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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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Vitiello F, Monterubbianesi R, Sparabombe S, Bourgeois D, Tosco V, Alshehri FA, Carrouel F, Putignano A, Orsini G. Use of over-the-counter mouthwashes as an additional measure in individual oral prophylaxis on adults with plaque-induced gingivitis: a double-blind, parallel, randomized controlled trial. BMC Oral Health 2024; 24:83. [PMID: 38229032 DOI: 10.1186/s12903-023-03779-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 12/14/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Plaque-induced gingivitis is a chronic inflammatory condition characterized by complete reversibility of tissue damage once the periodontal biofilm has been disorganised. The aim of this study was to evaluate the efficacy of two commercially available mouthwashes (MWs) versus a chlorhexidine (CHX) 0.12% MW in reducing gingival bleeding (GB) in adults with plaque-induced gingivitis. METHODS The present study was a double-blind, parallel, randomized controlled trial involving 6492 gingival sites (i.e. 39 subjects × 28 teeth × 6 sites/tooth) aged 18-75 years. During a 2-week period, subjects were randomized to receive MWs: a control CHX 0.12% MW (group C, 1818 sites); a MW test containing CHX 0.09% + Citrox®/P complex (group CX, 2628 sites); a MW test based on natural compounds (group P, 2016 sites). GB was assessed at the inclusion visit (T0) and after 2 weeks of MW use (T1). Analyses of GB were compared between groups and then restricted to subjects with bleeding sites between 10 and 30% (moderate gingivitis) or ≥ 30% (severe gingivitis) at T0. Pairwise comparisons were made between groups and logistic regression was used to identify correlates of GB (T1). RESULTS For total bleeding site analysis, GB reduction between T0 and T1 ranged from 23% (C), 26% (CX) and 36% (P), respectively (all p < 0.05). Multiple comparison between groups showed that group C was significantly less effective (p < 0.05) than groups CX and P. Splitting the analysis, in patients with severe gingivitis (≥ 30% bleeding sites at T0), all MWs had a positive effect on GB with a reduction at T1 of 36% (C), 33% (CX) and 42% (P), respectively. While GB reduction between T0 and T1, was significant for all groups, the comparison among groups showed no significant difference between group C and CX, whereas the improvement was significant for group P. On the other hand, in adults with moderate gingivitis (< 30% bleeding sites at T0), only CX and P had a positive effect on GB reduction at T1(9% in CX and 2% in P, respectively), although the differences between the three groups were not significant. CONCLUSION The daily use of MWs with natural components (groups P and CX) for 2 weeks should be considered positively as an adjunct to individual oral prophylaxis to reduce GB compared to the control MW containing CHX 0.12% (group C) in healthy adults with plaque-induced gingivitis. For subjects with severe gingivitis, it is advisable to first use natural MW (P) and then MW based on CHX 0.09% with natural components (CX), compared to MW with CHX 0.12% (C). For adults with moderate gingivitis, P and CX can be advisable, even if no definitive recommendations can be drawn. TRIAL REGISTRATION ACTRN12622000215729, 07/02/2022.
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Affiliation(s)
- Flavia Vitiello
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
- Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, 69008, France
| | - Riccardo Monterubbianesi
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
| | - Scilla Sparabombe
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
| | - Denis Bourgeois
- Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, 69008, France
| | - Vincenzo Tosco
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
| | - Fahad Ali Alshehri
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, 12372, Saudi Arabia
| | - Florence Carrouel
- Research Unit UR 4129, University Claude Bernard Lyon 1, University of Lyon, Lyon, 69008, France
| | - Angelo Putignano
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy
- National Institute of Health and Science of Aging (INRCA), Ancona, 60124, Italy
| | - Giovanna Orsini
- Department of Clinical Sciences and Stomatology (DISCO), Università Politecnica delle Marche, Ancona, 60126, Italy.
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Real-Time Analysis of Antiproliferative Effects of Mouthwashes Containing Alcohol, Sodium Fluoride, Cetylpyridinium Chloride, and Chlorhexidine In Vitro. BIOMED RESEARCH INTERNATIONAL 2021; 2021:2610122. [PMID: 34676260 PMCID: PMC8526215 DOI: 10.1155/2021/2610122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 09/09/2021] [Accepted: 09/22/2021] [Indexed: 11/30/2022]
Abstract
Objectives In this study, the cytotoxic responses of six different over-the-counter mouthwashes on L929 cells were analyzed by two different techniques: the traditional colorimetric tetrazolium-based reduction assay (MTT) and the modern impedance-based real-time cell analysis (RTCA) system to investigate their biocompatibility in vitro. Thus, the investigation of the antiproliferative effects of the specified materials via different techniques is vital to reach this goal. Materials and Methods First, L929 mouse fibroblasts were exposed to the dilutions of mouthwashes for 2 minutes. After incubation, the tetrazolium reduction method was used to assess the metabolic viability of cells measured by colorimetric MTT assay and morphological inspection of cells was performed via phase-contrast microscopy. Furthermore, the effect of each mouthwash on the proliferation, morphology, and adhesion of L929 cells was monitored continuously by a noninvasive and label-free RTCA system for 140 h. Results Our data showed that all of the mouthwashes had varying cytotoxic effects on fibroblasts compared to the control group in MTT assay. In addition to that, RTCA technology has provided the growth kinetic profiles that can be used to analyze if the treatment is causing antimitotic or DNA-damaging effect on cells. Thus, analysis via this system can tell us the mechanism of toxicity behind the cell growth inhibition in vitro. Here, we found that only mouthwash 1 moderately maintained the viability of the L929 cells, yet displaying antimitotic effects and the other mouthwashes (mouthwash 2-mouthwash 6) showed toxicity via DNA-damaging effects. Conclusions Of the six types of mouthwash tested, the most biocompatible result was obtained from a mouthwash containing alcohol (i.e., mouthwash 1). On the other hand, sodium fluoride- (NaF-) and cetylpyridinium chloride- (CPC-) containing mouthwash (i.e., mouthwash 2) showed the most cytotoxic effect.
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Sbaraini A, Adams GG, Reynolds EC. Experiences of oral health: before, during and after becoming a regular user of GC Tooth Mousse Plus ®. BMC Oral Health 2021; 21:14. [PMID: 33413323 PMCID: PMC7792129 DOI: 10.1186/s12903-020-01360-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 12/09/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Clinical trials and laboratory studies from around the world have shown that GC Tooth Mousse Plus® (TMP) is effective in protecting teeth from tooth decay and erosion, buffering dental plaque pH, remineralising white spot lesions and reducing dentine hypersensitivity. However, no other study has assessed the experiences of oral health, before, during and after individuals becoming regular users of TMP. The aim of this study was to identify how participants' oral health status changed after introducing TMP into their oral hygiene routine. METHODS A qualitative study using Charmaz's grounded theory methodology was conducted. Fifteen purposively sampled regular users of TMP were interviewed. Transcripts were analysed after each interview. Data analysis consisted of transcript coding, detailed memo writing, and data interpretation. RESULTS Participants described their experiences of oral health and disease, before, during and after introducing TMP into their daily oral hygiene routine, together with the historical, biological, financial, psychosocial, and habitual dimensions of their experiences. Before becoming a regular user of TMP, participants described themselves as having a damaged mouth with vulnerable teeth, dry mouth, and sensitivity. Various aspects of participants' histories were relevant, such as, family history and history of oral disease. Having a damaged mouth with vulnerable teeth, dry mouth and sensitivity was explained by those elements. Despite some initial barriers, once being prescribed TMP by a dental professional, a three-fold process of change was initiated: starting a new oral hygiene routine, persevering daily, and experiencing reinforcing outcomes. This process led to a fundamental lifestyle change. Participants transitioned from having a damaged mouth with vulnerable teeth to having a comfortable mouth with strong teeth; at the same time participants felt empowered by this newly found status of being able to keep their teeth for life. Barriers and facilitators for incorporating TMP on daily oral hygiene routine were also identified. CONCLUSIONS Participants valued having a comfortable mouth with strong teeth, which did not require repeated restorations. Seeing concrete results in their mouths and experiencing a more comfortable mouth boosted adherence to daily applications of TMP, which was maintained over time.
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Affiliation(s)
- Alexandra Sbaraini
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, VIC 3010 Australia
| | - Geoffrey G. Adams
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, VIC 3010 Australia
| | - Eric C. Reynolds
- Oral Health Cooperative Research Centre, Melbourne Dental School, Bio21 Institute, The University of Melbourne, Melbourne, VIC 3010 Australia
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5
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Mathur N, Tyagi S. Ramadan fasting and dental implications: A special review. JOURNAL OF DENTAL RESEARCH AND REVIEW 2021. [DOI: 10.4103/jdrr.jdrr_86_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Greene AC, Acharya AP, Lee SB, Gottardi R, Zaleski E, Little SR. Cranberry extract-based formulations for preventing bacterial biofilms. Drug Deliv Transl Res 2020; 11:1144-1155. [PMID: 32783154 DOI: 10.1007/s13346-020-00837-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Generating formulations for the delivery of a mixture of natural compounds extracted from natural sources is a challenge because of unknown active and inactive ingredients and possible interactions between them. As one example, natural cranberry extracts have been proposed for the prevention of biofilm formation on dental pellicle or teeth. However, such extracts may contain phenolic acids, flavonol glycosides along with other constituents like coumaroyl iridoid glycosides, flavonoids, alpha-linolenic acid, n-6 (or n-3) fatty acids, and crude fiber. Due to the presence of a variety of compounds, determining which molecules (and how many molecules) are essential for preventing biofilm growth is nontrivial to ascertain. Therefore, a formulation that could contain natural, unrefined, cranberry extract (with all its constituent compounds) at high loading would be ideal. Accordingly, we have generated several candidate formulations including poly(lactic-co-glycolic) acid (PLGA)-based microencapsulation of cranberry extract (CE15) as well as formulations including stearic acid along with polyvinylpyrrolidone (PVP) or Ethyl lauroyl arginate (LAE) complexed with cranberry extracts (CE15). We found that stearic acid in combination with PVP or LAE as excipients led to higher loading of the active and inactive compounds in CE15 as compared with a PLGA microencapsulation and also sustained release of CE15 in a tunable manner. Using this method, we have been able to generate two successful formulations (one preventative based, one treatment based) that effectively inhibit biofilm growth when incubated with saliva. In addition to cranberry extract, this technique could also be a promising candidate for other natural extracts to form controlled release systems.Graphical abstract.
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Affiliation(s)
- Ashlee C Greene
- Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Abhinav P Acharya
- Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA, 15261, USA.,Department of Chemical Engineering, Arizona State University, Tempe, AZ, 85284, USA
| | - Sang B Lee
- Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Riccardo Gottardi
- Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA, 15261, USA.,Center for Cellular and Molecular Engineering, Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, PA, 15219, USA.,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA.,Ri.MED Foundation, 90133, Palermo, Italy
| | - Erin Zaleski
- Johnson & Johnson Consumer Health, Skillman, NJ, 08558, USA
| | - Steven R Little
- Department of Chemical Engineering, University of Pittsburgh, Pittsburgh, PA, 15261, USA. .,McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, 15219, USA. .,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, 15261, USA. .,Department of Immunology, University of Pittsburgh, Pittsburgh, PA, 15213, USA. .,Department of Ophthalmology, University of Pittsburgh, Pittsburgh, PA, 15213, USA. .,Department of Pharmaceutical Science, University of Pittsburgh, Pittsburgh, PA, 15213, USA. .,Department of Pediatrics, Division of Pulmonary Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
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Inhibition of Cariogenic Plaque Formation on Root Surface with Polydopamine-Induced-Polyethylene Glycol Coating. MATERIALS 2016; 9:ma9060414. [PMID: 28773535 PMCID: PMC5456761 DOI: 10.3390/ma9060414] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 05/17/2016] [Accepted: 05/23/2016] [Indexed: 12/24/2022]
Abstract
Root caries prevention has been a challenge for clinicians due to its special anatomical location, which favors the accumulation of dental plaque. Researchers are looking for anti-biofouling material to inhibit bacterial growth on exposed root surfaces. This study aimed to develop polydopamine-induced-polyethylene glycol (PEG) and to study its anti-biofouling effect against a multi-species cariogenic biofilm on the root dentine surface. Hydroxyapatite disks and human dentine blocks were divided into four groups for experiments. They received polydopamine-induced-PEG, PEG, polydopamine, or water application. Contact angle, quartz crystal microbalance, and Fourier transform infrared spectroscopy were used to study the wetting property, surface affinity, and an infrared spectrum; the results indicated that PEG was induced by polydopamine onto a hydroxyapatite disk. Salivary mucin absorption on hydroxyapatite disks with polydopamine-induced-PEG was confirmed using spectrophotometry. The growth of a multi-species cariogenic biofilm on dentine blocks with polydopamine-induced-PEG was assessed and monitored by colony-forming units, confocal laser scanning microscopy, and scanning electron microscopy. The results showed that dentine with polydopamine-induced-PEG had fewer bacteria than other groups. In conclusion, a novel polydopamine-induced-PEG coating was developed. Its anti-biofouling effect inhibited salivary mucin absorption and cariogenic biofilm formation on dentine surface and thus may be used for the prevention of root dentine caries.
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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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Cardelle-Cobas A, Madureira AR, Costa E, Barros R, Tavaria FK, Pintado ME. Development of Oral Strips Containing Chitosan as Active Ingredient: A Product for Buccal Health. INT J POLYM MATER PO 2015. [DOI: 10.1080/00914037.2015.1030661] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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10
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Wilder RS, Bell KP, Phillips C, Paquette DW, Offenbacher S. Dentists’ Practice Behaviors and Perceived Barriers Regarding Oral-Systemic Evidence: Implications for Education. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.9.tb05796.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Rebecca S. Wilder
- Department of Dental Ecology and Director of Faculty Development; University of North Carolina School of Dentistry
| | | | | | | | - Steven Offenbacher
- Ora Pharma Distinguished Professor of Periodontal Medicine; Director of the Center for Oral and Systemic Diseases; University of North Carolina School of Dentistry
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11
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Van Leeuwen MPC, Rosema NAM, Versteeg PA, Slot DE, Van Winkelhoff AJ, Van der Weijden GA. Long-term efficacy of a 0.07% cetylpyridinium chloride mouth rinse in relation to plaque and gingivitis: a 6-month randomized, vehicle-controlled clinical trial. Int J Dent Hyg 2014; 13:93-103. [PMID: 25040299 DOI: 10.1111/idh.12082] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of 0.07% cetylpyridinium chloride (CPC) mouth rinse for reduction of gingival inflammation and inhibition of plaque compared to a vehicle control (VC) mouth rinse over a 6-month period. MATERIALS & METHODS Participants (n = 62) used their randomly assigned product as adjunct to toothbrushing. Bleeding, plaque and staining scores were assessed at baseline, 3 and 6 months. Plaque and saliva samples were taken at each assessment monitoring possible shifts in the composition of the microbiota. RESULTS A significant difference (P = 0.002) in favour of the CPC mouth rinse, with respect to plaque scores, was found. Bleeding scores at 6 months were not significantly different (P = 0.089). However, when correcting for baseline values, a tendency towards a significant difference in bleeding scores at end trail was observed in favour of the CPC mouth rinse (P = 0.061). Regarding staining at 3 and 6 months, a small but significant difference (8.6% and 10.4%, respectively) (P < 0.0001) was observed with lower scores for the VC group. There was a significant reduction in total anaerobic count in the CPC group at 6 months (P < 0.05). The ratio of aerobes/anaerobes was markedly increased at 3 months, especially in the CPC group. No further differences were observed between groups at 6 months. CONCLUSIONS The use of 0.07% CPC mouth rinse was significantly more effective in reducing plaque scores than the vehicle control. Bleeding scores were not different at 6 months. The test product was well accepted and did not cause any serious clinical side effects or negatively affected the microbiota.
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Affiliation(s)
- M P C Van Leeuwen
- Department of Periodontology, Academic Center for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, Amsterdam, The Netherlands; Clinic for Dentistry, Bussum, The Netherlands
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12
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Ros-Llor I, Lopez-Jornet P. Cytogenetic analysis of oral mucosa cells, induced by chlorhexidine, essential oils in ethanolic solution and triclosan mouthwashes. ENVIRONMENTAL RESEARCH 2014; 132:140-145. [PMID: 24769563 DOI: 10.1016/j.envres.2014.03.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 03/08/2014] [Accepted: 03/11/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate DNA damage and cytokinetic defects, proliferative potential and cell death caused by the frequent use of mouthrinses containing chlorhexidine, triclosan and essential oils in ethanolic solution, compared to a placebo mouthwash. STUDY DESIGN This double-blind, prospective, randomized clinical trial included 80 Caucasian patients. Subjects were divided into four groups: Group I used a mouthrinse, Triclosan; Group II used physiological saline; Group III used chlorhexidine; Group IV a mouthrinse with essential oils in ethanolic solution. All subjects used the mouthrinses for two weeks (15 ml, twice a day, rinsing for 30s). Two cell samples per subject were collected, before and after mouthrinse use (on day 0 and day 15). Samples were processed as follows: cell collection from cheeks with a cytobrush; cell centrifuge; slide preparation, fixation and staining; and fluorescent microscope analysis. 2000 exfoliated cells were screened for nuclear abnormalities, particularly the presence of micronuclei by means of cytome assay. RESULTS No significant differences between study times (before and after use of mouthwash) were identified for any of the variables studied (p>0.05). Differences between mouthrinse groups were also compared but no significant differences were found (p>0.05). CONCLUSIONS This study did not observe any genotoxic effect resulting from mouthrinse use.
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Affiliation(s)
- Irene Ros-Llor
- Department of Oral Medicine, Faculty of Medicine and Dentistry. Ageing Research Institute, University of Murcia, Murcia, Spain
| | - Pia Lopez-Jornet
- Department of Oral Medicine, Faculty of Medicine and Dentistry. Ageing Research Institute, University of Murcia, Murcia, Spain.
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Chalhoub E, Emami E, Freijé M, Kandelman D, Campese M, St-Georges A, Voyer R, Rompré P, Barbeau J, Leduc A, Durand R. Effectiveness of an alcohol-free essential oil-containing mouthwash in institutionalised elders receiving long-term care: a feasibility study. Gerodontology 2014; 33:69-78. [PMID: 24593317 DOI: 10.1111/ger.12119] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2014] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To conduct a feasibility study on investigating the effectiveness of an alcohol-free essential oil mouthwash (AF-EOMW) to reduce plaque accumulation and oral pathogen levels in institutionalised elders receiving long-term care and to obtain preliminary results. BACKGROUND Although simple, cost-effective strategies to improve oral hygiene in seniors such as the use of mouthwashes have been shown to reduce the risks of respiratory diseases, little information is available on the feasibility of implementing these measures. METHODS Twenty-five elderly participants with significant loss of autonomy were initially recruited and divided into two groups. A test group rinsed with an AF-EOMW twice a day, and a control group rinsed with tap water. Data on demographic characteristics, dental history and tobacco use were collected from a questionnaire. Problems encountered during recruitment and data collection were documented. Plaque index, denture cleanliness and salivary levels of several pathogens were measured at three time points: baseline (T0 ), day 22 (T1 ) and day 45 (T2 ). RESULTS Eighteen participants completed the study. Several problems were encountered during recruitment and execution of the study protocol. No significant differences in clinical or microbiological measures were found between the test group and controls at three time points (p > 0.05). CONCLUSION This pilot study shows that, if sufficient logistical and financial resources are available, it is feasible to conduct randomised clinical trials in a seniors' facility. The use of an AF-EOMW to improve oral hygiene in seniors was not found to be superior to tap water. However, larger controlled clinical studies are needed to confirm these results.
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Affiliation(s)
- Elsy Chalhoub
- Faculty of Dental Medicine, Université de Montréal, Montréal, QC, Canada
| | - Elham Emami
- Faculty of Dental Medicine, Université de Montréal, Montréal, QC, Canada
| | - Maria Freijé
- Faculty of Dental Medicine, Université de Montréal, Montréal, QC, Canada
| | - Daniel Kandelman
- Faculty of Dental Medicine, Université de Montréal, Montréal, QC, Canada
| | | | - Annie St-Georges
- Faculty of Dental Medicine, Université de Montréal, Montréal, QC, Canada
| | - René Voyer
- Faculty of Dental Medicine, Université de Montréal, Montréal, QC, Canada
| | - Pierre Rompré
- Faculty of Dental Medicine, Université de Montréal, Montréal, QC, Canada
| | - Jean Barbeau
- Faculty of Dental Medicine, Université de Montréal, Montréal, QC, Canada
| | - Annie Leduc
- Faculty of Dental Medicine, Université de Montréal, Montréal, QC, Canada
| | - Robert Durand
- Faculty of Dental Medicine, Université de Montréal, Montréal, QC, Canada
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Bagan JV, Vera-Sempere F, Marzal C, Pellín-Carcelén A, Martí-Bonmatí E, Bagan L. Cytological changes in the oral mucosa after use of a mouth rinse with alcohol. A prospective double blind control study. Med Oral Patol Oral Cir Bucal 2012; 17:e956-61. [PMID: 23085712 PMCID: PMC3505716 DOI: 10.4317/medoral.18843] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Accepted: 10/10/2012] [Indexed: 11/05/2022] Open
Abstract
AIM The aim of this preliminary study was to detect cytological changes in the oral mucosa after using a mouth wash with alcohol. MATERIAL AND METHODS A prospective double-blind, controlled study was performed, for 6 months. Group 1 consisted of 30 subjects who used a mouth rinse with 26.9% of alcohol [Listerine] and Group 2 consisted of 30 subjects who used a mouth rinse with the same ingredients but with no alcohol. We obtained three cytological samples from the oral mucosa. The presence of cytological atypia, binucleation and karyorrhesis, and type of cells were studied. We also used a fluorescent in situ hybridization technique (FISH) in 15 samples in each group, for the micronucleus. RESULTS We found no clinical mucosal alteration after using the mouth wash at the end of the study in either group. We observed no cytological differences between the groups at the end of the study (p>0.05). Regarding the study of the micronucleus by FISH, we observed no significant difference between the groups (p>0.05). CONCLUSIONS Our results showed no cytological alteration in patients using a mouth rinse with alcohol, but these findings should be considered preliminary results, to be confirmed in a greater sample of patients.
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Affiliation(s)
- Jose V Bagan
- Valencia University, Service of Stomatology and Maxillofacial Surgery, University General Hospital, Valencia, Spain
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15
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Türkez H, Togar B, Arabaci T. Evaluation of genotoxicity after application of Listerine(R) on human lymphocytes by micronucleus and single cell gel electrophoresis assays. Toxicol Ind Health 2011; 28:271-5. [PMID: 22033428 DOI: 10.1177/0748233711410918] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Listerine (LN) is one of the most commonly used mouth rinses worldwide although very limited information is available concerning its genotoxicity. In another view, the biological safety profile of oral care products is frequently assumed on the basis of simplistic test models. Therefore, the present study was undertaken to investigate the in vitro genotoxic potential of LN using micronucleus and single cell gel electrophoresis tests as genetic endpoints. Different concentrations of LN (0-100% of ml/culture, v/v) were applied to whole human blood cultures (n = 5). The result of the present study showed that there were no statistically significant differences (p > 0.05) between the control group and the groups treated with LN alone in both analysed endpoints. In conclusion, our result first demonstrated the absence of genotoxicity of LN on human lymphocytes.
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Affiliation(s)
- Hasan Türkez
- Faculty of Science, Department of Biology, Atatürk University, Erzurum, Turkey
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Koschier F, Kostrubsky V, Toole C, Gallo MA. In vitro effects of ethanol and mouthrinse on permeability in an oral buccal mucosal tissue construct. Food Chem Toxicol 2011; 49:2524-9. [DOI: 10.1016/j.fct.2011.06.018] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2011] [Revised: 06/01/2011] [Accepted: 06/07/2011] [Indexed: 10/18/2022]
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Hooper SJ, Lewis MAO, Wilson MJ, Williams DW. Antimicrobial activity of Citrox bioflavonoid preparations against oral microorganisms. Br Dent J 2011; 210:E22. [PMID: 21217705 DOI: 10.1038/sj.bdj.2010.1224] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2010] [Indexed: 11/09/2022]
Abstract
BACKGROUND Citrox is a formulation of soluble bioflavonoids obtained from citrus fruits. The non-toxic and antimicrobial properties of natural bioflavonoids are well documented, and consequently there has been interest in the therapeutic application of these substances. OBJECTIVE To determine the antimicrobial activity of two Citrox formulations (BC30 and MDC30) with different bioflavonoid combinations against a range of oral microorganisms. METHODS The antimicrobial activity of both formulations was tested against 14 bacterial species and six Candida species. The two Citrox formulations (dilution range 0.007-8% v/v) were firstly evaluated by determining the in vitro Minimal Inhibitory Concentration (MIC) against planktonic microorganisms in a broth microdilution assay. Secondly, the ability of the same serial dilutions to inhibit microbial growth was assessed in a modified microtitre biofilm assay. RESULTS Both Citrox formulations exhibited antimicrobial activity. The BC30 formulation demonstrated greater activity than MDC30 and significantly inhibited growth of all bacterial species and most candidal species tested at a concentration of 1% (v/v) in both the broth and the biofilm assay. CONCLUSION Bioflavonoid preparations of Citrox have a broad-spectrum of antimicrobial activity against oral microorganisms, and as such have the potential to be used within therapeutic preparations for the control of the oral microflora.
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Affiliation(s)
- S J Hooper
- Oral Microbiology, School of Dentistry, Cardiff University, Heath Park, Cardiff, CF14 4XY.
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18
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Oppermann RV, Haas AN, Villoria GEM, Primo LG, Serra-Negra JM, Ferreira EFE, Pannuti CM. Proposal for the teaching of the chemical control of supragingival biofilm. Braz Oral Res 2011; 24 Suppl 1:33-6. [PMID: 20857073 DOI: 10.1590/s1806-83242010000500006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2010] [Accepted: 07/15/2010] [Indexed: 11/22/2022] Open
Abstract
The mechanical control of supragingival biofilm is accepted as one of the most important measures to treat and prevent dental caries and periodontal diseases. Nevertheless, maintaining dental surfaces biofilm-free is not an easy task. In this regard, chemical agents, mainly in the form of mouthwashes, have been studied to help overcome the difficulties involved in the mechanical control of biofilm. The aim of this paper was to discuss proposals for the teaching of supragingival chemical control (SCC) in order to improve dentists' knowledge regarding this clinical issue. Firstly, the literature regarding the efficacy of antiseptics is presented, clearly showing that chemical agents are clinically effective in the reduction of biofilm and gingival inflammation when used as adjuvant agents to mechanical control. Thus, it is suggested that the content related to SCC be included in the curricular grid of dental schools. Secondly, some essential topics are recommended to be included in the teaching of SCC as follows: skills and competencies expected of a graduate dentist regarding SCC; how to include this content in the curricular grid; teaching-learning tools and techniques to be employed; and program content.
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Affiliation(s)
- Rui Vicente Oppermann
- Department of Periodontics, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil
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19
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Van Leeuwen MPC, Slot DE, Van der Weijden GA. Essential oils compared to chlorhexidine with respect to plaque and parameters of gingival inflammation: a systematic review. J Periodontol 2010; 82:174-94. [PMID: 21043801 DOI: 10.1902/jop.2010.100266] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The purpose of this review is to systematically evaluate the effects of an essential-oil mouthwash (EOMW) compared to a chlorhexidine mouthwash with respect to plaque and parameters of gingival inflammation. METHODS PubMed/MEDLINE and Cochrane CENTRAL databases were searched for studies up to and including September 2010 to identify appropriate articles. A comprehensive search was designed, and the articles were independently screened for eligibility by two reviewers. Articles that evaluated the effects of the EOMW compared to chlorhexidine mouthwash were included. Where appropriate, a meta-analysis was performed, and weighted mean differences (WMDs) were calculated. RESULTS A total of 390 unique articles were found, of which 19 articles met the eligibility criteria. A meta-analysis of long-term studies (duration ≥ 4 weeks) showed that the chlorhexidine mouthwash provided significantly better effects regarding plaque control than EOMW (WMD: 0.19; P = 0.0009). No significant difference with respect to reduction of gingival inflammation was found between EOMW and chlorhexidine mouthwash (WMD: 0.03; P = 0.58). CONCLUSION In long-term use, the standardized formulation of EOMW appeared to be a reliable alternative to chlorhexidine mouthwash with respect to parameters of gingival inflammation.
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Cortelli SC, Cortelli JR, Aquino DR, Costa FO. Self-performed supragingival biofilm control: qualitative analysis, scientific basis and oral-health implications. Braz Oral Res 2010; 24 Suppl 1:43-54. [DOI: 10.1590/s1806-83242010000500008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Accepted: 07/26/2010] [Indexed: 11/22/2022] Open
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Lemos CA, Villoria GEM. Reviewed evidence about the safety of the daily use of alcohol-based mouthrinses. Braz Oral Res 2009; 22 Suppl 1:24-31. [PMID: 19838548 DOI: 10.1590/s1806-83242008000500005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2008] [Accepted: 07/14/2008] [Indexed: 11/22/2022] Open
Abstract
Current scientific knowledge provides clear evidence that alcohol-based mouthwashes can be beneficial in a daily oral health routine, including dental hygiene and plaque control. Several issues are worth discussing, in spite of the wealth of supporting evidence. Despite some undesirable effects to some people, like burning sensation, and some contraindications, like the use by infants, alcohol addicts and patients with mucosal injuries, there is no reason to avoid the use of alcohol-containing mouthwashes as long as they are used following proper guidance by dental professionals and the manufacturers' instructions. The alleged correlation between oral cancer and alcohol-based mouthrinses presents so little, weak, inconsistent and even contradictory evidence in the literature that any kind of risk warning to patients would be uncalled for. Antimicrobial mouthrinses are safe and effective in reducing plaque and gingivitis, and should be part of a comprehensive oral health care regimen that includes brushing, flossing and rinsing to prevent or minimize periodontal disease.
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Affiliation(s)
- Celso Augusto Lemos
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
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Moharamzadeh K, Franklin KL, Brook IM, van Noort R. Biologic assessment of antiseptic mouthwashes using a three-dimensional human oral mucosal model. J Periodontol 2009; 80:769-75. [PMID: 19405830 DOI: 10.1902/jop.2009.080610] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND The biologic safety profile of oral health care products is often assumed on the basis of simplistic test models such as monolayer cell culture systems. We developed and characterized a tissue-engineered human oral mucosal model, which was proven to represent a potentially more informative and more clinically relevant alternative for the biologic assessment of mouthwashes. The aim of this study was to evaluate the biologic effects of alcohol-containing mouthwashes on an engineered human oral mucosal model. METHODS Three-dimensional (3D) models were engineered by the air/liquid interface culture technique using human oral fibroblasts and keratinocytes. The models were exposed to phosphate buffered saline (negative control), triethylene glycol dimethacrylate (positive control), cola, and three types of alcohol-containing mouthwashes. The biologic response was recorded using basic histology; a cell proliferation assay; 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide tissue-viability assay; transmission electron microscopy (TEM) analysis; and the measurement of release of interleukin (IL)-1beta by enzyme-linked immunosorbent assay. RESULTS Statistical analysis showed that there was no significant difference in tissue viability among the mouthwashes, cola, and negative control groups. However, exposure to the positive control significantly reduced the tissue viability and caused severe cytotoxic epithelial damage as confirmed by histology and TEM analysis. A significant increase of IL-1beta release was observed with the positive control and, to a lesser extent, with two of the tested mouthrinses. CONCLUSIONS The 3D human oral mucosal model can be a suitable model for the biologic testing of mouthwashes. The alcohol-containing mouthwashes tested in this study do not cause significant cytotoxic damage and may slightly stimulate IL-1beta release.
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Affiliation(s)
- Keyvan Moharamzadeh
- Department of Adult Dental Care, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
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Abstract
The most important preventive and therapeutic effort to reduce inflammation is to remove the dental plaque thoroughly. Oral self-care is thus of crucial importance to achieve and maintain oral health. There is a scarcity of scientific evidence on the most effective models for behavioural change aimed to improve oral hygiene. There is a need for randomized-controlled trials, based on behavioural sciences and performed with great methodological rigour, to investigate the usefulness of these proposed behavioural changes. Oral hygiene regimens for patients with natural teeth as well as dental implants should include brushing twice daily, inter-dental cleaning once daily and rinsing with efficient rinses as an adjunct to mechanical infection control. Power toothbrushes are preferable as they are more effective than manual toothbrushes. Inter-dental brushes seem to be most effective and useful for inter-dental cleaning. Scaling and root planing is effective in reducing inflammation and probing depths in patients with periodontitis.
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Affiliation(s)
- Kerstin Ohrn
- School of Health and Caring Sciences, Dalarna University, Falun, Sweden.
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Sliepen I, Van Essche M, Quirynen M, Teughels W. Effect of mouthrinses on Aggregatibacter actinomycetemcomitans biofilms in a hydrodynamic model. Clin Oral Investig 2009; 14:241-50. [PMID: 19462186 DOI: 10.1007/s00784-009-0286-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2008] [Accepted: 05/08/2009] [Indexed: 11/28/2022]
Abstract
The aim of the study was to evaluate the effects of Listerine, Meridol, and Perioaid on the viability and total number of bacteria in established biofilms using an in vitro model under hydrodynamic conditions. Biofilms of Aggregatibacter actinomycetemcomitans were placed in a modified Robbins device and rinsed twice daily during 4 days. Bacteria were quantified by culture and quantitative polymerase chain reaction. Visualization of the samples was performed by scanning electron and confocal laser scanning microscopy, combined with a fluorescent vital staining. All three mouthrinses caused a significant reduction in the number of cultivable A. actinomycetemcomitans in a biofilm. Perioaid was significantly the most powerful in killing the biofilm-protected bacteria and also in counteracting the development of thick dense microbial communities. The total amount of bacteria was not significantly affected by Listerine and Meridol.
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Affiliation(s)
- Isabelle Sliepen
- Research Group for Microbial Adhesion, Department of Periodontology, Catholic University Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
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