The influence of triclosan, zinc or propylene glycol on oral mucosa exposed to sodium lauryl sulphate

Effect of a gel containing green tea extract and hyaluronic acid on palate pain scores and wound healing after free gingival graft: a quasi-randomized controlled clinical trial

OBJECTIVES

The aim of this study was to evaluate the effect of a gel containing green tea extract and hyaluronic acid (HA) on pain scores and wound healing in donor sites after free gingival graft (FGG).

MATERIALS AND METHODS

Forty-two patients requiring FGG were included in three groups: (1) control group (n = 14), no material was placed in the donor area; only the clot was kept in position by sutures; (2) placebo group (n = 14), vehicle gel applied 3 times a day for 7 days; and (3) test group (n = 14), gel containing green tea extract and HA applied 3 times a day for 7 days. The wound size by clinical measurement (WS-CM) and photographic image (WS-PI), complete wound epithelialization (CWE), and palatal mucosa color were evaluated after 3 days and 1, 2, and 4 weeks postoperatively. The visual analog scale (VAS) for pain and analgesic consumption were used to assess participant's perception in the same postoperative periods.

RESULTS

A similar progressive reduction in the wound size, associated with an improvement in the color pattern, was observed in all groups (p > 0.05). No significant differences were found for CWE and pain assessment between the examined groups (p > 0.05).

CONCLUSION

The gel containing green tea extract and HA application in palatal wounds after FGG removal does not provide clinical healing benefits using this investigated protocol.

CLINICAL RELEVANCE

This is the first clinical study evaluating the effect of gel containing green tea extract and HA on the palate postoperative pain control and wound healing after FGG.

TRIAL REGISTRATION

http://clinicaltrials.gov : NCT05270161.

Hormesis: Wound healing and keratinocytes

Hormetic dose responses (i.e., a biphasic dose/concentration response characterized by a low dose stimulation and a high dose inhibition) are shown herein to be commonly reported in the dermal wound healing process, with the particular focus on cell viability, proliferation, and migration of human keratinocytes in in vitro studies. Hormetic responses are induced by a wide range of substances, including endogenous agents, numerous drug and nanoparticle preparations and especially plant derived extracts, including many well-known dietary supplements as well as physical stressor agents, such as low-level laser treatments. Detailed mechanistic studies have identified common signaling pathways and their cross-pathway communications that mediate the hormetic dose responses. These findings suggest that the concept of hormesis plays a fundamental role in wound healing, with important potential implications for agent screening and evaluation, as well as clinical strategies.

Cytotoxic effects of different detergent containing children's toothpastes on human gingival epithelial cells

Background

This study aimed to evaluate possible cytotoxic effects to gingival epithelial cells exposed to children toothpastes containing different detergent.

Methods

Tissues required for the isolation of human gingival epithelial cells were obtained by biopsy during the extraction of the impacted third molar tooth. Toothpaste solutions of different concentrations were prepared from five different children’s toothpastes with different detergent contents. Isolated gingival epithelial cells were stimulated with experimental groups consisting of toothpaste solutions (Colgate, Sensodyne, Splat, Nenedent, Perlodent) at different concentrations and a control group consisting of complete Dulbecco’s modified eagle medium. After the experiments, cell viability was evaluated using flow cytometry. 2 Way ANOVA was used to see the interaction effect of the main effects of toothpaste solution and concentration factors. Pairwise comparisons were made by Tukey post hoc tests. In the study, the significance level was taken as 0.05.

Results

As a result of the analysis, it was seen that the toothpaste solution and concentration factors and the interactions of these 2 factors were effective on the viable, early apoptotic, late apoptotic and necrotic cell rates. The statistically highest live cell ratios were detected in Splat’s toothpaste solutions (90.14% at 0.4% concentration) after the control group (90.82%) and the group with the lowest viability values was determined in Colgate group (75.74% at 0.4% concentration) (p < 0.05).

Conclusions

According to the results of the study, it was observed that toothpastes containing SLS affected the viability of cells more negatively than toothpastes with other detergent contents.

Is there a role of toothpastes in the development of recurrent aphthous stomatitis? A prospective controlled clinical trial with skin patch testing

OBJECTIVES

The oral mucosa is exposed to a large number of antigenic agents contained in toothpastes. These agents are reported to stimulate recurrent aphthous stomatitis (RAS) pathogenesis, and toothpastes that do not contain probable allergenic substances reduced the number and frequency of aphthous ulcers. We aimed to determine whether the skin patch test (SPT) can be used to determine if toothpaste allergens play a role in the etiology of RAS.

STUDY DESIGN

Sixty-three patients with RAS and 47 healthy volunteers were skin patch tested with sodium lauryl sulfate, cocamidopropyl betaine, propylene glycol, aluminum chloride hexahydrate, menthol, triclosan, and titanium dioxide, which are present in most of the toothpastes. Fisher's exact test and the Yates chi-square test were used to compare categorical variables and patch test results between 2 groups.

RESULTS

The SPT was positive in 8 (22.2%) patients with RAS and 11 (23.4%) control subjects, and the difference between the groups was not statistically significant (P < .05). Sodium lauryl sulfate, titanium dioxide, and menthol were the most common positive allergens in both groups.

CONCLUSIONS

Allergens in toothpastes did not appear to stimulate the formation of RAS. However, in order to determine a clearer relationship, a study in a larger patient series employing intraoral patch testing with more toothpaste ingredients is suggested.

Evaluation of zinc sulfate mucoadhesive formulation on recurrent aphthous stomatitis: a randomized double-blind, placebo-controlled clinical trial

BACKGROUND

Recurrent aphthous stomatitis (RAS) is a common lesion that affects the oral mucosa. There are several methods to treat RAS, including systemic and topical formulations. This study was conducted to evaluate the anti-inflammatory effect of topical zinc sulfate and its efficacy in the treatment of RAS.

METHODS

A double-blind randomized clinical trial was conducted on 46 patients with RAS. They were randomly assigned into two groups to receive a zinc sulfate mucoadhesive tablet or placebo for 7 days. The pain severity was measured at baseline and daily while the diameter of the lesion was measured at baseline and on days 3, 5, and 7. The obtained data were analyzed in SPSS V.16.

RESULTS

There was no significant difference in the mean diameter of lesions and pain at baseline between the two groups (P = 0.643 and P = 0.842, respectively). However, on the third, fifth, and seventh days of the study, the diameter of the lesion significantly reduced in the intervention group (P = 0.001) and the pain intensity became significantly different between groups from the fourth day of the study (P = 0.001).

CONCLUSION

Zinc sulfate mucoadhesive tablet was effective in recovery and reducing the pain and diameter of the aphthous lesion and could be considered for the treatment of RAS.

TRIAL REGISTRATION

Evaluation of the effectiveness of zinc sulfate mucoadhesive tablet in the improvement of recurrent aphthous stomatitis (RAS), IRCT20151109024975N9. Registered August 1, 2018, https://en.irct.ir/trial/32423 . This project was registered by the Iranian Registry of Clinical Trials ( http://www.irct.ir ). The IRCT ID was IRCT20151109024975N9.

Triclosan: An Update on Biochemical and Molecular Mechanisms

Triclosan (TCS) is a synthetic, chlorinated phenolic antimicrobial agent commonly used in commercial and healthcare products. Items made with TCS include soaps, deodorants, shampoos, cosmetics, textiles, plastics, surgical sutures, and prosthetics. A wealth of information obtained from in vitro and in vivo studies has demonstrated the therapeutic effects of TCS, particularly against inflammatory skin conditions. Nevertheless, extensive investigations on the molecular aspects of TCS action have identified numerous adversaries associated with the disinfectant including oxidative injury and influence of physiological lifespan and longevity. This review presents a summary of the biochemical alterations pertaining to TCS exposure, with special emphasis on the diverse molecular pathways responsive to TCS that have been elucidated during the present decade.

Risk Assessment of Triclosan, a Cosmetic Preservative

Triclosan (TCS) is an antimicrobial compound used in consumer products. The purpose of current study was to examine toxicology and risk assessment of TCS based on available data. Acute toxicities of oral, transdermal and inhalation routes were low, and phototoxicity and neurotoxicity were not observed. Topical treatment of TCS to animal caused mild irritation. TCS did not induce reproductive and developmental toxicity in rodents. In addition, genotoxicity was not considered based on in vitro and in vivo tests of TCS. It is not classified as a carcinogen in international authorities such as International Agency for Research on Cancer (IARC). No-observed-adverse-effect level (NOAEL) was determined 12 mg/kg bw/day for TCS, based on haematoxicity and reduction of absolute and relative spleen weights in a 104-week oral toxicity study in rats. Percutaneous absorption rate was set as 14%, which was human skin absorption study reported by National Industrial Chemicals Notification and Assessment Scheme (NICNAS) (2009). The systemic exposure dosage (SED) of TCS has been derived by two scenarios depending on the cosmetics usage of Koreans. The first scenario is the combined use of representative cosmetics and oral care products. The second scenario is the combined use of rinse-off products of cleansing, deodorants, coloring products, and oral care products. SEDs have been calculated as 0.14337 mg/kg bw/day for the first scenario and 0.04733 mg/kg bw/day for the second scenario. As a result, margin of safety (MOS) for the first and second scenarios was estimated to 84 and 253.5, respectively. Based on these results, exposure of TCS contained in rinse-off products, deodorants, and coloring products would not pose a significant health risk when it is used up to 0.3%.

Dentifrices for children differentially affect cell viability in vitro

Objectives

Child dentifrices vary in their composition, with possible differential impacts on cells in the oral soft tissue. While cytotoxicity studies have been performed on adult dentifrices, no respective studies have thus far been reported on child dentifrices.

Material and methods

Seventeen commercial dentifrices for children up to 12 years of age were evaluated with respect to their in vitro cytotoxicity on gingival fibroblasts, oral squamous cell carcinoma HSC-2 cells, and L929 mouse fibroblasts. Proliferation was analyzed and live-dead staining was performed.

Results

Ten child dentifrices greatly reduced cell viability with LC50 values below 5 %. Four dentifrices showed a moderate cytotoxicity with LC50 values between 5 and 20 %. Three child dentifrices showed almost no cytotoxicity with LC50 values above 95 %. The results of the assays for proliferation and live-dead staining supported these findings.

Conclusions

The different composition of the child dentifrices translated into a broad spectrum of in vitro cytotoxicity on cells of the oral cavity.

Clinical relevance

The in vitro data provide the scientific foundation for further in vivo research testing the clinical relevance of the present findings.

Outbreaks where food workers have been implicated in the spread of foodborne disease. Part 11. Use of antiseptics and sanitizers in community settings and issues of hand hygiene compliance in health care and food industries

Hand washing with soap is a practice that has long been recognized as a major barrier to the spread of disease in food production, preparation, and service and in health care settings, including hospitals, child care centers, and elder care facilities. Many of these settings present multiple opportunities for spread of pathogens within at-risk populations, and extra vigilance must be applied. Unfortunately, hand hygiene is not always carried out effectively, and both enteric and respiratory diseases are easily spread in these environments. Where water is limited or frequent hand hygiene is required on a daily basis, such as for many patients in hospitals and astronauts in space travel, instant sanitizers or sanitary wipes are thought to be an effective way of preventing contamination and spread of organisms among coworkers and others. Most concerns regarding compliance are associated with the health care field, but the food industry also must be considered. Specific reasons for not washing hands at appropriate times are laziness, time pressure, inadequate facilities and supplies, lack of accountability, and lack of involvement by companies, managers, and workers in supporting proper hand washing. To facilitate improvements in hand hygiene, measurement of compliant and noncompliant actions is necessary before implementing any procedural changes. Training alone is not sufficient for long-lasting improvement. Multiactivity strategies also must include modification of the organization culture to encourage safe hygienic practices, motivation of employees willing to use peer pressure on noncompliant coworkers, a reward and/or penalty system, and an operational design that facilitates regular hand hygiene.

Dual effects of sodium lauryl sulphate on human oral epithelial structure

Sodium lauryl sulphate (SLS) is a common detergent known to cause irritation and inflammatory reactions in skin. SLS is also the most commonly used toothpaste detergent and has been related to intraoral adverse effects. However, its specific biological effects on the oral mucosa (OM) have not yet been identified. The objective of this study was to investigate the putative effects of SLS on human oral epithelium using a novel in vitro reconstructed three-dimensional cell culture model. Reconstructed human OM, generated from primary normal human oral keratinocytes and fibroblasts, was exposed to clinically relevant concentrations of SLS (range 0.015-1.5%). The cultured tissues were evaluated by histomorphometry, immunohistochemistry (Ki-67, epithelial (E)-cadherin, alpha6-, beta1-integrins, cleaved caspase-3) and the TUNEL method. Increased epithelial thickness, enhanced proliferation (Ki-67), a more pronounced expression of E-cadherin throughout all epithelial cell layers and single TUNEL-positive cells in the middle spinous cell layers were observed in cultures exposed to low concentrations (0.015%) of SLS. At exposure to higher SLS concentrations (>or=0.15%), epithelial thickness, cell proliferation and E-cadherin expression gradually decreased and in the central areas of exposed regions, cells detached from each other and underwent cell death. In conclusion, clinically relevant concentrations of SLS have dual effects on reconstituted human OM; although occasional cell death within the epithelium was also observed, the increased epithelial thickness, proliferation and E-cadherin expression induced at lower concentrations might be associated with a protective mucosal response, whereas at higher concentrations a more destructive type of reaction predominated.

Zinc and skin health: overview of physiology and pharmacology

BACKGROUND

Zinc is known to have a critical role in overall human physiology, which likely explains many of its therapeutic uses for the last several thousand years. The specific roles zinc plays in skin health and function are less widely known yet are likely just as critical based on the manifestations of dietary zinc deprivation, which include moderate to severe dermatitis.

OBJECTIVE

To provide a critical review of the scientific literature as to the physiologic importance of zinc to skin, the biochemical basis for these effects, and pharmacologic aspects of zinc therapeutics.

RESULTS AND CONCLUSIONS

Skin is in a continual state of renewal, placing a high demand on zinc-based enzymes and proteins that direct this process. The importance of zinc physiologically is especially evident in studies of wound healing and inflammation reduction. During these processes, the high needs for zinc can be supplemented externally, generally increasing the rates of the natural processes. Topical zinc delivery involves the pharmacologic optimization of zinc delivery, often mediated by the solubility of the zinc material and interactions within the product matrix.

Recurrent aphthous stomatitis

Recurrent aphthous stomatitis remains a commonly occurring cause of oral pain and ulceration. Although the ulcerations of RAS are multifactorial and of unknown cause, recognition of the role of patient and environmental factors may be helpful in developing recommendations for treatment and prevention of future ulcers.

The effect of sodium lauryl sulphate, triclosan and zinc on the permeability of normal oral mucosa

OBJECTIVE

Sodium lauryl sulphate (SLS), an important component in many oral health products, is well established as a contact irritant in skin. Recent studies have suggested that it may also affect the structural integrity of oral mucosa. SLS is rarely used alone in dentifrices or mouthwashes and the aim of this study was to establish the effect of SLS both alone and in combination with Triclosan (TCN) and zinc (Zn) on the permeability barrier properties of normal human oral mucosa.

METHOD

Ventral tongue mucosa was obtained from nine males and seven females within 60 h of death and stored frozen at -70 degrees C until use. The permeability of the tissue to tritiated water was measured after pretreatment for 15 min with SLS alone, SLS/TCN, SLS/Zn and a SLS/TCN/Zn mixture. Treatment with distilled water (DW) served as control. The histological appearance of the tissue before and after treatment was also examined by light microscopy.

RESULTS

SLS treatment caused a significant increase in water permeability compared to control tissue (Kp = 11.7 +/- 1.00; 4.96 +/- 0.50 respectively; P < 0.005). Treatment with a SLS/TCN/Zn mixture, however, had no effect on the permeability to water (Kp = 5.5 +/- 0.56). Histological examination revealed that tissue exposed to SLS had a marked disruption of the epithelial surface whilst tissue treated with a SLS/TCN/Zn mixture was indistinguishable from controls.

CONCLUSION

Although mucosa exposed to SLS alone showed an increase in permeability to water, the addition of TCN and Zn to SLS appeared to prevent this effect. As SLS is included in some dental products to solubilise compounds such as TCN, its presence may have no effect on the permeability barrier property of oral mucosa.