Comparative evaluation of efficacy of 0.2% sodium hypochlorite (Hi Wash) mouthwash with 0.2% chlorhexidine mouthwash on plaque-induced gingivitis: A clinical trial

New Insights Regarding the Use of Relevant Synthetic Compounds in Dentistry

Worldwide, synthetic compounds are used for both in-office and at-home dental care. They are a valuable resource for both prophylactic and curative treatments for various dental problems, such as tooth decay, periodontal diseases, and many more. They are typically preferred due to their broad range of actions and ability to produce targeted, rapid, and long-lasting effects. Using a 0.12% chlorhexidine mouthwash is capable of reducing the plaque index from 47.69% to 2.37% and the bleeding index from 32.93% to 6.28% after just 2 weeks. Mouthwash with 0.1% OCT is also highly effective, as it significantly lowered the median plaque index and salivary bacterial counts in 152 patients in 5 days compared to a control group (p < 0.0001), while also reducing the gingival index (p < 0.001). When povidone-iodine was used as an irrigant during the surgical removal of mandibular third molars in 105 patients, it resulted in notably lower pain scores after 2 days compared to a control group (4.57 ± 0.60 vs. 5.71 ± 0.45). Sodium hypochlorite is excellent for root canal disinfection, as irrigating with 1% NaOCl completely eliminated the bacteria from canals in 65% patients. A 0.05% CPC mouthwash proved effective for perioperative patient care, significantly decreasing gingival bleeding (p < 0.001) and suppressing Streptococcus levels even one week post-surgery. Lastly, a 6% H2O2 paint-on varnish and 6% H2O2 tray formulations successfully bleached the teeth of 40 patients, maintaining a noticeably whiter appearance up to the 6-month follow-up, with significant color differences from the baseline (p < 0.005). Synthetic compounds have a large research base, which also provides a greater awareness of their mechanism of action and potential adverse effects. For a better understanding of how they work, several methods and assays are performed. These are protocolary techniques through which a compound's efficacy and toxicity are established.

The clinical effect of sodium hypochlorite oral rinse on peri-implantitis lesion: A pilot study

Peri-implantitis poses an imminent challenge to the field of implant dentistry. Considering the promising findings of sodium hypochlorite and periodontal lesions, the aim of the present study was to evaluate the clinical effects of sodium hypochlorite oral rinse on peri-implantitis lesions. Twelve peri-implantitis patients were instructed to rinse with 15 mL of a fresh solution of 0.25% sodium hypochlorite for 30 s twice a week for 3 months. At baseline and 3-month visits, probing depth and modified sulcular bleeding index were recorded at 6 points per lesion (mesiobuccal, buccal, distobuccal, mesiolingual, lingual, and distolingual). Individual and total bacterial loads of 18 pre-designated species of microorganisms were analyzed by real-time PCR methods. Probing depth decreased after the experiment, with an average difference of 1.1 mm and a standard deviation of 1.7 mm. The modified sulcular bleeding index decreased by a mean value of 0.8 with a standard deviation of 1.1. This study demonstrated the clinical effects of sodium hypochlorite oral rinse on peri-implantitis lesions and the reduction of periodontal probing depth and gingival bleeding index. This study suggested that the concentration of 0.25% be used for treatment of peri-implantitis.

Preliminary Evaluation of a NitrAdine-Based Brushing Solution for Patients Suffering from Gingivitis: A Prospective Clinical Case-Control Study

OBJECTIVES

 This article aimed to evaluate the clinical efficacy of a nonantibiotic biofilm-removal formulation based on NitrAdine (PerioTabs), combined with a regular home oral hygiene regimen, in Caucasian patients with gingivitis.

MATERIALS AND METHODS

 A sample of 60 patients were included in this clinical prospective study. All selected subjects underwent regular prophylaxis and professional oral hygiene at baseline; 30 days later, they were recalled for the measurements of the reference parameters about bleeding on probing (full-mouth bleeding upon probing score [FMBS]) and plaque index (full-mouth plaque score [FMPS]); no other clinical procedure was performed. Consequently, half of the patients (n = 30) were instructed to use PerioTabs for 10 days. The remaining patients (n = 30) were used as the negative control, only instructed to continue with their usual oral hygiene regimen. Fifteen days after, the clinical parameters of FMBS and FMPS were re-evaluated in both groups.

RESULTS

 Changes in the scores of clinical indices FMBS and FMPS were calculated and compared. A significant difference between pre- and post-values, for both FMBS and FMPS, was noticed in the test group; in particular, the bleeding index value demonstrated the more significant changes: 22 participants showed a clinically meaningful improvement, and 5 had a small improvement. Only three patients had no evidence of change. In addition, 50% of patients had a reduction in plaque levels. No side effects were reported.

CONCLUSIONS

 The adjunctive use of 10-day PerioTabs treatment in the daily oral hygiene routine seemed to be efficient in reducing gingival bleeding and plaque accumulation, with absence of adverse effects. These results should be confirmed in studies with a larger number of participants following a controlled-blinded design.

Effectiveness of probiotic lozenges and Chlorhexidine mouthwash on plaque index, salivary pH, and Streptococcus mutans count among school children in Makkah, Saudi Arabia

Purpose

To compare the effect of the probiotic lozenges and chlorhexidine (CHX) mouthwash on plaque index (PI) , salivary pH and Streptococcus mutans (S. mutans) 3 count among groups of Saudi children.

Methods

A total of 54 participants aged 8-12 years were randomly allocated into three groups, 18 children in each group. Children in the probiotic group consumed one probiotic lozenge (Biogaia prodentis) daily, while children in the CHX group were instructed to use CHX mouthwash twice daily. The control group was only instructed to follow regular oral hygiene measures. Saliva samples were taken at baseline, 15th and 30th days. PI scores, salivary pH values and S. mutans count were evaluated. Data were statistically analyzed using the ANOVA and the Tukey post-hoc test.

Results

Probiotic lozenges and CHX mouthwash significantly reduced PI and S. mutans count and increased the salivary pH values. However, there were no statistical differences between the effect of probiotic lozenges and CHX mouthwash on PI (p-value= 800) and pH values (p-value= 0.927) on the 30th day. Conversely a significant difference was reported among their effects on S. mutans count (p-value=0.014) on the 30th day. Greater acceptance and compliance of children to probiotic lozenges were reported.

Conclusions

Probiotic lozenges could be an alternative to CHX mouthwash and encouraged to be included with the daily oral hygiene measures.

Effect of a sodium hypochlorite mouthwash on plaque and clinical parameters of periodontal disease-a systematic review

OBJECTIVE

The present study aimed to establish the efficacy of sodium hypochlorite mouthwash (NaOCl-MW) compared with a control mouthwash on plaque and clinical parameters of periodontal disease.

METHODS

MEDLINE-PubMed, Embase and Cochrane-CENTRAL databases were searched for clinical trials on patients with gingivitis or periodontitis that assessed the effect of NaOCl-MW in comparison with a negative or positive control on plaque index (PI), gingival index (GI), and bleeding index (BI) scores and probing pocket depth (PPD). Data were extracted from the eligible studies.

RESULTS

Seven eligible papers were retrieved, which together represented six clinical trials. The studies showed considerable heterogeneity regarding methodological and clinical aspects that did not permit a meta-analysis. Two of the three studies in which NaOCl-MW was compared with a negative control showed that NaOCl-MW significantly reduced PI, GI and BI, and no effect was found on PPD. In three studies, NaOCl-MW was assessed using chlorhexidine mouthwash (CHX-MW) as a positive control; no difference was found for GI and BI. One of the three comparisons showed a statistically significant PI score favouring NaOCl-MW. One study measured PPD and found it to be significant in favour of NaOCl-MW.

CONCLUSIONS

Studies with a negative control group provided very weak quality evidence for a very small beneficial effect of NaOCl-MW on PI, GI and BI scores. Studies with a positive control group provided very weak quality evidence that NaOCl-MW had a similar effect as CHX-MW on PI, GI and BI scores. The outcome for PPD was inconclusive.

Oral nano-curcumin on gingival inflammation in patients with gingivitis and mild periodontitis

Gingivitis can trigger gingival diseases such as periodontitis. Since the complete removal of microbial plaques by mechanical procedures is not conceivable in some conditions and also chemical mouthwashes have a lot of side effects, finding a new treatment strategy would be useful. In the present study, for the first time, the effects of oral nano-curcumin on gingival inflammation in patients with gingivitis and mild periodontitis were assessed. Forty eight patients with gingivitis and mild periodontitis participated in this clinical trial. In one group the patients were treated with Sina curcumin capsules 80 mg and the other group received a placebo. Clinical parameters, including modified gingival index, papillary bleeding index, and plaque index were determined on days 0, 7, 14, and 28. There were no significant differences in age, sex, papillary bleeding index (PBI), and modified gingival index (MGI) between the two groups at baseline. There was a dropout of two patients (both from the placebo group). The MGI and PBI have a significantly decreasing trend in both case and control groups and the decreases were severe in the case group. The differences between PBI and MGI in the two groups were significant at 14 and 28 days. The plaque index did not significantly change in either group over the study period. The trend of changes in plaque index was not different between the two groups of the study. In the current study, no side effect was found in the patients. Oral nano-curcumin has positive effects on the decrease of inflammation and gingival bleeding in patients with gingivitis and mild periodontitis. Nano-curcumin capsules have a systemic target site with more bioavailability than topical forms.