1
|
Plata JC, Díaz-Báez D, Delgadillo NA, Castillo DM, Castillo Y, Hurtado CP, Neuta Y, Calderón JL, Lafaurie GI. Hypochlorous Acid as a Potential Postsurgical Antimicrobial Agent in Periodontitis: A Randomized, Controlled, Non-Inferiority Trial. Antibiotics (Basel) 2023; 12:1311. [PMID: 37627732 PMCID: PMC10451621 DOI: 10.3390/antibiotics12081311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Hypochlorous acid (HOCl) is an antimicrobial agent with high affinity to Gram-negative bacteria of the subgingival biofilm. It could have an equivalent or no inferiority effect to chlorhexidine (CHX) to avoid recolonization of these microorganisms after the post-surgical period. OBJECTIVE The objective is to compare the reduction of plaque index (PI), gingival index (GI), pocket depth (PD), gain of clinical attachment level (CAL), and bacterial recolonization of periodontopathic microorganisms in subgingival biofilm at 7, 21, and 90 days after Open Flap Debridement (OFD) under two antimicrobial protocols: (A) HOCl 0.05% followed by HOCl 0.025% and (B) CHX 0.2%/CHX 0.12% used per 21 days without regular oral hygiene during the post-surgical period. MATERIAL AND METHODS A no-inferiority randomized controlled trial was carried out. Thirty-two patients were randomly divided to receive each antiplaque protocol after OFD in patients with periodontitis. Clinical indexes and bacterial recolonization were assessed using qPCR for up to 90 days. Data were analyzed using repeated measures ANOVA, mixed effects models adjusted for treatment, time, and the Chi-squared/Fisher test. A no-inferiority analysis was also performed using the Hodges-Lehmann hypothesis test for non-inferiority. RESULTS HOCl was not inferior to CHX in reducing PI. Both groups showed a comparable reduction of recolonization for Porphyromonas gingivalis, Tannerella forsythia, and Eubacterium nodatum. However, the HOCl protocol was non-inferior to the CHX protocol for Treponema denticola and Aggregatibacter actinomicetemcomitans. CONCLUSIONS HOCl improved periodontal healing. HOCl showed an impact in reducing the recolonization of periodontopathic bacteria in the postoperative period.
Collapse
Affiliation(s)
- Julio Cesar Plata
- Master’s Program in Dental Sciences, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia;
- School of Dentistry, Universidad Cooperativa de Colombia, Bucaramanga P.O. Box 680001, Colombia;
| | - David Díaz-Báez
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Nathaly Andrea Delgadillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Diana Marcela Castillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Yormaris Castillo
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Claudia Patricia Hurtado
- School of Dentistry, Universidad Cooperativa de Colombia, Bucaramanga P.O. Box 680001, Colombia;
| | - Yineth Neuta
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Justo Leonardo Calderón
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| | - Gloria Inés Lafaurie
- Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; (D.D.-B.); (N.A.D.); (D.M.C.); (Y.C.); (Y.N.); (J.L.C.)
| |
Collapse
|
2
|
Zayed N, Boon N, Bernaerts K, Chatzigiannidou I, Van Holm W, Verspecht T, Teughels W. Differences in chlorhexidine mouthrinses formulations influence the quantitative and qualitative changes in in-vitro oral biofilms. J Periodontal Res 2021; 57:52-62. [PMID: 34581434 DOI: 10.1111/jre.12937] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 09/12/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Chlorhexidine mouthrinses are marketed in different formulations. This study aimed at investigating qualitative and quantitative changes in in-vitro multispecies oral biofilms, induced by different chlorhexidine-containing mouthrinses. BACKGROUND DATA Earlier studies comparing chlorhexidine mouthrinses are either clinical studies or in-vitro studies assessing the antimicrobial efficacy of the mouthrinses. However, no clear investigations are available regarding ecological impact of different chlorhexidine formulations on in-vitro multispecies oral biofilms after rinsing with different chlorhexidine formulations. METHODS Nine commercially available chlorhexidine mouthrinses were selected. Multispecies oral communities (14 species) were grown for 48 h in a Biostat-B Twin bioreactor. After that, they were used to develop biofilms on the surface of hydroxyapatite disks in 24-well pates for 48 h. Biofilms were then rinsed once or multiple times with the corresponding mouthrinse. Biofilms were collected before starting the rinsing experiment and every 24 h for 3 days and vitality quantitative PCR was performed. The experiment was repeated 3 independent times on 3 different days and the results were analyzed using a linear mixed model. RESULTS The mouthrinses provoked different effects in terms of change in total viable bacterial load (VBL), ecology, and community structure of the multispecies biofilms. There was no relation between chlorhexidine concentrations, presence, or absence of cetylpyridinium chloride and/or alcohol, and the observed effects. Some tested chlorhexidine mouthrinses (MC, HG, HH, and HI) strongly lowered the total VBL (≈1007 Geq/ml), but disrupted biofilm symbiosis (≥40% of the biofilms communities are pathobionts). On the other hand, other tested chlorhexidine mouthrinses (MD, ME, and HF) had limited impact on total VBL (≥1010 Geq/ml), but improved the biofilm ecology and community structure (≤10% of the biofilms communities are pathobionts). CONCLUSION Not all chlorhexidine mouthrinses have the same effect on oral biofilms. Their effect seems to be strongly product dependent and vary according to their compositions and formulations.
Collapse
Affiliation(s)
- Naiera Zayed
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium.,Department of Microbiology and Immunology, Faculty of Pharmacy, Menoufia University, Menoufia, Egypt
| | - Nico Boon
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Kristel Bernaerts
- Department of Chemical Engineering, Bio- and Chemical Systems Technology, Reactor Engineering and Safety, Leuven Chem&Tech, University of Leuven (KU Leuven), Leuven, Belgium
| | - Ioanna Chatzigiannidou
- Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Wannes Van Holm
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Tim Verspecht
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Center for Microbial Ecology and Technology (CMET), Ghent University (UGent), Gent, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, University of Leuven (KU Leuven), Leuven, Belgium.,Dentistry, University Hospitals Leuven, Leuven, Belgium
| |
Collapse
|
3
|
Tartaglia GM, Tadakamadla SK, Connelly ST, Sforza C, Martín C. Adverse events associated with home use of mouthrinses: a systematic review. Ther Adv Drug Saf 2019; 10:2042098619854881. [PMID: 31579502 PMCID: PMC6759706 DOI: 10.1177/2042098619854881] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 05/09/2019] [Indexed: 12/22/2022] Open
Abstract
Background Poor oral hygiene is strongly associated with oral and systemic diseases. Alongside mechanical tooth cleaning, the adjunctive use of mouthrinses has been widely advocated. Although research on the efficacy of various mouthrinse formulations is very active, there are a lack of conclusive data regarding their adverse effects. Methods We undertook a systematic review in accordance wih PRISMA guidelines of electronic databases of clinical trials of any duration with daily home use of mouthwashes, presenting clinical and subjective side effects (PROSPERO registration: CRD42016054037). Results After evaluating 614 titles and abstracts, 154 studies were selected for full-text analysis; 85 final papers were included. Based on the active ingredient in the test product, nine categories were created: cetyl pyridinium chloride, essential oils, chlorhexidine, triclosan, natural products, diclofenac, fluorides, delmopinol, and miscellaneous active substances. Most of the studies were of short duration (less than 6 months) with a defective 'methods' description; the reporting of adverse events often being overlooked. Both local morphological (oral mucosa and dental-crown staining, mucosal lesions) and functional (taste modifications, abnormal oral sensation) alterations were reported. Tooth staining was the most commonly listed adverse event, but it was quantitatively assessed only in a very small number of papers; most studies relied on patient reports. Staining was time associated; the longer the study, the higher its reported incidence and severity. Conclusions The reduced report of side effects may partly be due to a lack of an objective measure and lack of general guidelines that demand studies report their adverse events. The most frequently reported adverse effect was teeth staining. As in most studies, the effect was associated with trial duration; clinical trials should be of sufficient duration. New investigations meeting the suggested criteria of a minimal duration of 6 months should be planned.
Collapse
Affiliation(s)
- Gianluca M Tartaglia
- Department of Biomedical Sciences for Health, Functional Anatomy Research Centre (FARC), Università degli Studi di Milano, Via Luigi Mangiagalli 31, Milano, MI 20133, Italy Private Practice, SST Dental Clinic, Via Martiri della Libertà 58, 20090 Segrate, MI, Italy
| | | | - Stephen Thaddeus Connelly
- San Francisco Veterans Affairs Health System, University of California San Francisco, San Francisco, CA, USA
| | - Chiarella Sforza
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milano, Italy
| | - Conchita Martín
- Facultad de Odontología, Universidad Complutense de Madrid, Madrid, Spain
| |
Collapse
|
4
|
Antiplaque and antimicrobial efficacy of polyherbal mouth rinse among adult human volunteers – A short term randomized controlled trial. J Herb Med 2019. [DOI: 10.1016/j.hermed.2019.100273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
5
|
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.
Collapse
|
6
|
N-acetyl cysteine versus chlorhexidine mouthwashes in prevention and treatment of experimental gingivitis: a randomized, triple-blind, placebo-controlled clinical trial. Clin Oral Investig 2019; 23:3833-3842. [PMID: 30673864 DOI: 10.1007/s00784-019-02813-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/11/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To compare the efficacy of N-acetyl cysteine (NAC) mouthwash with chlorhexidine (CHX) in prevention and treatment of experimental gingivitis MATERIALS AND METHODS: Sixty subjects were assigned randomly and blindly into one of three equal groups: NAC, CHX, or placebo group. The study was conducted in two stages: preventive and treatment substudies. Professional prophylaxis was performed ahead of starting the preventive substudy. Then, the subjects were instructed to stop oral hygiene practices and begin rinsing twice/day with 15 ml of the assigned mouthwash (1.25% NAC, 0.2% CHX, or inert base). Plaque index (PI), gingival index (GI), and papillary bleeding index (PBI) were measured at baseline, 7, 14, and 21 days. The treatment substudy started on day 21 in which the subjects in the placebo group (now with established experimental gingivitis) were assigned to NAC (n = 10) or CHX (n = 10); the abovementioned indices were measured at 28 and 35 days. Efficacy of these interventions was compared. RESULTS All groups accumulated plaque and developed some degree of gingivitis: full-blown in the placebo group and remarkably mild in the CHX group. NAC had slight preventive properties at days 14 and 21. In the treatment substudy, CHX was associated with remarkable reduction in plaque and gingivitis while NAC resulted in insignificant reductions. CONCLUSIONS 1.25% NAC is marginally effective in prevention and treatment of experimental gingivitis. CLINICAL RELEVANCE When compared with the placebo, NAC showed promising preventive and treatment effects of gingivitis that deserve further development and studies. TRIAL REGISTRATION ISRCTN31352091.
Collapse
|
7
|
Dai R, Lam OLT, Lo ECM, Li LSW, McGrath C. Effect of oral hygiene programmes on oral opportunistic pathogens during stroke rehabilitation. Oral Dis 2018; 25:617-633. [PMID: 30447165 DOI: 10.1111/odi.13005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Revised: 10/28/2018] [Accepted: 11/11/2018] [Indexed: 01/30/2023]
Abstract
OBJECTIVES This study was to assess the effectiveness of a conventional oral hygiene care programme (COHCP) and an advanced oral hygiene care programme (AOHCP) on prevalence and viable counts of oral opportunistic pathogens among patients undergoing stroke rehabilitation. METHODS A total of 94 patients were randomized to two groups. Subjects were block randomized to either (a) COHCP: manual toothbrushing with oral hygiene instruction (OHI); or (b) AOHCP: powered toothbrushing, mouthrinsing with chlorhexidine and OHI. Prevalence and viable counts of oral opportunistic pathogens including yeasts, aerobic and facultative anaerobic gram-negative bacilli, Staphylococcus aureus, were assessed at baseline, the end of 3 and 6 months. RESULTS No significant difference was observed in the prevalence of oral opportunistic pathogens within each group over the clinical trial period. A significant decrease in the viable counts of S. aureus was found over the clinical trial period within AOHCP group (p < 0.05), while the viable counts of yeasts and anaerobic gram-negative bacillus (AGNB) remained stable within each group. Regression analysis failed to detect an association between intervention and the prevalence/viable counts of oral opportunistic pathogens. CONCLUSIONS Neither oral healthcare programme significantly affects AGNB, yeast or S. aureus over the study period in terms of prevalence and viable counts.
Collapse
Affiliation(s)
- Ruoxi Dai
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong.,Key Laboratory of Oral Diseases Research of Anhui Province, Stomatologic Hospital & College, Anhui Medical University, Hefei, China
| | - Otto L T Lam
- Prosthodontics, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
| | - Edward C M Lo
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
| | - Leonard S W Li
- Rehabilitation Medicine, Tung Wah Hospital, Hong Kong, Hong Kong
| | - Colman McGrath
- Dental Public Health, Faculty of Dentistry, The University of Hong Kong, Hong Kong, Hong Kong
| |
Collapse
|
8
|
Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review. Clin Oral Investig 2018; 23:21-32. [PMID: 30535817 DOI: 10.1007/s00784-018-2761-y] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 11/27/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Biofilm management and infection control are essential after periodontal and implant surgery. In this context, chlorhexidine (CHX) mouth-rinses are frequently recommended post-surgically. Despite its common use and many studies in this field, a systematic evaluation of the benefits after periodontal or implant surgery is-surprisingly-still missing. OBJECTIVES To evaluate the benefits of chlorhexidine rinsing after periodontal or implant surgery in terms of plaque and inflammation reduction potential. Furthermore, to screen whether the concentration changes or additives in CHX solutions reduce side effects associated with its use. MATERIALS AND METHODS A systematic literature search was performed for clinical trials, which compared CHX rinsing after periodontal or implant surgery with rinsing using placebo, non-staining formulations, or solutions with reduced concentrations of the active compound. Four databases (Medline, PubMed, Embase, Cochrane) were searched up to June 2018. Two reviewers independently identified and screened the literature. RESULTS From 691 titles identified, only eleven publications met the inclusion criteria and were finally included. Mainly early publications assessed the benefits of CHX over placebo rinsing, whereas more recent publications focused more on the evaluation of new formulations with regard to effectiveness and side effects. The use of CHX after surgery showed in general significant reduction in plaque (means of 29-86% after 1 week) and bleeding (up to 73%) as compared to placebo. No consensus, however, was found regarding the most beneficial CHX formulation avoiding side effects. CONCLUSION Chlorhexidine rinsing helps to reduce biofilm formation and gingival inflammation after surgery. However, no additional reduction of periodontal probing depth over any given placebo or control solution could be found irrespective of whether CHX was used or not. The use of additives such as antidiscoloration systems (ADS) or herbal extracts may reduce side effects while retaining efficacy. CLINICAL RELEVANCE Within the limitations of this review, it can be concluded that CHX may represent a valuable chemo-preventive tool immediately after surgery, during the time period in which oral hygiene capacity is compromised. To reduce the side effects of CHX and maintain comparable clinical effects, rinsing with less concentrated formulations (e.g., 0.12%) showed the most promising results so far.
Collapse
|
9
|
Erovic Ademovski S, Mårtensson C, Persson GR, Renvert S. The long-term effect of a zinc acetate and chlorhexidine diacetate containing mouth rinse on intra-oral halitosis-A randomized clinical trial. J Clin Periodontol 2017; 44:1010-1019. [PMID: 28727160 DOI: 10.1111/jcpe.12779] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2017] [Indexed: 11/28/2022]
Abstract
AIM To evaluate the long-term effects of a zinc acetate and chlorhexidine diacetate mouth rinse (Zn/CHX) on intra-oral halitosis. MATERIALS AND METHODS Forty-six adults with intra-oral halitosis were randomized into a 6-month, double-blind, placebo-controlled clinical study. The presence of intra-oral halitosis was evaluated at baseline, 3 and 6 months after treatment by assessment of organoleptic score (OLS) and by total volatile sulphur compounds (T-VSC), hydrogen sulphide (H2 S) and methyl mercaptan (MM) concentrations in exhaled air. RESULTS A Zn/CHX mouth rinse provided significantly better control of intra-oral halitosis than a placebo mouth rinse. At 3 and 6 months, individuals rinsing with the Zn/CHX rinse presented with reductions of the OLS, T-VSC (p < .01, respectively), H2 S (p < .001), and MM (p < .01) in subjects' exhaled air. At 6 months, 68.2% of individuals using the Zn/CHX rinse experienced a 1 or 2 category improvement in OLS compared with 19.1% of placebo-treated subjects. 91% of subjects in the Zn/CHX group were categorized as being effectively treated for intra-oral halitosis (i.e. H2 S < 112 ppb), compared to 43% in the placebo group. CONCLUSION Zn/CHX mouth rinse provides effective long-term efficacy against intra-oral halitosis, assessed both objectively and subjectively. With regular rinsing, the effect was sustained for 6 months.
Collapse
Affiliation(s)
| | - Carina Mårtensson
- School for Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Gösta Rutger Persson
- School for Health and Society, Kristianstad University, Kristianstad, Sweden.,Department of Periodontics, School of Dentistry, University of Washington, Seattle, WA, USA
| | - Stefan Renvert
- School for Health and Society, Kristianstad University, Kristianstad, Sweden.,School of Dental Science, Trinity College, Dublin, Ireland.,Blekinge Institute of Technology, Karlskrona, Sweden
| |
Collapse
|
10
|
Phaechamud T, Mahadlek J, Tuntarawongsa S. Peppermint oil/doxycycline hyclate-loaded Eudragit RS in situ forming gel for periodontitis treatment. JOURNAL OF PHARMACEUTICAL INVESTIGATION 2017. [DOI: 10.1007/s40005-017-0340-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
11
|
Dadawala S, Mufti S, Patel P, Shah M, Dave D. Effect of herbal mouthwash on periodontal parameters and P. gingivalis. ADVANCES IN HUMAN BIOLOGY 2017. [DOI: 10.4103/2321-8568.199529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
12
|
Laugisch O, Ramseier CA, Salvi GE, Hägi TT, Bürgin W, Eick S, Sculean A. Effects of two different post-surgical protocols including either 0.05 % chlorhexidine herbal extract or 0.1 % chlorhexidine on post-surgical plaque control, early wound healing and patient acceptance following standard periodontal surgery and implant placement. Clin Oral Investig 2016; 20:2175-2183. [PMID: 26795622 DOI: 10.1007/s00784-016-1713-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 01/10/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The aim of this study was to compare early wound healing, tooth staining and patient acceptance with two different post-surgical maintenance protocols. MATERIALS AND METHODS Forty patients scheduled for flap surgery to treat periodontal pockets or accommodate dental implants were randomly assigned to receive the following two different post-surgical maintenance protocols: (a) 2 weeks rinsing with a 0.05 % chlorhexidine digluconate (CHX)/herbal extract combination (test) or (b) a 0.1 % CHX solution (control). Early wound healing was evaluated clinically and immunologically. Tooth staining and patient acceptance were assessed by means of visual analogue scale (VAS). RESULTS Both groups presented with comparable wound healing profiles. No statistically significant differences were observed between the two protocols regarding early wound healing and plaque index (p > 0.05). However, in the control group, statistically significantly more patients felt discomfort due to tooth staining (p = 0.0467). Compared with patients from the test group, patients in the control group reported statistically significant more irritation of taste at week 1 (p = 0.0359) and at week 2 (p = 0.0042). CONCLUSIONS The present findings indicate that the two CHX protocols resulted in comparable healing and inhibition of plaque formation. Tooth staining and subjective discomfort related to irritation of taste were more frequent in the control group. CLINICAL RELEVANCE A post-operative protocol including 0.05 % CHX/herbal extract may have the potential to improve patient compliance during post-operative maintenance.
Collapse
Affiliation(s)
- Oliver Laugisch
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Christoph A Ramseier
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Giovanni E Salvi
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Tobias T Hägi
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Walter Bürgin
- School of Dental Medicine, University of Bern, Bern, Switzerland
| | - Sigrun Eick
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland
| | - Anton Sculean
- Department of Periodontology, School of Dental Medicine, University of Bern, Freiburgstrasse 7, 3010, Bern, Switzerland.
| |
Collapse
|
13
|
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.
Collapse
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
| |
Collapse
|
14
|
Rusu D, Stratul SI, Sarbu C, Roman A, Anghel A, Didilescu A, Jentsch H. Evaluation of a hydrophobic gel adhering to the gingiva in comparison with a standard water-soluble 1% chlorhexidine gel after scaling and root planing in patients with moderate chronic periodontitis. A randomized clinical trial. Int J Dent Hyg 2015; 15:53-64. [PMID: 26053503 DOI: 10.1111/idh.12155] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2014] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To evaluate the clinical, microbiological and enzymatic activity of a hydrophobic chlorhexidine-based gingiva-adhering gel containing herbal ingredients, compared with a commercially available 1% chlorhexidine water-soluble gel, during non-surgical therapy of moderate chronic periodontitis. METHODS A total of 34 subjects participated in this 6-month blinded randomized parallel controlled trial (ISRCTN35210084). After scaling and root planing (SRP), test group received the gel, by rubbing on the gingiva, once every second day, for 14 days. The control group received the control gel twice daily. Clinical parameters considered were the approximal plaque index, simplified oral hygiene index, modified gingival index, bleeding on probing, probing depth and clinical attachment level (primary outcome), assessed at baseline, 3 and 6 months, together with the frequency of detection of Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis (P.g.), Prevotella intermedia, Treponema denticola (T.d.), Tannerella forsythia (T.f.), and activity of neutrophil elastase and myeloperoxidase (secondary outcomes). RESULTS At 3 and 6 months, all clinical parameters improved significantly, without significant intergroup differences, except OHI-S, which improved at 3 months (P < 0.05). Microbiological data resulted in no significant intergroup differences at baseline and 6 months. At 3 months, significant differences for P.g., T.f. and T.d. were noted. A significant reduction of neutrophil elastase after 3 and 6 months was observed (P < 0.005), without significant intergroup differences. For myeloperoxidase, significant reductions were noted in both groups (P < 0.005 and P < 0.05), but no significant intergroup differences. The tested product seemed to have an increased efficacy, due to longer persistence on the gingiva, with reduced application frequency. CONCLUSIONS Both products had a relatively similar influence on the clinical, microbiological and enzymatic outcomes at 3 and 6 months after SRP.
Collapse
Affiliation(s)
- D Rusu
- Department of Periodontology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - S-I Stratul
- Department of Periodontology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - C Sarbu
- Department of Periodontology, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - A Roman
- Department of Periodontology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - A Anghel
- Department of Biochemistry, Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - A Didilescu
- Department of Embryology, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - H Jentsch
- Centre for Periodontology, Department of Conservative Dentistry and Periodontology, University of Leipzig, Leipzig, Germany
| |
Collapse
|
15
|
Bhat N, Mitra R, Oza S, Mantu VK, Bishnoi S, Gohil M, Gupta R. The antiplaque effect of herbal mouthwash in comparison to chlorhexidine in human gingival disease: a randomized placebo controlled clinical trial. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2015; 11:129-37. [PMID: 24698829 DOI: 10.1515/jcim-2014-0002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 03/08/2014] [Indexed: 11/15/2022]
Abstract
BACKGROUND The aim of this study was to compare the efficacy, safety, antiplaque and antigingivitis properties of a herbal mouthwash with chlorhexidine mouthwash. METHODS A double-blinded randomized clinical trial was conducted among 72 undergraduate students with age group 18-24 years. They were randomly divided into three mouthwash group with 24 participants in each group. Group A (herbal), Group B (chlorhexidine) and Group C (normal saline).The Turesky et al. 1970 plaque index and Loe and Silness 1963 gingival index was recorded. Student's t-test and one-way ANOVA were used to test the significance. RESULTS A statistically highly significant difference was obtained between mouthwash B and C (p=0.00) and a significant difference between mouthwash A and C (p=0.004), showing that chlorhexidine was superior to herbal mouthwash and saline. However, there was a nonsignificant difference between mouthwash A and B (p=0.435) showing that herbal and chlorhexidine mouthwash was equally effective in reducing plaque and gingivitis. CONCLUSIONS The efficacy of herbal mouthwash was equally effective in reducing plaque and gingivitis as compared to chlorhexidine mouthwash and may be considered as a good alternative. The chlorhexidine mouthwash was reported with many side effects which limits its acceptability and long-term use, whereas the presently tested herbal mouthwash had no side effects apart from mild burning sensation.
Collapse
|
16
|
Jablonski R, Mertz E, Featherstone JDB, Fulmer T. Maintaining oral health across the life span. Nurse Pract 2014; 39:39-48. [PMID: 24841464 DOI: 10.1097/01.npr.0000446872.76779.56] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Oral health is directly related to systemic health, yet many Americans have limited to no access to dental health professionals. Nurse practitioners are in an excellent position to fill this void by providing caries risk assessments, chemical therapy to prevent progression of caries, and appropriate patient education to prevent caries.
Collapse
Affiliation(s)
- Rita Jablonski
- Rita Jablonski is an associate professor at the University of Alabama at Birmingham, School of Nursing, Birmingham, Ala. Elizabeth Mertz is an assistant professor at the University of California, San Francisco, Calif. John D.B. Featherstone is a dean and professor at the University of California, School of Dentistry, San Francisco, Calif. Terry Fulmer is a dean and professor at Bouvé College of Health Sciences and professor of Public Policy and Urban Affairs at Northeastern University, Boston, Mass
| | | | | | | |
Collapse
|
17
|
Jain D, Dasar P, Nagarajappa S, Kumar S, Airen B, Warhekar S. In vitro activity of ethanolic and water extract of guava leaves at various concentrations against Lactobacillus acidophilus. JOURNAL OF INDIAN ASSOCIATION OF PUBLIC HEALTH DENTISTRY 2014. [DOI: 10.4103/2319-5932.144809] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
18
|
Chen Y, Wong RWK, McGrath C, Hagg U, Seneviratne CJ. Natural compounds containing mouthrinses in the management of dental plaque and gingivitis: a systematic review. Clin Oral Investig 2013; 18:1-16. [DOI: 10.1007/s00784-013-1033-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Accepted: 07/02/2013] [Indexed: 10/26/2022]
|
19
|
Celeste RK. Oxygenating Agents may Inhibit Tooth Staining Effect of Chlorhexidine. J Evid Based Dent Pract 2013; 13:9-10. [DOI: 10.1016/j.jebdp.2012.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
20
|
Lauenstein M, Kaufmann M, Persson GR. Clinical and microbiological results following nonsurgical periodontal therapy with or without local administration of piperacillin/tazobactam. Clin Oral Investig 2013; 17:1645-60. [DOI: 10.1007/s00784-012-0856-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Accepted: 09/27/2012] [Indexed: 10/27/2022]
|
21
|
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.
Collapse
Affiliation(s)
- Daniëlle A C Van Strydonck
- Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
| | | | | | | |
Collapse
|
22
|
van Maanen-Schakel NWD, Slot DE, Bakker EWP, Van der Weijden GA. The effect of an oxygenating agent on chlorhexidine-induced extrinsic tooth staining: a systematic review. Int J Dent Hyg 2012; 10:198-208. [PMID: 22594687 DOI: 10.1111/j.1601-5037.2012.00555.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although chlorhexidine digluconate (CHX) is currently the most effective mouthwash for reducing plaque and gingivitis, one of its side effects is extrinsic tooth staining. Interestingly, oxygenating agents may reduce this staining. OBJECTIVE The aim of this review was to systematically search the literature for data concerning the inhibiting effect of an oxygenating agent (OA) on CHX-induced tooth staining. METHODS MEDLINE-PubMed, Cochrane-CENTRAL, EMBASE and other relevant electronic databases were searched for articles that were published up to November 2011. Articles were included if they were randomized controlled trials or controlled clinical trials conducted with healthy subjects ≥ 16 years of age that compared the effects of CHX mouthrinse combined with an OA with the effects of CHX alone. RESULTS An independent screening of 1183 titles and abstracts resulted in 4 publications that met the inclusion criteria. The extracted data allowed meta-analyses of intermediate length studies and showed that combining an OA with CHX mouthrinses led to a significant reduction in tooth staining (mean difference: 0.27; P = 0.02) and plaque scores (mean difference: 0.10; P = 0.003) when compared with CHX alone. One of the included studies reported a side effect for one participant. The present review was limited by the availability of data, and the included studies were methodologically and clinically heterogeneous, which affected the quality and interpretation of the evidence. CONCLUSION There is moderate evidence that a combination of CHX and an OA reduces tooth staining without interfering with plaque growth inhibition.
Collapse
Affiliation(s)
- N W D van Maanen-Schakel
- School of Dental Hygiene, Hogeschool Utrecht, University of Applied Sciences, Utrecht, The Netherlands.
| | | | | | | |
Collapse
|
23
|
Lam OLT, McGrath C, Bandara HMHN, Li LSW, Samaranayake LP. Oral health promotion interventions on oral reservoirs of staphylococcus aureus: a systematic review. Oral Dis 2011; 18:244-54. [DOI: 10.1111/j.1601-0825.2011.01874.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|