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Toonen LSJ, van Swaaij BWM, Timmerman MF, Van der Weijden FGA, Slot DE. User perception of fluoride mouthwashes for daily use: A randomized clinical trial. Int J Dent Hyg 2024. [PMID: 39075729 DOI: 10.1111/idh.12842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 03/18/2024] [Accepted: 07/11/2024] [Indexed: 07/31/2024]
Abstract
AIM To assess user perceptions of different commercially available fluoride mouthwashes (FL-MWs). METHODS A single-blind, randomized clinical trial was conducted. Participants were randomly assigned to a sequence of six different FL-MWs, one of which contained alcohol. For each visit, participants rinsed with one specific mouthwash (15 mL) for 30 s. After rinsing, participants completed a questionnaire with a visual analogue scale. Questions focused on overall taste, mild/pungent feeling, taste duration, foaming effect, burning sensation, sensitivity, numbness, dryness, rinsing time, smell, and colour of the mouthwashes. Descriptive analyses and statistical tests regarding differences among and between the mouthwashes were performed. RESULTS Overall, 53 participants completed the study protocol, including nine who did, however, not rinse with the alcohol-containing mouthwash due to religious reasons. Among the mouthwashes, significant differences were found for foaming effect, sensitivity, rinsing time, smell, and colour (p < 0.05). Pairwise comparison for smell did not reveal a difference, and foaming was within the acceptance range (low to medium foaming). Coloured mouthwashes were more appreciated than transparent solutions (p = 0.00). The mouthwash containing essential oils and alcohol produced significantly more sensitivity (p = 0.00) and, in general, participants experienced the rinsing time significantly longer (p < 0.05) compared to the non-alcohol-containing mouthwashes. CONCLUSION There is heterogeneity in user perceptions and preferences for FL-MWs, with a significant difference in foaming effect, sensitivity, rinsing time, smell, and colour. Coloured mouthwashes are preferred. The mouthwash containing essential oils and alcohol was less acceptable in relation to sensitivity and rinsing time.
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Affiliation(s)
- L S J Toonen
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Dental Hygiene Hogeschool Arnhem Nijmegen (HAN), University of Applied Sciences, Nijmegen, The Netherlands
| | - B W M van Swaaij
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Dental Hygiene Hogeschool Arnhem Nijmegen (HAN), University of Applied Sciences, Nijmegen, The Netherlands
| | - M F Timmerman
- Department of Dentistry, Section Implantology and Periodontology Radboud University Medical Center (Radboud UMC), Nijmegen, The Netherlands
| | - Fridus G A Van der Weijden
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - D E Slot
- Department of Periodontology Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Sarembe S, Michler N, Ufer C, Kiesow A. In Vitro Model to Evaluate the Development of Discolorations on Human Enamel Caused by Treatment with Mouth Rinses and Black Tea Considering Brushing. Eur J Dent 2024; 18:925-932. [PMID: 38262467 PMCID: PMC11290939 DOI: 10.1055/s-0043-1777047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVES The study aimed to develop and test an in vitro model to investigate the staining potential of mouth rinses on human enamel, considering alternating intake of black tea and tooth brushing, thus mimicking the situation in the oral cavity more realistically. MATERIALS AND METHODS Eight mouth rinses with six different active ingredients (benzydamine hydrochloride [BNZ], polyhexamethylene biguanide hydrochloride [PHMB], chlorhexidine digluconate [CHX], hexetidine gluconate [HEX], octenidine dihydrochloride [OCT] and octenidine dihydrochloride + 2-phenoxyethanol [OCTP]) and concentrations were tested. Sets of six halved human molar crowns were initially pretreated by soaking in artificial saliva (30 min). Afterward, the cyclic treatment was started by soaking in artificial saliva (2 min), staining with black tea (1 min), brushing with toothpaste (5 s), and soaking in the mouth rinse (30 s). Samples were rinsed with distilled water after each treatment step. The cyclic treatment was repeated 30 times, mimicking the consumer behavior after 15 days. Photographic images were taken after 0, 10, 20, and 30 cycles. Color measurements were conducted after each staining and brushing step using a VITA-Easyshade spectrophotometer to determine the difference in lightness ∆L and the total color difference ∆E. STATISTICAL ANALYSIS Analysis of variance and post-hoc Tukey test (α = 0.05) were applied. RESULTS The new testing model with included brushing sequences allowed to assess the staining behavior on human teeth and provided a clear differentiation between the different investigated products. In detail, up to cycle 10, ΔE values increased for all mouth rinses with each additional cycle number. However, while ΔE values continued to increase for 0.15% BNZ, 0.1% PHMB, and 0.2% CHX between treatment cycle 10 and 30, ΔE values only slightly increased after treatment with 0.08% OCTP, 0.1% OCTP, 0.1% OCT, and 0.1% HEX. After 20 and 30 cycles, significantly less staining was found for 0.08% OCTP, 0.1% OCT, 0.1% HEX as compared to 0.2% CHX, 0.15% BNZ, and 0.1% PHMB (p < 0.05). ΔE-values were significantly lower after treatment with 0.1% OCTP as compared to 0.2% CHX1 and 0.2% CHX2 (p < 0.05). CONCLUSION The proposed new methodology was found to be appropriate for assessing the staining progression of mouth rinses over a simulated application period of 15 days. The model allows differentiation of products with different active ingredients and concentrations.
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Affiliation(s)
- Sandra Sarembe
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany
| | - Nicole Michler
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany
| | - Carolin Ufer
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany
| | - Andreas Kiesow
- Fraunhofer Institute for Microstructure of Materials and Systems IMWS, Halle (Saale), Germany
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Kaur J, Grover V, Gupta J, Gupta M, Kapur V, Mehta M, Lyle DM, Samujh T, Jain A. Effectiveness of subgingival irrigation and powered toothbrush as home care maintenance protocol in type 2 diabetic patients with active periodontal disease: A 4-month randomized controlled trial. J Indian Soc Periodontol 2023; 27:515-523. [PMID: 37781333 PMCID: PMC10538506 DOI: 10.4103/jisp.jisp_509_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/23/2022] [Accepted: 11/27/2022] [Indexed: 10/03/2023] Open
Abstract
Background There is a bidirectional link between diabetes and periodontal disease. Control of active periodontal infection is an essential requisite to maintain optimal oral and systemic health in diabetic patients. The purpose of this study was to evaluate the efficacy of subgingival irrigation and powered toothbrush as home care maintenance protocol in type 2 diabetic patients with active periodontal disease compared to routine oral hygiene. Materials and Methods Forty (n = 40) diabetic (HbA1c >7%) patients were enrolled in this parallel, examiner-blind, interventional clinical trial. Patients were randomized into two groups: Group A (sonic toothbrush and irrigation with water twice daily) or Group B (manual toothbrush and mouth rinsing with 0.12% Chlorhexidine gluconate (CHX) twice daily)). All patients received Phase I therapybefore the start of the study. Clinical parameters (plaque index [PI], gingival index [GI], oral hygiene index [OHI], pocket depth [PD], clinical attachment level [CAL], and bleeding index [BI]) were assessed at baseline, 1, 2, and 4 months. Levels of C-reactive protein (CRP), HbA1c, and interleukin (IL)-1 β were assessed at baseline and 4 months only. Verbal and written instructions were provided to each subject specific to their intervention allocation. Descriptive, parametric, and nonparametric analyses were used where appropriate. Results Sixteen (n = 16) patients in Group A and fifteen (n = 15) patients in Group B completed the 4-month study. Both groups showed a significant difference in BI, PD, CAL, and HbA1c from baseline to 4 months. There were no differences within groups for OHI, GI, or PI and CRP, IL-1 β. The results are based on an underpowered study due to the drop out of 9 patients reducing the number below the needed 19 patients per group based on the power analysis. Conclusion Results from this study provide information for future studies on self-care regimens for individuals living with Type 2 diabetes.
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Affiliation(s)
- Jaspreet Kaur
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Vishakha Grover
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Jyoti Gupta
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Mili Gupta
- Department of Biochemistry, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Vinay Kapur
- Department of Medicine, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | - Manjula Mehta
- Department of Microbiology, Dr. Harvansh Singh Judge Institute of Dental Sciences and Hospital, Panjab University, Chandigarh, India
| | | | - Tanvi Samujh
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
| | - Ashish Jain
- Department of Periodontology, Dr. Harvansh Singh Judge Institute of Dental Sciences, Panjab University, Chandigarh, India
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Choi YS, Lee JS, Lee HG. Nanoencapsulation of Grapefruit Seed Extract and Cinnamon Oil for Oral Health: Preparation, In Vitro, and Clinical Antimicrobial Activities. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2023; 71:5646-5654. [PMID: 36988548 DOI: 10.1021/acs.jafc.2c05518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
This study aimed to formulate mucoadhesive antimicrobial nanoparticles using natural antimicrobials and biopolymers for oral health and verify their antimicrobial activity in clinical studies. A combination of grapefruit seed extract and cinnamon oil (GCN) and chitosan/carrageenan (CS/CR) were selected as synergistic antimicrobial combinations and mucoadhesive wall materials for nanoparticles, respectively. GCN nanoparticles (NPs; size = 357 nm and polydispersity index = 0.188) prepared by ionic gelation between CS and CR exhibited synergistic antimicrobial activity between grapefruit seed extract and cinnamon oil and significantly higher antimicrobial activity against Streptococcus mutans and sobrinus than free GCN in a time-kill assay. The clinical antibacterial activity of GCN was significantly increased and sustained by nanoencapsulation in the mouth-rinse test and GCN NP-treated drinking yogurt. These results suggest that GCN-loaded CS/CR nanoencapsulation is a promising technique that can inhibit oral bacteria with or without the presence of other food ingredients.
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Affiliation(s)
- Ye Seul Choi
- Department of Food and Nutrition, Hanyang University, 17 Haengdang-dong, Seongdong-gu, Seoul 133-791, Republic of Korea
| | - Ji-Soo Lee
- Department of Food and Nutrition, Hanyang University, 17 Haengdang-dong, Seongdong-gu, Seoul 133-791, Republic of Korea
| | - Hyeon Gyu Lee
- Department of Food and Nutrition, Hanyang University, 17 Haengdang-dong, Seongdong-gu, Seoul 133-791, Republic of Korea
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Pandiyan I, Rathinavelu PK, Arumugham MI, D S, Balasubramaniam A. Efficacy of Chitosan and Chlorhexidine Mouthwash on Dental Plaque and Gingival Inflammation: A Systematic Review. Cureus 2022; 14:e23318. [PMID: 35464533 PMCID: PMC9014838 DOI: 10.7759/cureus.23318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2022] [Indexed: 11/14/2022] Open
Abstract
Mouthwash is the effective chemical plaque control mechanism being practiced globally. Teeth and tongue discoloration, a temporary change in taste perception, an increase in calculus deposits, a burning sensation, and genotoxicity of buccal epithelial cells are all possible side effects. This review evaluates the efficacy of chitosan mouthwash in comparison to chlorhexidine mouthwash in combating plaque accumulation and gingival inflammation. Electronic databases such as Medline, Cochrane, LILACS, TRIP, Google scholar, and clinical trial registries (CTRI) for ongoing trials were searched with appropriate medical subheadings (MeSH) and search terms. Randomized clinical trials comparing the efficacy of chitosan mouthwash and chlorhexidine mouthwash on dental plaque accumulation and gingivitis were included. The outcome variables of interest were plaque index, gingival index, gingival bleeding index, and colony-forming unit (CFU/ml). All data from the included studies were extracted in a customized extraction sheet. The risk of bias across the studies was assessed using the Cochrane tool for intervention (ROB-2), which consisted of six domains. Of the included three studies, we found one study with an overall low risk of bias and two studies with an overall high risk of bias across the domains. Though there was a significant reduction in plaque accumulation, gingival inflammation, and colony-forming units on the use of chitosan mouthwash and chlorhexidine mouthwash separately, all three included studies reported that a combination of both be more effective.
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Li B, Shi L, Liu R, Li Z, Cao S, Li J. A lingering mouthwash with sustained antibiotic release and biofilm eradication for periodontitis. J Mater Chem B 2021; 9:8694-8707. [PMID: 34622266 DOI: 10.1039/d1tb01742j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Dental plaque biofilms are believed to be one of the principal virulence factors in periodontitis resulting in tooth loss. Traditional mouthwashes are limited due to the continuous flow of saliva and poor drug penetration ability in the biofilm. Herein, we fabricated an antibiotic delivery platform based on natural polysaccharides (chitosan and cyclodextrin) as a novel mouthwash for the topical cavity delivery of minocycline. The penetration and residence mechanisms demonstrate that the platform can prolong the residence time up to 12 h on biofilms. Furthermore, sustained release can enhance the penetration of drugs into biofilms. In vitro antibiofilm experimental results indicated that the mouthwash effectively kills bacteria and eradicate biofilms. Effective treatment in vivo was confirmed by the significantly reduced dental plaque and alleviated inflammation observed in a rat periodontitis model. In summary, this novel platform can improve antibiofilm efficiency and prevent drugs from being washed away by saliva, which may provide benefits for many oral infectious diseases.
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Affiliation(s)
- Bohua Li
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China.
| | - Liuqi Shi
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China. .,School of Material Science and Engineering, Zhengzhou University, Zhengzhou 450001, China
| | - Ruixing Liu
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China.
| | - Zhanrong Li
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China.
| | - Shaokui Cao
- School of Material Science and Engineering, Zhengzhou University, Zhengzhou 450001, China
| | - Jingguo Li
- Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou 450003, China. .,School of Material Science and Engineering, Zhengzhou University, Zhengzhou 450001, China
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Park OJ, Kwon Y, Park C, So YJ, Park TH, Jeong S, Im J, Yun CH, Han SH. Streptococcus gordonii: Pathogenesis and Host Response to Its Cell Wall Components. Microorganisms 2020; 8:microorganisms8121852. [PMID: 33255499 PMCID: PMC7761167 DOI: 10.3390/microorganisms8121852] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/23/2020] [Accepted: 11/23/2020] [Indexed: 02/08/2023] Open
Abstract
Streptococcus gordonii, a Gram-positive bacterium, is a commensal bacterium that is commonly found in the skin, oral cavity, and intestine. It is also known as an opportunistic pathogen that can cause local or systemic diseases, such as apical periodontitis and infective endocarditis. S. gordonii, an early colonizer, easily attaches to host tissues, including tooth surfaces and heart valves, forming biofilms. S. gordonii penetrates into root canals and blood streams, subsequently interacting with various host immune and non-immune cells. The cell wall components of S. gordonii, which include lipoteichoic acids, lipoproteins, serine-rich repeat adhesins, peptidoglycans, and cell wall proteins, are recognizable by individual host receptors. They are involved in virulence and immunoregulatory processes causing host inflammatory responses. Therefore, S.gordonii cell wall components act as virulence factors that often progressively develop diseases through overwhelming host responses. This review provides an overview of S. gordonii, and how its cell wall components could contribute to the pathogenesis and development of therapeutic strategies.
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Affiliation(s)
- Ok-Jin Park
- Department of Oral Microbiology and Immunology, School of Dentistry, Dental Research Institute, Seoul National University, Seoul 08826, Korea; (O.-J.P.); (Y.K.); (C.P.); (Y.J.S.); (T.H.P.); (S.J.); (J.I.)
| | - Yeongkag Kwon
- Department of Oral Microbiology and Immunology, School of Dentistry, Dental Research Institute, Seoul National University, Seoul 08826, Korea; (O.-J.P.); (Y.K.); (C.P.); (Y.J.S.); (T.H.P.); (S.J.); (J.I.)
| | - Chaeyeon Park
- Department of Oral Microbiology and Immunology, School of Dentistry, Dental Research Institute, Seoul National University, Seoul 08826, Korea; (O.-J.P.); (Y.K.); (C.P.); (Y.J.S.); (T.H.P.); (S.J.); (J.I.)
| | - Yoon Ju So
- Department of Oral Microbiology and Immunology, School of Dentistry, Dental Research Institute, Seoul National University, Seoul 08826, Korea; (O.-J.P.); (Y.K.); (C.P.); (Y.J.S.); (T.H.P.); (S.J.); (J.I.)
| | - Tae Hwan Park
- Department of Oral Microbiology and Immunology, School of Dentistry, Dental Research Institute, Seoul National University, Seoul 08826, Korea; (O.-J.P.); (Y.K.); (C.P.); (Y.J.S.); (T.H.P.); (S.J.); (J.I.)
| | - Sungho Jeong
- Department of Oral Microbiology and Immunology, School of Dentistry, Dental Research Institute, Seoul National University, Seoul 08826, Korea; (O.-J.P.); (Y.K.); (C.P.); (Y.J.S.); (T.H.P.); (S.J.); (J.I.)
| | - Jintaek Im
- Department of Oral Microbiology and Immunology, School of Dentistry, Dental Research Institute, Seoul National University, Seoul 08826, Korea; (O.-J.P.); (Y.K.); (C.P.); (Y.J.S.); (T.H.P.); (S.J.); (J.I.)
| | - Cheol-Heui Yun
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul 08826, Korea;
- Institute of Green Bio Science Technology, Seoul National University, Pyeongchang 25354, Korea
| | - Seung Hyun Han
- Department of Oral Microbiology and Immunology, School of Dentistry, Dental Research Institute, Seoul National University, Seoul 08826, Korea; (O.-J.P.); (Y.K.); (C.P.); (Y.J.S.); (T.H.P.); (S.J.); (J.I.)
- Correspondence: ; Tel.: +82-2-880-2310
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Lee JS, Choi YS, Lee HG. Synergistic antimicrobial properties of nanoencapsulated clove oil and thymol against oral bacteria. Food Sci Biotechnol 2020; 29:1597-1604. [PMID: 33088608 PMCID: PMC7561649 DOI: 10.1007/s10068-020-00803-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 07/02/2020] [Accepted: 07/29/2020] [Indexed: 12/14/2022] Open
Abstract
This study aimed to improve the antimicrobial activity of natural extracts against oral bacteria by synergistic combination and nanoencapsulation. Among five natural antimicrobials: clove oil, thymol, naringin, naringenin, and licorice, clove oil and thymol were selected by comparing the antimicrobial activities against Streptococcus mutans and Streptococcus sobrinus before and after nanoencapsulation. The combination of clove oil and thymol (CLTY) was nanoencapsulated using chitosan and poly-γ-glutamic acid. While free CLTY showed additive and synergistic antimicrobial activity against S. mutans and S. sobrinus, respectively, CLTY nanoparticles (NPs) exhibited synergistic activity against both strains in a time-kill kinetic assay. CLTY NPs significantly decreased the growth of salivary S. mutans during testing, compared with free CLTY in the mouth rinse test. These results indicate that nanoencapsulation can significantly increase the synergistic antimicrobial activity of CLTY and maintain its antimicrobial activity in oral cavities for a longer time.
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Affiliation(s)
- Ji-Soo Lee
- Department of Food and Nutrition, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul, 133-791 Republic of Korea
| | - Ye Seul Choi
- Department of Food and Nutrition, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul, 133-791 Republic of Korea
| | - Hyeon Gyu Lee
- Department of Food and Nutrition, Hanyang University, 17 Haengdang-dong, Sungdong-gu, Seoul, 133-791 Republic of Korea
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Effect of mixed chlorhexidine and hydrogen peroxide mouthrinses on developing plaque and stain in gingivitis patients: a randomized clinical trial. Clin Oral Investig 2020; 25:1697-1704. [PMID: 32757075 DOI: 10.1007/s00784-020-03470-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/24/2020] [Indexed: 10/23/2022]
Abstract
AIMS To evaluate the effects of mixed chlorhexidine (CHX)/hydrogen peroxide (H2O2) mouthrinses compared with CHX mouthrinse alone on plaque, tooth stain, and gingivitis. MATERIALS AND METHODS This study was a double-blind, randomized two group parallel experiment, using a 14-day non-brushing half-mouth model. The test group was randomly assigned to the mixed 0.12% CHX and 1.5% H2O2 mouthrinse, whereas the control group used 0.12% CHX. Sixty healthy volunteers were enrolled in the study and received scaling and polishing 2 weeks prior to the experiment and then rinsed with the allocated mouthrinses twice daily for 2 weeks. The plaque, stain, and gingivitis scores were evaluated and recorded by a calibrated investigator. RESULTS Fifty-two subjects completed the study (CHX + H2O2n = 25/CHX n = 27). There were significant differences between the control and test groups for plaque index (CHX 0.64 ± 0.41 vs. CHX + H2O2 0.46 ± 0.36, p = 0.035) and stain intensity at proximal areas (CHX 0.26 ± 0.36 vs. CHX + H2O2 0.09 ± 0.14, p = 0.019) at the end of the experimental non-brushing side. However, the gingival indices did not differ significantly (CHX 0.61 ± 0.34 vs. CHX + H2O2 0.62 ± 0.31, p = 0.938) between groups. CONCLUSIONS In the absence of oral hygiene practice, the mixed CHX + H2O2 mouthrinse was slightly superior in reducing plaque scores and stain compared with CHX alone. CLINICAL RELEVANCE The clinical effectiveness of CHX + H2O2 is comparable with CHX mouthwash alone. Therefore, the use of the mixed mouthrinse is beneficial compared with CHX for minimizing biofilm and tooth staining.
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Effectiveness of Different Commercial Chlorhexidine-Based Mouthwashes After Periodontal and Implant Surgery: A Systematic Review. IMPLANT DENT 2019; 28:74-85. [PMID: 30648980 DOI: 10.1097/id.0000000000000854] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The aim of the present study was to review the effectiveness, side effects, and patient acceptance of different concentrations and formulation of chlorhexidine-based mouthwashes used after periodontal and implant surgery. MATERIALS AND METHODS The PRISMA guideline was adopted in the search strategy using electronic databases PubMed and MEDLINE to identify randomized and case-control prospective studies on humans written in English language and published up to September 2017. RESULTS A total of 10 articles were selected for a total of 344 patients. Because of the significant heterogeneity of the outcome measures, meta-analysis was not performed, and the data were summarized in a table. A positive relationship between the use of chlorhexidine and reduction of plaque was found, demonstrating the effectiveness of the substance in terms of antisepsis and decrease of inflammation after periodontal and implant surgery. CONCLUSION Chlorhexidine is recognized as the primary agent for plaque control and the gold standard in preventing infection, although the presence of largely known side effects would affect patient compliance. Future research should be directed at finding chlorhexidine formulation with negligible adverse effects, without compromising or even increasing its effectiveness as the antiseptics and antiplaque agent.
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Daood U, Burrow MF, Yiu CKY. Effect of a novel quaternary ammonium silane cavity disinfectant on cariogenic biofilm formation. Clin Oral Investig 2019; 24:649-661. [PMID: 31115692 DOI: 10.1007/s00784-019-02928-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Accepted: 04/30/2019] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Evaluate effect of quaternary ammonium silane (QAS) cavity disinfectant on cariogenic biofilm. MATERIALS AND METHODS Single- (Streptococcus mutans or Lactobacillus acidophilus), dual- (Streptococcus mutans/Lactobacillus Acidophilus), and multi-species (Streptococcus mutans, Actinomyces naeslundii, and Streptococcus sanguis) biofilms were grown on acid-etched dentine discs. Biofilms were incubated (120 min/37 °C) and allowed to grow for 3 days anaerobically. Discs (no treatment) served as control (group 1). Groups II, III, IV, and V were then treated with 2% chlorhexidine, and 2%, 5%, and 10% QAS (20 s). Discs were returned to well plates with 300 μL of bacterial suspension and placed in anaerobic incubator at 37 °C and biofilms redeveloped for 4 days. Confocal microscopy, Raman, CFU, and MTT assay were performed. RESULTS Raman peaks show shifts at 1450 cm-1, 1453 cm-1, 1457 cm-1, 1460 cm-1, and 1462 cm-1 for control, 2% CHX, 2%, 5%, and 10% QAS groups in multi-species biofilms. There was reduction of 484 cm-1 band in 10% QAS group. CLSM revealed densely clustered green colonies in control group and red confluent QAS-treated biofilms with significantly lower log CFU for single/dual species. Metabolic activities of Streptococcus mutans and Lactobacillus acidophilus decreased with increasing QAS exposure time. CONCLUSION Quaternary ammonium silanes possess antimicrobial activities and inhibit growth of cariogenic biofilms. CLINICAL SIGNIFICANCE Available data demonstrated use of QAS as potential antibacterial cavity disinfectant in adhesive dentistry. Experimental QAS can effectively eliminate caries-forming bacteria, when used inside a prepared cavity, and can definitely overcome problems associated with present available cavity disinfectants.
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Affiliation(s)
- U Daood
- Clinical Dentistry, Restorative Division, Faculty of Dentistry, International Medical University Kuala Lumpur, 126, Jalan Jalil Perkasa 19, Bukit Jalil, Bukit Jalil, Wilayah Persekutuan, 57000, Kuala Lumpur, Malaysia.
| | - M F Burrow
- Prosthodontic Dentistry, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Pokfulam, Hong Kong, SAR, China
| | - C K Y Yiu
- Paediatric Dentistry and Orthodontics, Faculty of Dentistry, The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Pokfulam, Hong Kong, SAR, China
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Xie SX, Boone K, VanOosten SK, Yuca E, Song L, Ge X, Ye Q, Spencer P, Tamerler C. Peptide Mediated Antimicrobial Dental Adhesive System. APPLIED SCIENCES (BASEL, SWITZERLAND) 2019; 9:557. [PMID: 33542835 PMCID: PMC7857482 DOI: 10.3390/app9030557] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The most common cause for dental composite failures is secondary caries due to invasive bacterial colonization of the adhesive/dentin (a/d) interface. Innate material weakness often lead to an insufficient seal between the adhesive and dentin. Consequently, bacterial by-products invade the porous a/d interface leading to material degradation and dental caries. Current approaches to achieve antibacterial properties in these materials continue to raise concerns regarding hypersensitivity and antibiotic resistance. Herein, we have developed a multi-faceted, bio-functionalized approach to overcome the vulnerability of such interfaces. An antimicrobial adhesive formulation was designed using a combination of antimicrobial peptide and a ε-polylysine resin system. Effector molecules boasting innate immunity are brought together with a biopolymer offering a two-fold biomimetic design approach. The selection of ε-polylysine was inspired due to its non-toxic nature and common use as food preservative. Biomolecular characterization and functional activity of our engineered dental adhesive formulation were assessed and the combinatorial formulation demonstrated significant antimicrobial activity against Streptococcus mutans. Our antimicrobial peptide-hydrophilic adhesive hybrid system design offers advanced, biofunctional properties at the critical a/d interface.
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Affiliation(s)
- Sheng-Xue Xie
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
| | - Kyle Boone
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
- Bioengineering Program, 1530 W. 15th St., University of Kansas, Lawrence, KS 66045, USA
| | - Sarah Kay VanOosten
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
- Bioengineering Program, 1530 W. 15th St., University of Kansas, Lawrence, KS 66045, USA
| | - Esra Yuca
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
- Department of Molecular Biology and Genetics, Yildiz Technical University, 34210 Istanbul, Turkey
| | - Linyong Song
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
| | - Xueping Ge
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
| | - Qiang Ye
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
| | - Paulette Spencer
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
- Bioengineering Program, 1530 W. 15th St., University of Kansas, Lawrence, KS 66045, USA
- Department of Mechanical Engineering, 1530 W. 15th St., University of Kansas, Lawrence, KS 66045, USA
| | - Candan Tamerler
- Institute for Bioengineering Research, University of Kansas, 1530 W. 15th St., Lawrence, KS 66045, USA
- Bioengineering Program, 1530 W. 15th St., University of Kansas, Lawrence, KS 66045, USA
- Department of Mechanical Engineering, 1530 W. 15th St., University of Kansas, Lawrence, KS 66045, USA
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13
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Albuquerque YE, Danelon M, Salvador MJ, Koga-Ito CY, Botazzo Delbem AC, Ramirez-Rueda RY, Lacerda Gontijo AV, Brighenti FL. Mouthwash containing Croton doctoris essential oil: in vitro study using a validated model of caries induction. Future Microbiol 2018; 13:631-643. [DOI: 10.2217/fmb-2017-0209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Aim: To validate an in vitro caries model and to evaluate an experimental mouthwash containing Croton doctoris essential oil. Materials & methods: To validate the experimental model, we used McBain medium and polymicrobial biofilms. The EOM (essential oil mouthwash) was tested using the validated model. Microbial composition (colony-forming unit/ml), acidogenicity, enamel demineralization (percentage of surface enamel hardness loss), cytotoxicity and essential oil composition were evaluated. Results: The model was validated with 0.5% sucrose, duration of 4 days and treatments twice per day. There were statistically significant differences between the EOM, the negative control and chlorhexidine mouthwash in colony-forming unit/ml and percentage of surface enamel hardness loss. Cytotoxicity was similar to that of chlorhexidine mouthwash. A total of 66.11% of the essential oil consists of sesquiterpenes. Conclusion: The experimental mouthwash showed antimicrobial activity against polymicrobial biofilms and reduced enamel demineralization.
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Affiliation(s)
- Yasmin Etienne Albuquerque
- Faculdade de Odontologia, Universidade Estadual Paulista (UNESP), Campus de Araraquara. R Humaitá, 1680, Araraquara – SP 14801-903, Brazil
| | - Marcelle Danelon
- Faculdade de Odontologia, Universidade Estadual Paulista (UNESP), Campus de Araçatuba. R José Bonifácio, 1193, Araçatuba – SP 16015-050, Brazil
| | - Marcos José Salvador
- Department of Plant Biology, PPG BTPB and PPG BV, Institute of Biology, University of Campinas - UNICAMP, Postal box 6109, Campinas – SP 13083-970, Brazil
| | - Cristiane Yumi Koga-Ito
- Instituto de Ciência e Tecnologia, Universidade Estadual Paulista (UNESP), Campus de São José dos Campos Av Eng Francisco José Longo, 777, São José dos Campos – SP 12245-000, Brazil
| | - Alberto Carlos Botazzo Delbem
- Faculdade de Odontologia, Universidade Estadual Paulista (UNESP), Campus de Araçatuba. R José Bonifácio, 1193, Araçatuba – SP 16015-050, Brazil
| | - Román Yesid Ramirez-Rueda
- Department of Plant Biology, PPG BTPB and PPG BV, Institute of Biology, University of Campinas - UNICAMP, Postal box 6109, Campinas – SP 13083-970, Brazil
| | - Aline Vidal Lacerda Gontijo
- Department of Plant Biology, PPG BTPB and PPG BV, Institute of Biology, University of Campinas - UNICAMP, Postal box 6109, Campinas – SP 13083-970, Brazil
| | - Fernanda Lourenção Brighenti
- Faculdade de Odontologia, Universidade Estadual Paulista (UNESP), Campus de Araraquara. R Humaitá, 1680, Araraquara – SP 14801-903, Brazil
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14
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Lee KY, Cha SM, Choi SM, Cha JD. Antibacterial and synergistic effects of the n-BuOH fraction of Sophora flavescens root against oral bacteria. J Oral Sci 2018; 59:77-86. [PMID: 28367902 DOI: 10.2334/josnusd.16-0151] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The antibacterial activity of an extract and several fractions of Sophora flavescens (S. flavescens) root alone and in combination with antibiotics against oral bacteria was investigated by checkerboard assay and time-kill assay. The minimum inhibitory concentration/minimum bactericidal concentration (MIC/MBC) values for all examined bacteria were 0.313-2.5/0.625-2.5 μg/mL for the n-BuOH fraction, 0.625-5/1.25-10 μg/mL for the EtOAc fraction, 0.25-8/0.25-16 μg/mL for ampicillin, 0.5-256/1-512 μg/mL for gentamicin, 0.008-32/0.016-64 μg/mL for erythromycin, and 0.25-64/0.5-128 μg/mL for vancomycin. The n-butanol (n-BuOH) and ethyl acetate (EtOAc) fractions exhibited stronger antibacterial activity against oral bacteria than other fractions and extracts. The MICs and MBCs were reduced to between one half and one quarter when the n-BuOH and EtOAc fractions were combined with antibiotics. After 24 h of incubation, combination of 1/2 MIC of the n-BuOH fraction with antibiotics increased the degree of bactericidal activity. The present results suggest that n-BuOH and EtOAc extracts of S. flavescens root might be applicable as new natural antimicrobial agents against oral pathogens.
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Affiliation(s)
- Kyung-Yeol Lee
- Department of Oral Microbiology, School of Dentistry, Chonbuk National University
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15
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Vandana K, Reddy VC, Sudhir KM, Kumar K, Raju SH, Babu JN. Effectiveness of stevia as a mouthrinse among 12-15-year-old schoolchildren in Nellore district, Andhra Pradesh - A randomized controlled trial. J Indian Soc Periodontol 2018; 21:37-43. [PMID: 29386799 PMCID: PMC5767988 DOI: 10.4103/jisp.jisp_54_17] [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: 11/04/2022] Open
Abstract
Aim The aim of this study is to determine the effectiveness of stevia as a daily mouthrinse among 12-15 year-old schoolchildren in Nellore District, Andhra Pradesh. Materials and Methods A randomized, controlled triple blind trial was carried out among 108 children in B. V. S Municipallity Girls High school in Nellore. Children were randomly allocated into four groups comprising 27 in each group. Four mouthrinses composed of 0.2% chlorhexidine gluconate; 0.05% sodium fluoride, 10.6% stevioside and placebo were provided to the study participants. Plaque index, gingival index, and International Caries Detection and Assessment System (ICDAS) II, respectively, were used for assessing oral condition. The mouthrinsing was carried out for 6 months. Results Group C showed maximum reduction of 8% and 10% on plaque and gingival scores, respectively, followed by Group A and Group B. However, Group D participants showed 1.5% and 1.8% increase in plaque and gingival scores, respectively. Analysis of ICDAS scores at 6 months indicated that values recorded were same as baseline for all the three groups except that for Group D, there was an increase in the prevalence of cavitated lesion D2-6from 5.6% to 5.8%. Conclusion Stevia demonstrated very potent antiplaque and antigingivitis properties as compared to other mouthrinses at the end of 6 months trial.
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Affiliation(s)
- Kuna Vandana
- Department of Public Health Dentistry, Dr. Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannavaram, Andhra Pradesh, India
| | | | - Kudlur Maheswarappa Sudhir
- Department of Public Health Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Krishna Kumar
- Department of Public Health Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Saraswathi Harikrishnam Raju
- Department of Public Health Dentistry, GSL Dental College, Gannavaram, Andhra Pradesh, India.,Department of Orthopaedics, Pinnamaneni Siddhartha Institute of Medical Sciences, Gannavaram, Andhra Pradesh, India
| | - Javvaji Narendra Babu
- Department of Public Health Dentistry, GSL Dental College, Gannavaram, Andhra Pradesh, India.,Department of Orthopaedics, Pinnamaneni Siddhartha Institute of Medical Sciences, Gannavaram, Andhra Pradesh, India
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16
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Yang L, Wang X, Suchyta DJ, Schoenfisch MH. Antibacterial Activity of Nitric Oxide-Releasing Hyperbranched Polyamidoamines. Bioconjug Chem 2018; 29:35-43. [PMID: 29243926 PMCID: PMC6773256 DOI: 10.1021/acs.bioconjchem.7b00537] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Hyperbranched polyamidoamines (h-PAMAM) were prepared using a one-pot reaction to have similar molecular weight to third generation PAMAM (G3-PAMAM) dendrimers, and then functionalized with N-diazeniumdiolate nitric oxide (NO) donors. A wide range of NO storage capacities (∼1-2.50 μmol mg-1) and NO-release kinetics (t1/2 ∼30-80 min) were achieved by changing the extent of propylene oxide (PO) modification. The therapeutic potential of these materials was evaluated by studying their antibacterial activities and toxicity against common dental pathogens and human gingival fibroblast cells, respectively. Our results indicate that the combination of NO release and PO modification is necessary to yield h-PAMAM materials with efficient bactericidal action without eliciting unwarranted cytotoxicity. Of importance, NO-releasing PO-modified h-PAMAM polymers exhibited comparable biological properties (i.e., antibacterial action and cytotoxicity) to defect-free G3-PAMAM dendrimers, but at a substantially lower synthetic burden.
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Affiliation(s)
- Lei Yang
- Department of Chemistry, University of North Carolina – Chapel Hill, Chapel Hill, NC 27599
| | - Xingzhi Wang
- Department of Chemistry, University of North Carolina – Chapel Hill, Chapel Hill, NC 27599
| | - Dakota J. Suchyta
- Department of Chemistry, University of North Carolina – Chapel Hill, Chapel Hill, NC 27599
| | - Mark H. Schoenfisch
- Department of Chemistry, University of North Carolina – Chapel Hill, Chapel Hill, NC 27599
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17
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Mhaske SP, Ambiti R, Jagga U, Paul U, Shanmukappa SM, Iska D. Clinicomicrobiological Evaluation of 2% Chitosan Mouthwashes on Dental Plaque. J Contemp Dent Pract 2018; 19:94-97. [PMID: 29358542 DOI: 10.5005/jp-journals-10024-2218] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIM This study was conducted to evaluate microbiological and clinical effects of a chitosan chlorhexidine (CH) mouthrinse on plaque control. MATERIALS AND METHODS Subjects were divided into three groups. Group I included 15 subjects who used 0.2% chlorhexidine digluconate (CHX), group II included 15 subjects who used 2% chitosan (CH) solution, and group III involves 15 subjects who used 0.2% chlorhexidine/2% CH combination. Plaque index (PI), gingival index (GI), and probing depth (PD) were recorded at the baseline, on day 0, and after 4 days. Supragingival plaque samples were subjected for microbiological evaluation. Statistical analysis was done using statistical software IBM Statistical Package for the Social Sciences (SPSS), version 21. RESULTS Plaque index was lowest in group I at day 0, while it was highest in group III. At day 4, PI was highest in group II, while lowest in group III. Gingival index was lowest in group I and highest in group II at day 0, and lowest in group I and highest in group III at day 4. There was no statistical difference in Streptococcus mutans (S. mutans) count between groups at any time interval. CONCLUSION Both chitosan and CH were found to be effective in controlling plaque. However, a combination of both provides even better results. CLINICAL SIGNIFICANCE The present study showed that chitosan can be used as an antiplaque agent.
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Affiliation(s)
- Sheetal P Mhaske
- Department of Oral Pathology and Microbiology, M.A. Rangoonwala College of Dental Sciences & Research Centre Pune, Maharashtra, India, e-mail:
| | - Rajesh Ambiti
- Department of Periodontology, Pacific Dental College, Udaipur Rajasthan, India
| | - Umang Jagga
- Department of Pediatric and Preventive Dentistry, Sri Sukhmani Dental College & Hospital, Dera Bassi, Punjab, India
| | - Uttam Paul
- Private Practitioner, Department of Conservative Dentistry and Endodontics, Precision Dental Clinic & Implant Centre, Guwahati Assam, India
| | - Shruthi M Shanmukappa
- Department of Periodontology, Subbaiah Institute of Dental Sciences, Shimoga, Karnataka, India
| | - Divya Iska
- Department of Orthodontics, Sri Ramachandra Dental College and Hospital, Chennai, Tamil Nadu, India
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18
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Haydari M, Bardakci AG, Koldsland OC, Aass AM, Sandvik L, Preus HR. Comparing the effect of 0.06% -, 0.12% and 0.2% Chlorhexidine on plaque, bleeding and side effects in an experimental gingivitis model: a parallel group, double masked randomized clinical trial. BMC Oral Health 2017; 17:118. [PMID: 28821290 PMCID: PMC5562977 DOI: 10.1186/s12903-017-0400-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 07/04/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Chlorhexidine is the gold standard of dental plaque prevention. The aim of the present study was to compare the plaque and gingivitis inhibiting effect of commercial products containing 0.2%, 0.12% and 0.06% chlorhexidine in a modified experimental gingivitis model. METHODS In three groups of healthy volunteers, experimental gingivitis was induced and monitored over 21 days and simultaneously treated with the commercial solutions containing 0.2%, 0.12% and 0.06% chlorhexidine. The maxillary right quadrant of each individual received mouthwash only, whereas the maxillary left quadrant was subject to both rinsing and mechanical oral hygiene. Compliance and side effects were monitored at days 7, 14, and 21. Plaque and gingivitis scores were obtained at baseline and day 21. RESULTS The commercial mouthwash containing 0.2% chlorhexidine resulted in statistically significantly lower plaque scores than the 0.12 and 0.06% mouthwashes after 21 days use, whereas no statistically significant difference was found between the effects of the two latter. CONCLUSION A commercially available mouthwash containing 0.2% chlorhexidine had statistically significant better effect in preventing dental plaque than the 0.12% and 0.06% solutions. TRIAL REGISTRATION ClinicalTrials.gov NCT02911766 . Registration date: September 9th 2016.
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Affiliation(s)
- Maliha Haydari
- Department of Periodontology, Institute of Clinical Odontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Ayse Gul Bardakci
- Department of Periodontology, Institute of Clinical Odontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Odd Carsten Koldsland
- Department of Periodontology, Institute of Clinical Odontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Anne Merete Aass
- Department of Periodontology, Institute of Clinical Odontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Leiv Sandvik
- Department of Periodontology, Institute of Clinical Odontology, Faculty of Dentistry, University of Oslo, Oslo, Norway
| | - Hans R Preus
- Department of Periodontology, Institute of Clinical Odontology, Faculty of Dentistry, University of Oslo, Oslo, Norway.
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19
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Santos GOD, Milanesi FC, Greggianin BF, Fernandes MI, Oppermann RV, Weidlich P. Chlorhexidine with or without alcohol against biofilm formation: efficacy, adverse events and taste preference. Braz Oral Res 2017; 31:e32. [PMID: 28513784 DOI: 10.1590/1807-3107bor-2017.vol31.0032] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 03/24/2017] [Indexed: 11/22/2022] Open
Abstract
In recent years, different chlorhexidine formulations have been tested, including an alcohol-free alternative, but the effect of this solution on early biofilm formation is not clear. A crossover, randomized, double-blind clinical trial was conducted to evaluate the effect of two chlorhexidine solutions against supra- and subgingival biofilm formation (NCT#02656251). Thirty-five participants were randomized and asked to rinse twice daily with 15 ml of an alcohol-containing 0.12% chlorhexidine solution, an alcohol-free 0.12% chlorhexidine solution, or placebo. The study was conducted in three experimental periods of 4 days each, with a 10-day washout between the periods. All the experimental periods followed the same protocol, except that the solutions were switched. Biofilm distribution was evaluated every 24 hours by the Plaque-Free Zone Index, during 96 hours. Adverse events were self-reported and sensory evaluation was performed using a hedonic scale. Compared to the placebo, the chlorhexidine solutions resulted in a significantly higher number of surfaces free of plaque over 96 hours (p < 0.01), and were able to prevent subgingival biofilm formation (p < 0.01). The alcohol-free chlorhexidine solution was associated with a lower incidence of adverse events, compared with alcohol-containing chlorhexidine (p < 0.05); it also received better sensory evaluation and acceptance by trial participants, compared with the alcohol-containing chlorhexidine (p = 0.007), and had a similar inhibitory effect on the formation of supra- and subgingival biofilms.
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Affiliation(s)
- Gabriela Otero Dos Santos
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Fernanda Carpes Milanesi
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Bruna Frizon Greggianin
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Marilene Issa Fernandes
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Rui Vicente Oppermann
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre, RS, Brazil
| | - Patricia Weidlich
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Periodontology, Porto Alegre, RS, Brazil
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Tartaglia GM, Kumar S, Fornari CD, Corti E, Connelly ST. Mouthwashes in the 21 st century: a narrative review about active molecules and effectiveness on the periodontal outcomes. Expert Opin Drug Deliv 2016; 14:973-982. [PMID: 27835926 DOI: 10.1080/17425247.2017.1260118] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Poor oral hygiene is a major risk factor for oral diseases. Regular home-based care is essential to maintain good oral hygiene. In particular, mouthrinses can support conventional tooth brushing in reducing accumulation of oral plaque. Areas covered: The most common molecules contained in mouthrinses (chlorhexidine, essential oils, cetyl pyridinium chloride, triclosan, octeneidine, delmopinol, polyvinylpyrrolidone, hyaluronic acid, natural compounds) are discussed, together with relevant clinical and in vitro studies, focusing on their effects on periodontal health. Currently, chlorhexidine is the most efficacious compound, with both antiplaque and antibacterial activities. Similar results are reported for essential oils and cetyl pyridinium chloride, although with a somewhat reduced efficacy. Considering the adverse effects of chlorhexidine and its time-related characteristics, this molecule may best be indicated for acute/short-term use, while essential oils and cetyl pyridinium chloride may be appropriate for long-term, maintenance treatment. Expert opinion: The literature has not clearly demonstrated which compound is the best for mouthrinses that combine good efficacy and acceptable side effects. Research should focus on substances with progressive antibacterial activity, prompting a gradual change in the composition of oral biofilm and mouthrinses that combine two or more molecules acting synergistically in the mouth.
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Affiliation(s)
- Gianluca M Tartaglia
- a Department of Biomedical Sciences for Health, Functional Anatomy Research Center (FARC) , Università degli Studi di Milano , Milano , Italy.,b SST Dental Clinic , Segrate , Italy
| | - Santhosh Kumar
- c Population and Social Health Research Programme, Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University , Gold Coast , Australia
| | | | - Eleonora Corti
- d Department of Regulatory Affairs , Biokosmes srl , Bosisio Parini , Italy
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21
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Cantarelli R, Negrini TC, Muniz FW, Oballe HJ, Arthur RA, Rösing CK. Antimicrobial potential and gustatory perception of chlorhexidine gluconate mouthwashes with or without alcohol after a single rinse - a randomized controlled crossover clinical trial. Int J Dent Hyg 2016; 15:280-286. [DOI: 10.1111/idh.12255] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2016] [Indexed: 11/28/2022]
Affiliation(s)
- R Cantarelli
- Post-Graduate Program in Dentistry; Federal University Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - TC Negrini
- Department of Conservative Dentistry; Federal University Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - FW Muniz
- Post-Graduate Program in Dentistry; Federal University Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - HJ Oballe
- Post-Graduate Program in Dentistry; Federal University Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - RA Arthur
- Department of Preventive and Community Dentistry; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
| | - CK Rösing
- Department of Periodontology; Federal University of Rio Grande do Sul; Porto Alegre Rio Grande do Sul Brazil
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22
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García-Gargallo M, Zurlohe M, Montero E, Alonso B, Serrano J, Sanz M, Herrera D. Evaluation of new chlorhexidine- and cetylpyridinium chloride-based mouthrinse formulations adjunctive to scaling and root planing: pilot study. Int J Dent Hyg 2016; 15:269-279. [PMID: 27762095 DOI: 10.1111/idh.12254] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To compare the effect of two newly formulated chlorhexidine (CHX) and cetylpyridinium chloride (CPC) mouthrinses after scaling and root planing (SRP) in terms of clinical, microbiological, patient-based variables and adverse events, with a positive control with the same active components, already marketed and tested. METHODS A pilot, randomized clinical trial, double-blind, parallel design with 1-month follow-up was conducted. Chronic periodontitis patients requiring non-surgical periodontal therapy were enrolled and randomly assigned to: (i) SRP and test-1 (new reformulation: 0.12% CHX and 0.05% CPC); (ii) SRP and test-2 (new formulation: 0.03% CHX and 0.05% CPC); or (iii) SRP and positive control (commercial product: 0.12% CHX and 0.05% CPC). All variables were evaluated at baseline and 1 month after SRP. Quantitative variables were compared by means of anova or Kruskal-Wallis test and qualitative variables by chi-square or McNemar tests. RESULTS Thirty patients (10 per group) were included. After 1 month, there were significant differences among groups in plaque levels (P = 0.016) as test-1 showed less sites with plaque than test-2 (31.15% [standard error-SE 2.21%] versus 49.39% [SE 4.60%), respectively). No significant differences were found for global patient perception of the product or in adverse effects. Test groups showed better results in levels and proportions (P = 0.022) of Capnocytophaga spp. CONCLUSIONS Within the limitations of this pilot study, it can be concluded that the newly formulated 0.12% CHX and 0.05% CPC mouthrinse showed larger plaque level reductions, without showing more adverse effects, when compared to the other two mouthrinses, after SRP.
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Affiliation(s)
- M García-Gargallo
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - M Zurlohe
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - E Montero
- Section of Graduate Periodontology, Faculty of Odontology, University Complutense, Madrid, Spain
| | - B Alonso
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, Faculty of Odontology, University Complutense, Madrid, Spain
| | - J Serrano
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, Faculty of Odontology, University Complutense, Madrid, Spain
| | - M Sanz
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, Faculty of Odontology, University Complutense, Madrid, Spain
| | - D Herrera
- Etiology and Therapy of Periodontal Diseases (ETEP) Research Group, Faculty of Odontology, University Complutense, Madrid, Spain
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Kadkhoda Z, Amarlu Z, Eshraghi S, Samiei N. Antimicrobial effect of chlorhexidine on Aggregatibacter actinomycetemcomitans biofilms associated with peri-implantitis. J Dent Res Dent Clin Dent Prospects 2016; 10:176-80. [PMID: 27651884 PMCID: PMC5025219 DOI: 10.15171/joddd.2016.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2015] [Accepted: 07/24/2016] [Indexed: 11/24/2022] Open
Abstract
Background. This study aimed to assessthe antimicrobial effect of chlorhexidine (CHX) on Aggregatibacter actinomycetemcomitans biofilms isolated from subgingival plaque of peri-implantitis lesions. Methods. Thirteen patients requiring peri-implantitis treatment were consecutively selected and their subgingival biofilm was collected by inserting fine sterile paper points into peri-implant pockets for 15 seconds. A. actinomycetemcomitans was isolated from the subgingival biofilm and cultured. In this study, the standard strain of A. actinomycetemcomitans served as the positive control group and a blank disc impregnated with water served as the negative control; 0.1 mL of the bacterial suspension was cultured on specific culture medium and blank discs (6 mm in diameter) impregnated with 0.2%CHX mouthrinse (Behsa Pharmaceutical Co.) and negative control discs were placed on two sides of the bacterial culture plate. The size of growth inhibition zone was measured by a blinded independent observer in millimetres. Results. According to the results of disc diffusion test, the mean diameter of growth inhibition zone of A. actinomycetemcomitans around discs impregnated with CHX was larger in both standard (positive control) and biofilm samples of A. actinomycetemcomitans compared to the negative control group (blank disc) (P<0.001). Conclusion. Use of0.2% CHX mouthwash had antibacterial effects on A. actinomycetemcomitans species isolated from peri-implantitis sites.
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Affiliation(s)
- Zeinab Kadkhoda
- Associate Professor, Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Saeed Eshraghi
- Associate Professor, Department of Pathobiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Samiei
- Postgraduate Student, Department of Periodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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Cytotoxicity of three commercial mouthrinses on extracellular matrix metabolism and human gingival cell behaviour. Toxicol In Vitro 2016; 34:88-96. [DOI: 10.1016/j.tiv.2016.03.015] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Revised: 03/14/2016] [Accepted: 03/25/2016] [Indexed: 11/19/2022]
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Abdulbaqi HR, Himratul-Aznita WH, Baharuddin NA. Anti-plaque effect of a synergistic combination of green tea and Salvadora persica L. against primary colonizers of dental plaque. Arch Oral Biol 2016; 70:117-124. [PMID: 27343694 DOI: 10.1016/j.archoralbio.2016.06.011] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 06/09/2016] [Accepted: 06/09/2016] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Green tea (Gt), leafs of Camellia sinensis var. assamica, is widely consumed as healthy beverage since thousands of years in Asian countries. Chewing sticks (miswak) of Salvadora persica L. (Sp) are traditionally used as natural brush to ensure oral health in developing countries. Both Gt and Sp extracts were reported to have anti-bacterial activity against many dental plaque bacteria. However, their combination has never been tested to have anti-bacterial and anti-adherence effect against primary dental plaque colonizers, playing an initial role in the dental plaque development, which was investigated in this study. METHODS Two-fold serial micro-dilution method was used to measure minimal inhibitory concentration (MIC) of aqueous extracts of Gt, Sp and their combinations. Adsorption to hexadecane was used to determine the cell surface hydrophobicity (CSH) of bacterial cells. Glass beads were used to mimic the hard tissue surfaces, and were coated with saliva to develop experimental pellicles for the adhesion of the primary colonizing bacteria. RESULTS Gt aqueous extracts exhibited better anti-plaque effect than Sp aqueous extracts. Their combination, equivalent to 1/4 and 1/2 of MIC values of Gt and Sp extracts respectively, showed synergistic anti-plaque properties with fractional inhibitory concentration (FIC) equal to 0.75. This combination was found to significantly reduce CSH (p<0.05) and lower the adherence ability (p<0.003) towards experimental pellicles. CONCLUSION Combination between Gt and Sp aqueous extracts exhibited synergistic anti-plaque activity, and could be used as a useful active agent to produce oral health care products.
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Affiliation(s)
- Hayder Raad Abdulbaqi
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia
| | - Wan Harun Himratul-Aznita
- Department of Oral and Craniofacial Sciences, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia.
| | - Nor Adinar Baharuddin
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, 50603 Kuala Lumpur, Malaysia
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Decker EM, Bartha V, Kopunic A, von Ohle C. Antimicrobial efficiency of mouthrinses versus and in combination with different photodynamic therapies on periodontal pathogens in an experimental study. J Periodontal Res 2016; 52:162-175. [PMID: 27038101 DOI: 10.1111/jre.12379] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND AND OBJECTIVE In the therapy of destructive periodontal disease, chemical antimicrobial agents and increasingly photodynamic therapy (PDT) play an important adjunctive role to standard mechanical anti-infective treatment procedures. However, both antiseptic methods have their shortcomings in terms of eliminating periodontal pathogens. The aim of the study was to compare the antibacterial efficacy of different antiseptic mouthrinses, of a conventional and a new, modified PDTplus as well as of the different antiseptic mouthrinses combined with either the conventional or the modified PDTplus against periopathogens. MATERIAL AND METHODS Six representative periodontitis-associated bacterial strains were grown for 24 h under anaerobic conditions. After mixing the individual cell pellets they were exposed to 10 different antiseptic mouthrinse formulations: chlorhexidine (0.2%, 0.06%, CHX); CHX + cetylpyridinium chloride (each 0.05%); sodium hypochlorite (0.05%); polyhexanide (0.04%, PHMB1; 0.1%, PHMB2); octenidine dihydrochloride (0.1%); fluoride (250 ppm); essential oils; povidone iodine (10%); and saline (0.9%, NaCl) as control. Furthermore, the bacteria were treated with conventional PDT based on light-emitting diodes and a new modified photodisinfection combining photosensitizer with hydrogen peroxide to PDTplus also based on light-emitting diodes. In addition to the single treatments, a combined application of antiseptic exposure followed by use of PDT or PDTplus was performed. The microbial viability was characterized by analyzing colony growth and fluorescence-based vitality proportions. RESULTS Nearly all mouthrinses caused a statistically significant growth inhibition. The most effective antiseptics, CHX (0.2%), CHX/cetylpyridinium chloride and octenidine dihydrochloride, inhibited bacterial growth completely. Conventional PDT resulted in moderate reduction of colony growth. The modified PDTplus achieved maximum antimicrobial effect. The combination of antiseptic exposure and PDT against periopathogens predominantly increased antibacterial efficacy compared to the single applications. The mouthrinse containing essential oil seemed to interfere with PDT. CONCLUSION A combination therapy of preceding chemotherapeutical exposure and subsequent photodisinfection may be a more effective and promising antibacterial treatment than single applications of the antiseptic methods. The modified PDTplus using oxygen-enriched toluidine showed a superior antibacterial effect on periodontal pathogens to conventional PDT and to the majority of the investigated mouthrinses.
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Affiliation(s)
- E-M Decker
- Department for Pediatric and Operative Dentistry, Periodontology and Endodontology, University of Tübingen, Center of Dentistry, Oral Medicine and Maxillofacial Surgery, Tuebingen, Germany
| | - V Bartha
- Department for Pediatric and Operative Dentistry, Periodontology and Endodontology, University of Tübingen, Center of Dentistry, Oral Medicine and Maxillofacial Surgery, Tuebingen, Germany
| | - A Kopunic
- Department for Pediatric and Operative Dentistry, Periodontology and Endodontology, University of Tübingen, Center of Dentistry, Oral Medicine and Maxillofacial Surgery, Tuebingen, Germany
| | - C von Ohle
- Department for Pediatric and Operative Dentistry, Periodontology and Endodontology, University of Tübingen, Center of Dentistry, Oral Medicine and Maxillofacial Surgery, Tuebingen, Germany
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Dhavan AA, Ionescu AC, Kaduskar RD, Brambilla E, Dallavalle S, Varoni EM, Iriti M. Antibacterial and antifungal activities of 2,3-pyrrolidinedione derivatives against oral pathogens. Bioorg Med Chem Lett 2016; 26:1376-80. [DOI: 10.1016/j.bmcl.2016.01.082] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 01/28/2016] [Accepted: 01/29/2016] [Indexed: 10/22/2022]
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Backlund CJ, Worley BV, Schoenfisch MH. Anti-biofilm action of nitric oxide-releasing alkyl-modified poly(amidoamine) dendrimers against Streptococcus mutans. Acta Biomater 2016; 29:198-205. [PMID: 26478472 PMCID: PMC4695967 DOI: 10.1016/j.actbio.2015.10.021] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 09/03/2015] [Accepted: 10/14/2015] [Indexed: 01/02/2023]
Abstract
The effect of nitric oxide (NO)-releasing dendrimer hydrophobicity on Streptococcus mutans killing and biofilm disruption was examined at pH 7.4 and 6.4, the latter relevant to dental caries. Generation 1 (G1) poly(amidoamine) (PAMAM) dendrimers were modified with alkyl epoxides to generate propyl-, butyl-, hexyl-, octyl-, and dodecyl-functionalized dendrimers. The resulting secondary amines were reacted with NO to form N-diazeniumdiolate NO donor-modified dendrimer scaffolds (total NO ∼1μmol/mg). The bactericidal action of the NO-releasing dendrimers against both planktonic and biofilm-based S. mutans proved greatest with increasing alkyl chain length and at lower pH. Improved bactericidal efficacy at pH 6.4 was attributed to increased scaffold surface charge that enhanced dendrimer-bacteria association and ensuing membrane damage. For shorter alkyl chain (i.e., propyl and butyl) dendrimer modifications, increased antibacterial action at pH 6.4 was due to faster NO-release kinetics from proton-labile N-diazeniumdiolate NO donors. Octyl- and dodecyl-modified PAMAM dendrimers proved most effective for eradicating S. mutans biofilms with NO release mitigating dendrimer scaffold cytotoxicity. STATEMENT OF SIGNIFICANCE We report the antibacterial and anti-biofilm efficacy of dual-action nitric oxide (NO)-releasing dendrimers against S. mutans, an etiological agent in dental caries. This work was undertaken to enhance the anti-biofilm action of these scaffolds by employing various alkyl chain modifications. Furthermore, we evaluated the ability of NO to eradicate cariogenic biofilms. We found that at the lower pH associated with dental caries (pH ∼6.4), NO has a more pronounced antibacterial effect for alkyl modifications less capable of biofilm penetration and membrane disruption. Of greatest significance, we introduce dendrimers as a new macromolecular antibacterial agent against the cariogenic bacteria S. mutans.
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Affiliation(s)
| | - Brittany V. Worley
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
| | - Mark H. Schoenfisch
- Department of Chemistry, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599
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Mor-Reinoso C, Pascual A, Nart J, Quirynen M. Inhibition of de novo plaque growth by a new 0.03 % chlorhexidine mouth rinse formulation applying a non-brushing model: a randomized, double blind clinical trial. Clin Oral Investig 2015; 20:1459-67. [PMID: 26475499 DOI: 10.1007/s00784-015-1625-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 09/30/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the plaque inhibitory effect of a new 0.03 % chlorhexidine digluconate (CHX) and 0.05 % cetylpyridinium chloride (CPC) mouthrinse formulation and to explore patients' experience and side effects after its use. MATERIALS AND METHODS This short-term, randomized, double blind, parallel, clinical trial enrolled 150 periodontally healthy patients. These volunteers were randomly allocated to one of following mouthrinse groups (n = 50/group): 0.12 % CHX + 0.05 % CPC (Perio-Aid® Treatment alcohol-free), 0.03 % CHX + 0.05 % CPC new test formulation or to the placebo group. Clinical parameters (plaque, gingival, and stain indexes) and microbiological samples were taken at baseline, before supragingival cleaning, and after 4 days of undisturbed plaque growth, rinsing twice/day with one of the mouthrinses. RESULTS Plaque reduction was similar for the 0.12 % CHX (-0.52 ± 0.55) and 0.03 % CHX (-0.47 ± 0.49) groups. Both showed significant reductions in plaque accumulation compared to the placebo (p < 0.001). The new formulation had less of a negative impact on taste perception when compared to the 0.12 % CHX solution. The new CHX mouthrinse was also able to control bacterial loads and reduce some periodontopathogens. CONCLUSIONS This study indicated that the new 0.03 % CHX + 0.05 % CPC formulation exerted clinical efficacy similar to that achieved by an already-marketed 0.12 % CHX + 0.05 % CPC mouthrinse, but with slightly fewer side effects. CLINICAL RELEVANCE Lower CHX mouthrinse formulations could be effective in the inhibition of plaque regrowth with reduced unpleasant subjective side effects.
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Affiliation(s)
- Carolina Mor-Reinoso
- Department of Periodontology, Hospital General de Catalunya, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, C.P. 08195, Sant Cugat del Vallès, Barcelona, Spain
| | - Andres Pascual
- Department of Periodontology, Hospital General de Catalunya, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, C.P. 08195, Sant Cugat del Vallès, Barcelona, Spain.
| | - Jose Nart
- Department of Periodontology, Hospital General de Catalunya, Universitat Internacional de Catalunya, C/ Josep Trueta s/n, C.P. 08195, Sant Cugat del Vallès, Barcelona, Spain
| | - Marc Quirynen
- Departments of Oral Health Sciences and Periodontology, Katholieke Universiteit Leuven, University Hospitals & Dentistry Leuven, Leuven, Belgium
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Keukenmeester RS, Slot DE, Rosema NAM, Van der Weijden GA. Determination of a comfortable volume of mouthwash for rinsing. Int J Dent Hyg 2015; 10:169-74. [DOI: 10.1111/j.1601-5037.2012.00565.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- RS Keukenmeester
- School of Dental Hygiene; Inholland University of Applied Sciences; Amsterdam The Netherlands
- Department of Periodontology; Academic Center for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | - DE Slot
- Department of Periodontology; Academic Center for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | - NAM Rosema
- Department of Periodontology; Academic Center for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
| | - GA Van der Weijden
- Department of Periodontology; Academic Center for Dentistry Amsterdam (ACTA); University of Amsterdam and VU University; Amsterdam The Netherlands
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Genovesi A, Barone A, Toti P, Covani U. The efficacy of 0.12% chlorhexidine versus 0.12% chlorhexidine plus hyaluronic acid mouthwash on healing of submerged single implant insertion areas: a short-term randomized controlled clinical trial. Int J Dent Hyg 2015; 15:65-72. [PMID: 26084554 DOI: 10.1111/idh.12158] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The study was performed to evaluate the incidence of post-surgical adverse events at submerged implant sites as well as the antiplaque, antigingivitis and antistaining effects in the entire dentition of patients treated with two mouthwashes. METHODS The present randomized controlled clinical study considered 40 patients subjected to dental implant treatment. Two 0.12% chlorhexidine mouthwashes were compared for 15 days: one with 0.1% hyaluronic acid (CHX⊗HYL group) and one without it (CHX group). Surgical outcome variables, and plaque, gingival, and staining indexes were recorded. RESULTS Significant differences were found between the two rinses regarding the presence of oedema within 2 days after surgery (20% for the CHX⊗HYL group and 78% for the CHX group). No other significant differences were recorded between the two mouthwashes. No intergroup differences in plaque, staining and gingivitis indexes were registered. The intragroup analysis revealed that for the plaque and gingival indexes, the differences between the baseline values (before surgery) and those at 15 days were all found to be significant just for CHX⊗HYL rinse, with final values ranging from 0.18 to 0.23 for the plaque index and from 0.06 to 0.07 for the gingival index. The staining index increased for both mouthwash types with significant results (with final value of 0.19 and 0.31 for CHX⊗HYL and CHX groups, respectively). CONCLUSIONS In the sites of patients subjected to dental implant placement, an additional anti-oedematigenous effect in early healing seemed to be disclosed for 0.12% CHX⊗HYL mouthwash. Regarding antiplaque and antigingivitis activities, HYL seemed to be ineffective.
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Affiliation(s)
- A Genovesi
- Department of Surgery, Medical Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.,Tuscan Stomatologic Institute, Versilia General Hospital, Lido di Camaiore, Lucca, Italy
| | - A Barone
- Department of Surgery, Medical Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.,Tuscan Stomatologic Institute, Versilia General Hospital, Lido di Camaiore, Lucca, Italy
| | - P Toti
- Department of Surgery, Medical Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.,Tuscan Stomatologic Institute, Versilia General Hospital, Lido di Camaiore, Lucca, Italy
| | - U Covani
- Department of Surgery, Medical Molecular and Critical Area Pathology, University of Pisa, Pisa, Italy.,Tuscan Stomatologic Institute, Versilia General Hospital, Lido di Camaiore, Lucca, Italy
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Gupta RK, Gupta D, Bhaskar DJ, Yadav A, Obaid K, Mishra S. Preliminary antiplaque efficacy of aloe vera mouthwash on 4 day plaque re-growth model: randomized control trial. Ethiop J Health Sci 2015; 24:139-44. [PMID: 24795515 PMCID: PMC4006208 DOI: 10.4314/ejhs.v24i2.6] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Due to increasing resistance to antibiotics and rising incidence of oral diseases, there is a need for alternative treatment modalities to combat oral diseases. The aim of the present study was to access the effect of Aloe vera mouthwash on the dental plaque in the experimental period of 4 days and to compare it with the bench mark control chlorhexidine and placebo (saline water). Material and Methods A total of 300 systemically healthy subjects were randomly allocated into 3 groups: Aloe vera mouthwash group (n=100), control group (=100)-chlorhexidene group and saline water-Placebo (n=100). To begin with, Gingival index (GI) and plaque index (PI) were recorded. Then, baseline plaque scores were brought to zero by professionally cleaning the teeth with scaling and polishing. After randomization of the participants into three groups they were refrained from regular mechanical oral hygiene measures. Subjects were asked to swish with respective mouthwash (Aloe vera mouthwash, 0.2%chlorhexidine gluconate mouthwash, or normal saline) as per therapeutic dose for 4 days. Results The results showed that Aloe vera mouthrinse is equally effective in reducing plaque as Chlorhexidine compared to placebo over a period of 4 days. There was a significant reduction on plaque in Aloe vera and chlorhexidine groups and no statistically significant difference was observed among them (p>0.05). Aloe vera mouthwash showed no side effects. Conclusion The results of the present study indicated that Aloe vera may prove an effective mouthwash due to its ability in reducing dental plaque.
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Affiliation(s)
| | - Devanand Gupta
- Department of Public Health Dentistry, T.M.D.C. & R.C., Moradabad, Uttar Pradesh, India
| | - Dara John Bhaskar
- Department of Public Health Dentistry, T.M.D.C. & R.C., Moradabad, Uttar Pradesh, India
| | - Ankit Yadav
- Departmentof Orthodontics and Dentofacial Orthopedics, T.M.D.C. & R.C., Moradabad, Uttar Pradesh, India
| | - Khursheed Obaid
- Departmentof Pedodontics and Preventive Dentistry, K.D Dental College and Hospital, Mathura, Uttar Pradesh, India
| | - Sumit Mishra
- Department of Prosthodontics, T.M.D.C. & R.C., Moradabad, Uttar Pradesh, India
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Elad S, Raber-Durlacher JE, Brennan MT, Saunders DP, Mank AP, Zadik Y, Quinn B, Epstein JB, Blijlevens NMA, Waltimo T, Passweg JR, Correa MEP, Dahllöf G, Garming-Legert KUE, Logan RM, Potting CMJ, Shapira MY, Soga Y, Stringer J, Stokman MA, Vokurka S, Wallhult E, Yarom N, Jensen SB. Basic oral care for hematology-oncology patients and hematopoietic stem cell transplantation recipients: a position paper from the joint task force of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Society for Blood and Marrow Transplantation (EBMT). Support Care Cancer 2015; 23:223-36. [PMID: 25189149 PMCID: PMC4328129 DOI: 10.1007/s00520-014-2378-x] [Citation(s) in RCA: 111] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 07/30/2014] [Indexed: 12/17/2022]
Abstract
PURPOSE Hematology-oncology patients undergoing chemotherapy and hematopoietic stem cell transplantation (HSCT) recipients are at risk for oral complications which may cause significant morbidity and a potential risk of mortality. This emphasizes the importance of basic oral care prior to, during and following chemotherapy/HSCT. While scientific evidence is available to support some of the clinical practices used to manage the oral complications, expert opinion is needed to shape the current optimal protocols. METHODS This position paper was developed by members of the Oral Care Study Group, Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) and the European Society for Blood and Marrow Transplantation (EBMT) in attempt to provide guidance to the health care providers managing these patient populations. RESULTS The protocol on basic oral care outlined in this position paper is presented based on the following principles: prevention of infections, pain control, maintaining oral function, the interplay with managing oral complications of cancer treatment and improving quality of life. CONCLUSION Using these fundamental elements, we developed a protocol to assist the health care provider and present a practical approach for basic oral care. Research is warranted to provide robust scientific evidence and to enhance this clinical protocol.
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Affiliation(s)
- Sharon Elad
- Division of Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, 625 Elmwood Ave., Rochester, NY, 14620, USA,
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Vlahovic Z, Markovic A, Golubovic M, Scepanovic M, Kalanovic M, Djinic A. Histopathological comparative analysis of peri-implant soft tissue response after dental implant placement with flap and flapless surgical technique. Experimental study in pigs. Clin Oral Implants Res 2014; 26:1309-14. [PMID: 25039366 DOI: 10.1111/clr.12456] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2014] [Indexed: 01/23/2023]
Abstract
AIM The aim of this study was comparing the effect of flapless vs. flap technique of implant placement on inflammation degree of peri-implant soft tissue, through histopathological analysis. METHOD The experiment was conducted on five domestic pigs. Nine weeks after tooth extraction, implants were installed. Each animal received six implants in mandible. According to split-mouth design, randomly one side was used for flapless technique using mini-incision, while on the other side, flap was raised. After 7, 14, 21, 28, and 90 days, the experimental animals were sacrificed. Samples for histopathological analyzes were taken from the buccal side of peri-implant mucosa next to the neck of implants, from three levels. The degree of inflammatory response in the peri-implant soft tissue was estimated through ordinal scores from 0 to 3. RESULTS In the flap group Score 3 indicating high degree of inflammation was present from day 7 to day 21, in contrast to flapless group where Score 3 was not recorded during the entire follow-up. Three months after implantation, there were no signs of inflammation neither around flap nor around flapless implants. CONCLUSION Flapless surgical implantation technique using mini-incision decreases peri-implant soft tissue inflammatory reaction compared with flap surgery.
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Affiliation(s)
- Zoran Vlahovic
- Department of Dental Medicine, Faculty of Medical Science, University of Priština, Kosovska Mitrovica, Serbia
| | - Aleksa Markovic
- School of Dentistry, University of Belgrade, Belgrade, Serbia
| | - Mileta Golubovic
- Faculty of Medicine, University of Montenegro, Podgorica, Montenegro
| | | | | | - Ana Djinic
- School of Dentistry, University of Belgrade, Belgrade, Serbia
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Ulkur F, Arun T, Ozdemir F. The effects of three different mouth rinses in a 4-day supragingival plaque regrowth study. Eur J Dent 2014; 7:352-358. [PMID: 24926216 PMCID: PMC4053625 DOI: 10.4103/1305-7456.115420] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE This study compares the effects of three different mouth rinses with respect to reducing Streptococcus mutans (S. mutans) colony counts on the teeth and tongue surfaces. MATERIALS AND METHODS In this study, comparison tests using the alcohol-free 0.1% chlorhexidine mouth rinse, alcohol-containing essential oil mouth rinse, and alcohol-free essential oil-containing mouth rinse were conducted. Patients were instructed to avoid mechanical cleaning with either a toothbrush or toothpick for 4 days. The first samples were collected from teeth surfaces and the dorsum of the tongue after a professional cleaning, and the second samples were collected after a 4-day plaque re-growth period. The supragingival plaque from the buccal surfaces of teeth #11, 14, 31, 34 as well as samples from the dorsum of the tongue, were assessed using the Dentocult(®) strips. RESULTS The Listerine(®) and Ondrohexidine(®) groups did not show any statistically significant differences between the values of the two samples (P = 0.734, P = 0.307). The MC(®) group and the control group showed significantly higher results than the first sample values. The effectiveness of the mouth rinses on S. mutans colony counts from the teeth surfaces were higher in the Listerine(®), Ondrohexidine(®), and Mouthwash Concentrate(®) groups. The difference between the first and second samples of the S. mutans colony counts from the tongue surface was found to be statistically significant, and S. mutans colony counts were higher than the first sample (P = 0.015). CONCLUSION Alcohol and essential oil-containing Listerine(®) mouth rinse, alcohol-free Ondrohexidine(®), alcohol-free essential oil-containing MC(®) mouth rinse had the same effect on S. mutans counts, higher than the 1% alcohol solution on teeth surface. They had the ability to maintain the S. mutans counts at the same level for 4 days in patients who did not perform any mechanical oral hygiene regimen.
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Affiliation(s)
- Feyza Ulkur
- Department of Orthodontics, Faculty of Dentistry, Yeditepe University Istanbul, Turkiye
| | - Tulin Arun
- Department of Orthodontist, Private Practice, Istanbul, Turkiye
| | - Fulya Ozdemir
- Department of Orthodontics, Faculty of Dentistry, Yeditepe University Istanbul, Turkiye
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Tyski S, Bocian E, Mikucka A, Grzybowska W. Antibacterial activity of selected commercial products for mouth washing and disinfection, assessed in accordance with PN-EN 1040. Med Sci Monit 2013; 19:458-66. [PMID: 23764523 PMCID: PMC3692377 DOI: 10.12659/msm.883952] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Currently, there is a wide range of products for mouth washing on the Polish market. They have different qualitative and quantitative compositions, and they differ particularly in the concentration of active substances. In antisepsis and disinfection, the significant reduction in number of cells of microorganisms in a particular environment is very crucial. The chemical agents should provide a significant decrease in number of microorganisms in a relatively short time. The purpose of this study was to examine the bactericidal activity of selected herbal products used for treatment of inflammation, and disinfection and washing of the mouth, having antibacterial activity as declared by the manufacturers. Material/Methods The study included 28 products for mouth washing and disinfection available in Poland. Bactericidal activity was studied using a quantitative suspension test according to the standard PN-EN 1040. Results Only 1 of 4 tested herbal products, registered as medicinal products, showed satisfactory antibacterial activity when they were used according to the manufacturer’s recommendations. A total of 13 preparations (48%) complied with the standard requirements against all tested strains. Up to 19% of products showed no bactericidal activity against bacterial strains, and up to 33% were only effective against certain microorganisms. Conclusions The informational literature accompanying most antiseptics should be corrected by the manufacturers, providing information about antimicrobial activity consistent with the requirements of applicable standards. The information on the packaging or in the leaflets for antiseptic products should be corrected by the manufacturers to include accurate information on antimicrobial activity.
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Affiliation(s)
- Stefan Tyski
- Department of Antibiotics and Microbiology, National Medicines Institute, Warsaw, Poland.
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Dost F, Farah CS. Stimulating the discussion on saliva substitutes: a clinical perspective. Aust Dent J 2013; 58:11-7. [DOI: 10.1111/adj.12023] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2012] [Indexed: 11/29/2022]
Affiliation(s)
- F Dost
- School of Dentistry; The University of Queensland; Brisbane and The University of Queensland Centre for Clinical Research; Herston
| | - CS Farah
- School of Dentistry; The University of Queensland; Brisbane and The University of Queensland Centre for Clinical Research; Herston
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De Siena F, Del Fabbro M, Corbella S, Taschieri S, Weinstein R. Evaluation of chlorhexidine 0.05% with the adjunct of fluoride 0.05% in the inhibition of plaque formation: a double blind, crossover, plaque regrowth study. Int J Dent Hyg 2012. [PMID: 23181710 DOI: 10.1111/idh.12010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the effect of mouthrinses containing 0.05% chlorhexidine + 0.05% fluoride solution on early dental plaque regrowth. MATERIALS AND METHODS Thirty periodontally healthy subjects were included in the study. A crossover 4-day plaque regrowth protocol was adopted. The test product was initially used in 15 patients, while a placebo was administered to the other 15 patients. Then, after a washout period, each patient used the other product. No other oral hygiene manoeuvre was allowed. Full-mouth plaque and bleeding scores (FMPS and FMBS) were evaluated at baseline and after 4 days. RESULTS All subjects completed the study. The mean age was 27 ± 8.4 years. Five patients were smokers with a mean daily consumption of 1 ± 2.5 cigarettes. FMPS at baseline was 8.0 ± 4.4 for control group and 7.9 ± 3.8 for test group, without significant difference. After the 4-day plaque regrowth the mean FMPS significantly increased to 31.9 ± 16.5 and 36.3 ± 16.1 for control and test group, respectively (no significant difference between the two groups). CONCLUSIONS The test product was safe and well tolerated by subjects. The similar outcomes of the two experimental groups suggest that the two products have an equivalent effect on early dental plaque regrowth. Studies with longer follow-up are needed to clarify whether there is a beneficial long-term effect of daily rinses with the tested solution.
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Affiliation(s)
- F De Siena
- Department of Biomedical, Surgical and Dental Sciences, Centre for Research in Oral Health, IRCCS Istituto Ortopedico Galeazzi, University of Milan, Milan, Italy
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Biofilm Formation on Composite Resins for Dental Restorations: An in Situ Study on the Effect of Chlorhexidine Mouthrinses. Int J Artif Organs 2012; 35:792-9. [DOI: 10.5301/ijao.5000165] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/01/2012] [Indexed: 11/20/2022]
Abstract
Purpose Biofilm formation on the surface of dental restorative materials by oral bacteria is considered an important step in the development of secondary caries. The aim of this study was to evaluate the in situ effect of a chlorhexidine (CHX)-containing mouthrinse on the biofilm formation occurring on the surface of human enamel and of two resin-based commercially available materials: a silorane-based material (Filtek Silorane®) and a methacrylate-based material (Filtek Supreme XT®). Methods 53 disks were obtained for each of the two composites and 37 disks for enamel. The surface was characterized by determining the surface roughness and the surface free energy of 5 samples for each of the three materials tested, then the remaining samples were mounted on splints worn by 16 volunteers. The participants were randomly divided into two groups: an experimental group that used 0.12% CHX-based mouthrinse and a control group that used a placebo mouthrinse. Biofilm formation on the different surfaces after a 24 h period was assessed using MTT assay. Results The two composites in the group treated with the placebo mouthrinse showed a similar biofilm formation, which was significantly higher than that occurring on enamel surfaces. The CHX-based mouthrinse significantly reduced biofilm formation on the surfaces of the two resin-based materials when compared with the placebo mouthrinse. The reduction was particularly relevant on the Filtek Silorane surfaces. Conclusions The new silorane-based material seems to interact with CHX in a promising way from the point of view of biofilm formation control.
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Van Strydonck DAC, Slot DE, Van der Velden U, Van der Weijden F. Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: a systematic review. J Clin Periodontol 2012; 39:1042-55. [PMID: 22957711 DOI: 10.1111/j.1600-051x.2012.01883.x] [Citation(s) in RCA: 196] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2012] [Indexed: 11/30/2022]
Abstract
AIM To systematically evaluate the efficacy of chlorhexidine (CHX) mouthrinses on plaque, gingival inflammation and staining in gingivitis patients. MATERIAL & METHODS Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched through April 2011. Randomized controlled clinical trials comparing CHX to placebo/control mouthrinses or oral hygiene (OH) ≥ 4 weeks were included. RESULTS Among 1355 titles, 30 publications fulfilled the selection criteria. Meta-analysis (MA) showed significant weighted mean differences (WMD) favouring CHX. This was -0.39 [95% CI: -0.70; -0.08] for the Plaque Index Silness & Löe, -0.67 [95% CI: -0.82; -0.52] for the Plaque-Index Quigley & Hein (PIQH), -0.32 [95% CI: -0.42; -0.23] for the Gingival Index (GI), -0.08 [95% CI: -0.10; -0.05] for the bleeding aspect of the GI, -0.21 [95% CI: -0.37; -0.04] for the Papillary BIeeding Index, -0.16 [95% CI: -0.26; -0.07] for Bleeding on Marginal Probing and 0.91 [95% CI: 0.12;1.70] for the Lobene Stain Index. MA of studies with a low risk of author-estimated bias showed a WMD of -0.68 [95% CI: -0.85; -0.51] for the PIQH and -0.24 [95% CI: -0.29; -0.20] for the GI in favour of CHX. Relative to control, the reduction with CHX for plaque was 33% and for gingivitis 26%. CHX rinsing groups demonstrated significantly more staining. CONCLUSIONS In gingivitis patients, CHX mouthrinses together with OH versus placebo- or control mouthrinse provide significant reductions in plaque and gingivitis scores, but a significant increase in staining score.
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Affiliation(s)
- Daniëlle A C Van Strydonck
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
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López RM, Uribe MR, Rodríguez BO, Casasempere IV. Comparison between amine fluoride and chlorhexidine with institutionalized elders: a pilot study. Gerodontology 2012; 30:112-8. [DOI: 10.1111/j.1741-2358.2012.00650.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Arunachalam LT, Merugu S, Sudhakar U. Comparison of intraoral distribution of two commercially available chlorhexidine mouthrinses with and without alcohol at three different rinsing periods. J Int Soc Prev Community Dent 2012; 2:20-4. [PMID: 24478962 PMCID: PMC3894089 DOI: 10.4103/2231-0762.103450] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives: This study compared the intraoral distribution of 0.1% chlorhexidine with alcohol (CHX+Alc) and 0.2% chlorhexidine without alcohol (CHX-Alc) with shorter rinsing times (10s,20s,30s) following a 72h non brushing period. Materials and Methods: This study was designed as a single blind, randomized two group parallel experiment with a total of 30(15male,15 female) dental students. To disclose the plaque, erythrosine-containing disclosing agent was added to both the mouthrinses. Group I (0.1% CHX+Alc) & Group II (0.2% CHX-Alc) were asked to rinse with respective mouthrinse for cumulative periods of 10,20 and 30s, following which plaque was scored. Results: In Group I, comparison between 10&20, 10&30s was statistically significant but no significance was observed between 20&30s, whereas in Group II, comparison between all the time points were statistically significant. On comparison of plaque scores, plaque scores of both the groups at 10 & 30s sec, show no statistical significance but at 20 seconds was significant (P<0.001). The mean plaque scores of lingual surfaces were lesser in group II whereas in group I lingual surfaces recorded more plaque than the vestibular surfaces. Conclusions: Within the limitations of this study, it can be concluded that rinsing for 30 seconds with 0.2% CHX-Alc (Rexidin) is enough for intraoral spread of the mouthrinse whereas rinsing with 0.1% CHX+Alc(Eludril) for achieves the same in 20 seconds, for effective plaque inhibition, both of which will have a positive influence on patient compliance.
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Affiliation(s)
- L T Arunachalam
- Department of Periodontics, Thai Moogambigai Dental College, Golden George Nagar, Chennai, Tamil Nadu, India
| | - S Merugu
- Department of Periodontics, Thai Moogambigai Dental College, Golden George Nagar, Chennai, Tamil Nadu, India
| | - U Sudhakar
- Department of Periodontics, Thai Moogambigai Dental College, Golden George Nagar, Chennai, Tamil Nadu, India
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Marchetti E, Mummolo S, Di Mattia J, Casalena F, Di Martino S, Mattei A, Marzo G. Efficacy of essential oil mouthwash with and without alcohol: a 3-day plaque accumulation model. Trials 2011; 12:262. [PMID: 22171999 PMCID: PMC3292473 DOI: 10.1186/1745-6215-12-262] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2011] [Accepted: 12/15/2011] [Indexed: 11/29/2022] Open
Abstract
Background The aim of this study was to evaluate the antiplaque effect of a new alcohol free essential oil mouthwash with respect to a control of an essential oil with alcohol mouthwash, using an in vivo plaque regrowth model of 3-days. Methods The study was designed as a double-masked, randomized, crossover clinical trial, involving 30 volunteers to compare two different essential oil containing mouthwashes, during a 3-day plaque accumulation model. After receiving a thorough professional prophylaxis at the baseline, over the next 3-days each volunteer refrained from all oral hygiene measures and had two daily rinses with 20 ml of the test mouthwash (alcohol free essential oil) or the control mouthwash (essential oil with alcohol). At the end of the each experimental period, plaque was assessed and the panelists filled out a questionnaire. Each subject underwent a 14 days washout period and there was a second allocation. Results The essential oil mouthwash with ethanol shows a better inhibitory effect of plaque regrowth in 3-days than the mouthwash test with only essential oil in the whole mouth (plaque index = 2.18 against 2.46, respectively, p < 0.05); for the lower jaw (plaque index = 2.28 against 2.57, respectively, p < 0.05); for the upper jaw (plaque index = 2.08 against 2.35, respectively, p < 0.05); for the incisors (plaque index = 1.93 against 2.27, respectively, p < 0.05); and the canines (plaque index = 1.99 against 2.47, respectively, p < 0.05). Conclusion The essential oil containing mouthwash without alcohol seems to have a less inhibiting effect on the plaque regrowth than the traditional alcoholic solution. Trial Registration ClinicalTrials.gov NCT01411618
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Affiliation(s)
- Enrico Marchetti
- Department of Health Sciences, School of Dentistry, University of L'Aquila, P.le G. Liberatore, Ed. Delta 6, 67100 L'Aquila, Italy.
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Synergistic antibacterial effect between silibinin and antibiotics in oral bacteria. J Biomed Biotechnol 2011; 2012:618081. [PMID: 21941436 PMCID: PMC3173953 DOI: 10.1155/2012/618081] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2011] [Revised: 07/04/2011] [Accepted: 07/14/2011] [Indexed: 01/09/2023] Open
Abstract
Silibinin is a composition of the silymarin group as a hepatoprotective agent, and it exhibits various biological activities, including antibacterial activity. In this study, the antibacterial activities of silibinin were investigated in combination with two antimicrobial agents against oral bacteria. Silibinin was determined with MIC and MBC values ranging from 0.1 to 3.2 and 0.2 to 6.4 μg/mL, ampicillin from 0.125 to 64 and 0.5 to 64 μg/mL, gentamicin from 2 to 256 and 4 to 512 μg/mL, respectively. The ranges of MIC50 and MIC90 were 0.025–0.8 μg/mL and 0.1–3.2 μg/mL, respectively. The antibacterial activities of silibinin against oral bacteria were assessed using the checkerboard and time-kill methods to evaluate the synergistic effects of treatment with ampicillin or gentamicin. The results were evaluated showing that the combination effects of silibinin with antibiotics were synergistic (FIC index <0.5) against all tested oral bacteria. Furthermore, a time-kill study showed that the growth of the tested bacteria was completely attenuated after 2–6 h of treatment with the MBC of silibinin, regardless of whether it was administered alone or with ampicillin or gentamicin. These results suggest that silibinin combined with other antibiotics may be microbiologically beneficial and not antagonistic.
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Moon SE, Kim HY, Cha JD. Synergistic effect between clove oil and its major compounds and antibiotics against oral bacteria. Arch Oral Biol 2011; 56:907-16. [DOI: 10.1016/j.archoralbio.2011.02.005] [Citation(s) in RCA: 112] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 01/03/2011] [Accepted: 02/10/2011] [Indexed: 10/18/2022]
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Chan EY, Lee YK, Poh TH, Ng IHL, Prabhakaran L. Translating evidence into nursing practice: oral hygiene for care dependent adults. INT J EVID-BASED HEA 2011; 9:172-83. [DOI: 10.1111/j.1744-1609.2011.00214.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Jönsson D, Ramberg P, Demmer RT, Kebschull M, Dahlén G, Papapanou PN. Gingival tissue transcriptomes in experimental gingivitis. J Clin Periodontol 2011; 38:599-611. [PMID: 21501207 DOI: 10.1111/j.1600-051x.2011.01719.x] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AIMS We investigated the sequential gene expression in the gingiva during the induction and resolution of experimental gingivitis. MATERIAL AND METHODS Twenty periodontally and systemically healthy non-smoking volunteers participated in a 3-week experimental gingivitis protocol, followed by debridement and 2-week regular plaque control. We recorded clinical indices and harvested gingival tissue samples from four interproximal palatal sites in half of the participants at baseline, Day 7, Day 14 and Day 21 (the "induction phase"), and at Day 21, Day 25, Day 30 and Day 35 in the other half (the "resolution phase"). RNA was extracted, amplified, reversed transcribed, amplified, labelled and hybridized using Affymetrix Human Genome U133Plus2.0 microarrays. Paired t-tests compared gene expression changes between consecutive time points. Gene ontology analyses summarized the expression patterns into biologically relevant categories. RESULTS The median gingival index was 0 at baseline, 2 at Day 21 and 1 at Day 35. Differential gene regulation peaked during the third week of induction and the first 4 days of resolution. Leucocyte transmigration, cell adhesion and antigen processing/presentation were the top differentially regulated pathways. CONCLUSIONS Transcriptomic studies enhance our understanding of the pathobiology of the reversible inflammatory gingival lesion and provide a detailed account of the dynamic tissue responses during the induction and resolution of experimental gingivitis.
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Affiliation(s)
- Daniel Jönsson
- Division of Periodontics, Section of Oral and Diagnostic Sciences, College of Dental Medicine, Columbia University, New York, NY 10032, USA
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Berchier CE, Slot DE, Van der Weijden GA. The efficacy of 0.12% chlorhexidine mouthrinse compared with 0.2% on plaque accumulation and periodontal parameters: a systematic review. J Clin Periodontol 2010; 37:829-39. [DOI: 10.1111/j.1600-051x.2010.01575.x] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Stratul SI, Rusu D, Didilescu A, Mesaros-Anghel M, Lala C, Tion L, Sculean A, Jentsch H. Prospective clinical study evaluating the long-time adjunctive use of chlorhexidine after one-stage full-mouth SRP. Int J Dent Hyg 2010; 8:35-40. [PMID: 20096080 DOI: 10.1111/j.1601-5037.2009.00390.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Scaling and root planing are the causal procedure in the treatment of periodontitis. Many attempts have been made to improve the outcome. The aim of this study was to verify the influence of the extended use of chlorhexidine after one-stage full-mouth (FM) SRP in patients with chronic periodontitis on the clinical outcome after 3 months. METHODS Eighty-one patients with pockets > or =5 mm were treated by FM. All patients rinsed additionally with 0.2% chlorhexidine (CHX) twice daily over 3 months. Plaque index, bleeding on probing, probing depth (PD) and clinical attachment level (CAL) were recorded at baseline and after 1 and 3 months. RESULTS In the test group, all variables were significantly improved after 1 and 3 months. Mean reduction of PD and CAL gain was 2.25 +/- 1.08 and 1.67 +/- 1.08 after 1 and 2.99 +/- 1.11 and 2.33 +/- 1.31 after 3 months respectively. CONCLUSIONS Over 3 months of extended use of CHX mouth rinse after SRP showed slightly but statistically significant better results.
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Affiliation(s)
- S-I Stratul
- Victor Babes University of Medicine and Pharmacy, Timisoara, Romania.
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