C31G) in plaque control and early wound healing was compared postoperatively. MATERIALS AND METHODS In this, randomized, double-blind, controlled clinical trial 42 patients were allocated to three groups assigned to 2 weeks rinsing after non-regenerative periodontal flap surgery with or without osseous surgery with C31G (group A), alcohol-free CHX 0.12% (group B) or alcohol-based CHX 0.12% (group C). At days 7 and 14, plaque and early wound healing indices were recorded. At day 14, total bacterial counts were estimated utilizing real-time quantitative polymerase chain reaction (qPCR). Statistics included linear and generalized linear mixed models. RESULTS At day 7, healing response was not significantly different among groups. At day 14, group A revealed the highest while group C demonstrated the lowest plaque index values (B vs A, odds ratio-OR = 0.18, p = 0.012; C vs A, OR = 0.01, p < 0.001; C vs B, OR = 0.06, p < 0.001). Group C demonstrated the lowest bacterial counts levels at day 14 (38.470 × 106, 48.190 × 106, and 3.020 × 106 for groups A, B, and C, respectively). At day 14, healing was significantly better in group C compared to B (p = 0.007). Group A showed no significant differences compared to other groups. CONCLUSIONS (1) The presence of alcohol may increase the effectiveness of CHX in early wound healing, (2) C31G might be an alternative solution prescribed during early postoperative period after non-regenerative periodontal flap surgery. CLINICAL RELEVANCE The present study found that active agent C31G displayed no significant differences to CHX formulations regarding periodontal wound healing improvement and might be used alternatively after non-regenerative periodontal flap surgery. In addition, an alcohol based 0.12% CHX mouthwash was more effective than an alcohol-free 0.12% CHX and C31G mouthrinse on plaque control in the absence of mechanical oral hygiene.
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Affiliation(s)
- Anastasios M Gkatzonis
- Department of Periodontology, School of Dental Medicine, National and Kapodistrian University of Athens, 2 Thivon Str, 115 27, Athens, Greece.
| | - Spyridon I Vassilopoulos
- Department of Periodontology, School of Dental Medicine, National and Kapodistrian University of Athens, 2 Thivon Str, 115 27, Athens, Greece
| | - Ioannis K Karoussis
- Department of Periodontology, School of Dental Medicine, National and Kapodistrian University of Athens, 2 Thivon Str, 115 27, Athens, Greece
| | - Archontia Kaminari
- Institute of Biosciences and Applications, National Center for Scientific Research "Demokritos", Athens, Greece
| | - Phoebus N Madianos
- Department of Periodontology, School of Dental Medicine, National and Kapodistrian University of Athens, 2 Thivon Str, 115 27, Athens, Greece
| | - Ioannis A Vrotsos
- Department of Periodontology, School of Dental Medicine, National and Kapodistrian University of Athens, 2 Thivon Str, 115 27, Athens, Greece
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Sjödin T, Nilner K, Sparre B, Bernet C, Åström M. A clinical and microbiological study on the enantiomers of delmopinol. Acta Odontol Scand 2016; 74:355-61. [PMID: 26940371 DOI: 10.3109/00016357.2016.1151546] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective The clinical part of this study aimed to investigate whether the racemate of delmopinol [(±)-delmopinol] is equivalent to its two enantiomers [(+)-delmopinol and (-)-delmopinol] with respect to efficiency and to determine and compare their pharmacokinetic properties. The purpose of the pre-clinical part was to elucidate possible differences in antimicrobial efficiency. Materials and methods The compounds were tested clinically in a double-blind, randomized, cross-over study comprising three treatment periods of 4 days each. The antimicrobial efficacy of the enantiomers was compared in vitro with respect to planktonic and biofilm bacteria of different species. Results No statistically significant differences in prevention of plaque formation were observed. Except for a somewhat higher systemic exposure in terms of AUC and Cmax indicated for (-)-delmopinol compared to (+)-delmopinol, the pharmacokinetic properties were similar. The most common adverse event was a transient anaesthetic feeling in the mouth. This event was reported with the same frequency for all three test solutions. The enantiomers showed similar antimicrobial effects on planktonic bacteria and their biofilms. Conclusions The enantiomers were found to be equally effective with respect to inhibition of plaque development and only minor differences were observed with respect to their pharmacokinetic properties. No differences could be observed in the adverse events reports. There is, therefore, no reason to use one of the enantiomers of delmopinol instead of the racemate. This was further supported by the antimicrobial tests. It is suggested that the combined action of cationic and neutral delmopinol is important for its effect on biofilms.
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Affiliation(s)
- Torgny Sjödin
- Department of Oral Biology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Krister Nilner
- Department of Prosthodontics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Sarkar S, Bhattacharjee C, Curcio S. Studies on adsorption, reaction mechanisms and kinetics for photocatalytic degradation of CHD, a pharmaceutical waste. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2015; 121:154-163. [PMID: 25956186 DOI: 10.1016/j.ecoenv.2015.04.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 04/22/2015] [Accepted: 04/27/2015] [Indexed: 06/04/2023]
Abstract
The photocatalytic degradation of chlorhexidine digluconate (CHD), a disinfectant and topical antiseptic and adsorption of CHD catalyst surface in dark condition has been studied. Moreover, the value of kinetic parameters has been measured and the effect of adsorption on photocatalysis has been investigated here. Substantial removal was observed during the photocatalysis process, whereas 40% removal was possible through the adsorption route on TiO2 surface. The parametric variation has shown that alkaline pH, ambient temperature, low initial substrate concentration, high TiO2 loading were favourable, though at a certain concentration of TiO2 loading, photocatalytic degradation efficiency was found to be maximum. The adsorption study has shown good confirmation with Langmuir isotherm and during the reaction at initial stage, it followed pseudo-first-order reaction, after that Langmuir Hinshelwood model was found to be appropriate in describing the system. The present study also confirmed that there is a significant effect of adsorption on photocatalytic degradation. The possible mechanism for adsorption and photocatalysis has been shown here and process controlling step has been identified. The influences of pH and temperature have been explained with the help of surface charge distribution of reacting particles and thermodynamic point of view respectively.
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Affiliation(s)
- Santanu Sarkar
- Environmental Research Group, R&D, Tata Steel Ltd., Jamshedpur, 831001, India
| | | | - Stefano Curcio
- Department of Informatics, Modeling, Electronics and Systems Engineering (D.I.M.E.S.), University of Calabria, Via-P. Bucci, Cubo 42a, 87036 Rende (CS), Italy
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Hunter A, Kalathingal S, Shrout M, Plummer K, Looney S. The effectiveness of a pre-procedural mouthrinse in reducing bacteria on radiographic phosphor plates. Imaging Sci Dent 2014; 44:149-54. [PMID: 24944965 PMCID: PMC4061299 DOI: 10.5624/isd.2014.44.2.149] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2013] [Revised: 11/26/2013] [Accepted: 12/04/2013] [Indexed: 12/03/2022] Open
Abstract
Purpose This study assessed the effectiveness of three antimicrobial mouthrinses in reducing microbial growth on photostimulable phosphor (PSP) plates. Materials and Methods Prior to performing a full-mouth radiographic survey (FMX), subjects were asked to rinse with one of the three test rinses (Listerine®, Decapinol®, or chlorhexidine oral rinse 0.12%) or to refrain from rinsing. Four PSP plates were sampled from each FMX through collection into sterile containers upon exiting the scanner. Flame-sterilized forceps were used to transfer the PSP plates onto blood agar plates (5% sheep blood agar). The blood agar plates were incubated at 37℃ for up to 72 h. An environmental control blood agar plate was incubated with each batch. Additionally, for control, 25 gas-sterilized PSP plates were plated onto blood agar and analyzed. Results The mean number of bacterial colonies per plate was the lowest in the chlorhexidine group, followed by the Decapinol, Listerine, and the no rinse negative control groups. Only the chlorhexidine and Listerine groups were significantly different (p=0.005). No growth was observed for the 25 gas-sterilized control plates or the environmental control blood agar plates. Conclusion The mean number of bacterial colonies was the lowest in the chlorhexidine group, followed by the Decapinol, Listerine, and the no rinse groups. Nonetheless, a statistically significant difference was found only in the case of Listerine. Additional research is needed to test whether a higher concentration (0.2%) or longer exposure period (two consecutive 30 s rinse periods) would be helpful in reducing PSP plate contamination further with chlorhexidine.
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Affiliation(s)
- Allison Hunter
- Radiology Oral Health and Diagnostic Sciences, Georgia Regents University, College of Dental Medicine, Augusta, GA, USA
| | - Sajitha Kalathingal
- Radiology Oral Health and Diagnostic Sciences, Georgia Regents University, College of Dental Medicine, Augusta, GA, USA
| | - Michael Shrout
- Department of Oral Rehabilitation, Georgia Regents University, College of Dental Medicine, Augusta, GA, USA
| | - Kevin Plummer
- Department of Oral Rehabilitation, Georgia Regents University, College of Dental Medicine, Augusta, GA, USA
| | - Stephen Looney
- Radiology Oral Health and Diagnostic Sciences, Georgia Regents University, College of Dental Medicine, Augusta, GA, USA. ; Department of Biostatistics and Epidemiology Georgia Regents University Medical College of Georgia, Augusta, GA, USA
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Greenman J, McKenzie C, Saad S, Wiegand B, Zguris JC. Effects of chlorhexidine on a tongue-flora microcosm and VSC production using an in vitro biofilm perfusion model. J Breath Res 2008; 2:046005. [PMID: 21386192 DOI: 10.1088/1752-7155/2/4/046005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
An in vitro perfusion biofilm model, derived from tongue-scrape microflora removed from one individual, was employed to study sulfide biogenesis and the effects of repeated exposure to chlorhexidine (CHX). Volatile sulfur compounds (VSC) were measured using a carbon veil electrode within the biofilm and a halimeter for liquid and gas phase levels, respectively. The microflora of the perfusate and the biofilm were assessed by microbiological techniques and polymerase chain reaction (PCR) to estimate diversity. Biofilms treated with a 1 mL pulse of 0.1% CHX twice a day for three days showed (1) a large reduction in viable count (>90% kill), (2) a (slow) reduction in the VSC production rate, consistent with the reduction in microbes rather than direct inhibitory effects on the biotransformation steps, and (3) a preferential reduction of strict anaerobes. Treated biofilms allowed to recover over 3-5 days showed a nominal amount of regrowth in some experiments, although population numbers were still well below those found in untreated controls. The microbiological composition of biofilms treated but allowed to recover was markedly different from the controls, with proportionally fewer strict anaerobes. Thus, CHX treatment caused detectable ecological shifts with consequent long-term effects on the response of the biofilm in terms of VSC generation, consistent with clinical observations. The model appears highly suited for testing the efficacy of putative anti-malodour or antimicrobial agents.
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Affiliation(s)
- J Greenman
- University of the West of England, Bristol, UK
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de Araújo Nobre M, Cintra N, Maló P. Peri-implant maintenance of immediate function implants: a pilot study comparing hyaluronic acid and chlorhexidine. Int J Dent Hyg 2007; 5:87-94. [PMID: 17461960 DOI: 10.1111/j.1601-5037.2007.00239.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION In implants, maintenance assumes an important role. The role of chlorhexidine (CHX) is well known in maintenance, while only limited evidence exists on the practical use of hyaluronic acid (HA). The objective of this study was to compare the health status of the peri-implant complex (hard and soft tissues surrounding the implant) during the healing period of immediate function implants, using HA or CHX gels in the patient's maintenance protocol. STUDY POPULATION AND METHODOLOGY: Thirty complete edentulous patients, with four immediate function Brånemark System implants placed in the mandible (total of 120 implants), were randomly assigned to two groups (HA and CHX) using only these two chemicals in their daily implant self-care. Both groups were followed up for 6 months, with clinical observations on the 10th day, 2 months, 4 months and 6 months post-surgically. RESULTS During the course of the study, HA and CHX produced good results in maintaining a healthy peri-implant complex in immediate function implants for complete rehabilitations in the edentulous mandible. Statistically significant differences were found in favour of the HA group in the modified bleeding index on the second observation (P = 0.003). The difference was more marked in the axial implants placed in the fifth sextant (P = 0.05). Correlation coefficient between plaque and bleeding index revealed a potentially better result for CHX at 6 months. CONCLUSION The findings point out the importance of a maintenance protocol in immediate function implants. Both chemicals are valid tools for implant maintenance. The authors suggest that it might be advantageous to administer HA in the first 2 months and CHX between 2 and 6 months.
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Addy M, Moran J, Newcombe RG. Meta-analyses of studies of 0.2% delmopinol mouth rinse as an adjunct to gingival health and plaque control measures. J Clin Periodontol 2006; 34:58-65. [PMID: 17116159 DOI: 10.1111/j.1600-051x.2006.01013.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Delmopinol is a third-generation anti-plaque agent used as a mouthwash to reduce plaque and alleviate gingivitis. OBJECTIVE To create an overview of the anti-plaque efficacy of 0.2% delmopinol as an adjunct to normal oral hygiene measures by meta-analysis of completed clinical trials. MATERIALS AND METHODS Eight double-blind, parallel-group studies were identified. Study durations ranged from 8 to 24 weeks. Five studies (n=913) involved supervised rinsing; three studies (n=467) involved unsupervised rinsing. These sets of trials were analysed separately and in combination. Efficacy outcomes comprised modified plaque index, modified gingival index (MGI) and gingival bleeding on probing (BOP). RESULTS Delmopinol 0.2% was superior to placebo for the reduction of plaque scores in both sets of studies. Effects on MGI and BOP were also better with delmopinol 0.2% than with placebo. In most instances, 95% confidence intervals were wholly in favour of delmopinol. Pooled analysis of all eight studies confirmed statistically significant effects of delmopinol 0.2% compared with placebo (p<0.00001). Delmopinol met the efficacy criteria of the American Dental Association in studies of extended duration. CONCLUSION Delmopinol 0.2% mouthwash is effective as an adjunct measure for reducing plaque burden and indices of gingivitis, whether or not it is used under supervision.
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Affiliation(s)
- Martin Addy
- Division of Restorative Dentistry (Perio), University of Bristol Dental School, Lower Maudlin Street, Bristol BS1 2LY, UK.
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Brecx M, Netuschil L, Hoffmann T. How to select the right mouthrinses in periodontal prevention and therapy. Part II. Clinical use and recommendations. Int J Dent Hyg 2006; 1:188-94. [PMID: 16451500 DOI: 10.1034/j.1601-5037.2003.00046.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Based on scientific proof, only few mouthrinse solutions can be recommended. However, it is impossible to construct an extended table that would provide precise recommendations or advices for mouthrinse utilisation related to any possible discomfort or diseases. Only reliable information on the drugs available against periodontal disease can be offered to the therapist. By evaluation of her or his individual experiences, she or he has to judge all the armamentarium she or he possesses to react in the best possible way in each specific situation.
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Affiliation(s)
- M Brecx
- Department of Conservative Dentistry, Medical Faculty Carl Gustav Carus, University of Technology, Dresden, Germany
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McBain AJ, Bartolo RG, Catrenich CE, Charbonneau D, Ledder RG, Gilbert P. Effects of triclosan-containing rinse on the dynamics and antimicrobial susceptibility of in vitro plaque ecosystems. Antimicrob Agents Chemother 2004; 47:3531-8. [PMID: 14576113 PMCID: PMC253811 DOI: 10.1128/aac.47.11.3531-3538.2003] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Dental plaque microcosms were established under a feast-famine regimen within constant-depth film fermentors and exposed four times daily postfeeding to a triclosan (TR)-containing rinse (dentifrice) (TRD). This was diluted so that the antimicrobial content was 0.6 mg/ml. Microcosms were characterized by heterotrophic plate counts and PCR-denaturing gradient gel electrophoresis (DGGE) with primers specific for the V2-V3 region of the eubacterial 16S rRNA gene (rDNA). Dominant isolates and PCR amplicons were identified by partial sequencing of 16S rDNA. TRD caused considerable decreases in the counts of both gram-negative organisms and total anaerobic cells, transiently lowered the numbers of streptococci and actinomycetes, and markedly increased the proportion of lactobacilli. DGGE indicated the presence of putatively unculturable bacteria and showed that a Porphyromonas sp. and Selenomonas infelix had been inhibited by TRD. Pure culture studies of 10 oral bacteria (eight genera) showed that Neisseria subflava, Prevotella nigrescens, and Porphyromonas gingivalis were highly susceptible to TR, while the lactobacilli and streptococci were the least susceptible. Clonal expansion of the lactobacilli in the pulsed microcosm could be explained on the basis of TR activity. The mean MICs of TR, chlorhexidine, erythromycin, penicillin V, and vancomycin for the population before and after 5 days of exposure to TRD showed few significant changes. In conclusion, changes in plaque microcosm populations following repeated exposure to TRD showed inhibition of the most susceptible flora and clonal expansion of less susceptible species.
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Affiliation(s)
- Andrew J McBain
- School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester M13 9PL, United Kingdom
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McBain AJ, Bartolo RG, Catrenich CE, Charbonneau D, Ledder RG, Gilbert P. Effects of a chlorhexidine gluconate-containing mouthwash on the vitality and antimicrobial susceptibility of in vitro oral bacterial ecosystems. Appl Environ Microbiol 2003; 69:4770-6. [PMID: 12902270 PMCID: PMC169085 DOI: 10.1128/aem.69.8.4770-4776.2003] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Oral bacterial microcosms, established using saliva inocula from three individuals, were maintained under a feast-famine regime within constant-depth film fermenters. Steady-state communities were exposed four times daily, postfeeding, to a chlorhexidine (CHX) gluconate-containing mouthwash (CHXM) diluted to 0.06% (wt/vol) antimicrobial content. The microcosms were characterized by heterotrophic plate counts and PCR-denaturing gradient gel electrophoresis (DGGE). CHXM caused significant decreases in both total anaerobe and total aerobe/facultative anaerobe counts (P < 0.05), together with lesser decreases in gram-negative anaerobes. The degree of streptococcal and actinomycete inhibition varied considerably among individuals. DGGE showed that CHXM exposure caused considerable decreases in microbial diversity, including marked reductions in Prevotella sp. and Selenomonas infelix. Pure-culture studies of 10 oral bacteria (eight genera) showed that Actinomyces naeslundii, Veillonella dispar, Prevotella nigrescens, and the streptococci were highly susceptible to CHX, while Lactobacillus rhamnosus, Fusobacterium nucleatum, and Neisseria subflava were the least susceptible. Determination of the MICs of triclosan, CHX, erythromycin, penicillin V, vancomycin, and metronidazole for microcosm isolates, before and after 5 days of CHXM exposure, showed that CHXM exposure altered the distribution of isolates toward those that were less susceptible to CHX (P < 0.05). Changes in susceptibility distributions for the other test agents were not statistically significant. In conclusion, population changes in plaque microcosms following repeated exposure to CHXM represented an inhibition of the most susceptible flora with a clonal expansion of less susceptible species.
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Affiliation(s)
- Andrew J McBain
- School of Pharmacy and Pharmaceutical Sciences, University of Manchester, Manchester M13 9PL, United Kingdom
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15
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Arweiler NB, Auschill TM, Reich E, Netuschil L. Substantivity of toothpaste slurries and their effect on reestablishment of the dental biofilm. J Clin Periodontol 2002; 29:615-21. [PMID: 12354086 DOI: 10.1034/j.1600-051x.2002.290705.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Toothpastes are good vehicles for antibacterial substances to exert a prolonged effect. This effect depends on the substantivity and ability to interfere with plaque metabolism and/or vitality. It was the purpose of this clinical, randomized 2 x 4 cell crossover study to evaluate and to compare the antibacterial effects of two toothpastes (Colgate Total(R), COL and Parodontax(R), PAR) applied as slurries on established plaque over 24 h (Part I) and their effect on 4-day plaque regrowth (Part II). Chlorhexamed(R) (0.1%; CHX) and water served as positive and negative controls. MATERIAL AND METHODS After professional toothcleaning eight students were asked to refrain from all mechanical hygiene measures for the next 72 h. After 48 h plaque was sampled and vitality of the plaque flora examined (baseline, VF0%). The subjects then rinsed for 1 min with 15 mL of one of the test or control solutions. Every second hour up to 14 h and 24 h after rinsing, plaque sampling and staining was performed to assess plaque vitality (VF2-24, Part I). In Part II, the classical 4-day plaque regrowth design was used with two rinses (1 min) a day as the only oral hygiene measure. Vitality values were assessed on day 1 and day 4 (VF1, VF2). At day 4, teeth were stained to assess the whole mouth plaque index (PlI) and to evaluate the percentage of plaque area (PA) of the anterior teeth. RESULTS Compared to placebo, all active rinses reduced plaque vitality significantly over a period of 24 h (Part I). PAR, COL and CHX revealed reductions of 18-31%, 28-50% and 19-50%, respectively. In Part II, similar reductions of all parameters were found for all active rinses (PAR 12-30%, COL 34-51%, CHX 40-64%). CONCLUSIONS Colgate Total has shown a significant action on plaque regrowth and a high substantivity during 24 h, while Parodontax revealed a more moderate but still significant effect.
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Affiliation(s)
- Nicole B Arweiler
- Albert-Ludwigs-University of Freiburg, Department of Operative Dentistry and Periodontology, Freiburg, Germany
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16
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Burgemeister S, Decker EM, Weiger R, Brecx M. Bactericidal effect of delmopinol on attached and planktonic Streptococcus sanguinis cells. Eur J Oral Sci 2001; 109:425-7. [PMID: 11767281 DOI: 10.1034/j.1600-0722.2001.00121.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The aim of this investigation was to determine the antibacterial effect of varying concentrations of delmopinol-HCl on attached as well as on planktonic Streptooccus sanguinis cells in vitro. In addition, a possible antiadhesive effect on attached micro-organisms was to be investigated. S. sanguinis cells were allowed to attach to glass surfaces. These as well as planktonic cells were exposed to delmopinol-HCI in concentrations ranging from 0.2% to 0.00005% for 2 min. The percentage of vital bacteria was calculated by means of a fluorescence staining method. Total counts of attached bacteria were performed to determine any possible detaching effect by the delmopinol-HCl. The CFU were determined for the planktonic bacteria. Attached as well as planktonic bacteria showed a marked decrease in vitality following exposure to 0.2% delmopinol-HCl. After exposure to 0.05% this was only the case with the attached microorganisms. The total number of attached bacteria was not reduced by the delmopinol treatment. During initial dental biofilm formation, delmopinol-HCl causes a bactericidal effect when applied in concentrations of 0.05% and higher.
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Affiliation(s)
- S Burgemeister
- Department of Conservative Dentistry, School of Dental Medicine, University of Tübingen, Germany.
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17
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Meiller TF, Kelley JI, Jabra-Rizk MA, Depaola LG, Baqui AA, Falkler WA. In vitro studies of the efficacy of antimicrobials against fungi. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2001; 91:663-70. [PMID: 11402279 DOI: 10.1067/moe.2001.113550] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The purpose of this study was to compare the efficacy of Listerine Antiseptic, Tartar Control Listerine Antiseptic, and Peridex mouthrinses and a 0.2% chlorhexidine digluconate solution against known pathogenic fungi. STUDY DESIGN Standardized methods were used to compare the antimicrobial efficacy of the above agents versus representative fungal species. Minimum inhibitory concentration-minimum fungicidal concentrations in macrobroth dilutions, suspension kill-time, and effectiveness against an artificial biofilm-attached population were studied. RESULTS All antimicrobials tested were effective against the fungal species under investigation at the concentration available commercially. Listerine Antiseptic showed a greater efficacy against attached artificial biofilm populations than the other antimicrobials tested. CONCLUSIONS Listerine Antiseptic, Tartar Control Listerine Antiseptic, and Peridex mouthrinses show promise as a means to control the pathogenic fungal species under investigation and may have applications to reduce oral colonization.
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Affiliation(s)
- T F Meiller
- Department of Oral Medicine and Diagnostic Sciences, Unversity of Maryland Dental School, Balitmore, Md 21201, USA.
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