Objectives. The aim of this investigation was to evaluate whether the adenosine triphosphate (ATP) bioluminescence method is an appropriate tool to assess the efficacy of antiseptic mouthrinses in terms of quantitative reductions of total viable microbial counts in mixed biofilm populations in vitro.
Study Design. Three mouthrinses, containing respectively, chlorhexidine and cetylpyridinium chloride (CHX/CPC), essential oils (EO) and amine fluoride/stannous fluoride (AFSF), as well as Phosphate Buffered Saline (PBS) used as control, were tested in an in vitro static biofilm model by ATP bioluminescence and compared to culture method. Biofilms were grown on saliva-coated hydroxyapatite disks for 72 hours and then exposed for 1 minute to the mouthrinse or control by immersion. The antibacterial effect of the rinses was tested by analysis of variance. The reliability of the ATP bioluminescence method was assessed by calculating the Pearson correlation coefficients when compared to the viable cell counts obtained by culture.
Results. Using ATP bioluminescence, the antimicrobial activity of the tested mouthrinses was demonstrated when compared to the PBS control. The ATP bioluminescence values were significantly correlated (0.769, p<0.001) to the viable cell counts. CHX/CPC and AFSF showed similar antimicrobial activity, although AFSF had a less homogeneous effect, being both more effective than the EO rinse.
Conclusion. ATP bioluminescence viability testing may be considered a useful tool to assess the in vitro efficacy of antibacterial compounds. In the proposed model, CHX/CPC and AFSF containing mouthrinses demonstrated superior antimicrobial activity, as compared to EO rinses, in a multispecies biofilm model.
Key words:Biofilm, ATP bioluminescence,mouthrinse, essential oils, chlorhexidine, amine fluoride/stannous fluoride.
A microscopic method for noninvasively visualizing the action of an antimicrobial agent inside a biofilm was developed and applied to describe spatial and temporal patterns of mouthrinse activity on model oral biofilms. Three species biofilms of Streptococcus oralis, Streptococcus gordonii, and Actinomyces naeslundii were grown in glass capillary flow cells. Bacterial cells were stained with the fluorogenic esterase substrate Calcien AM (CAM). Loss of green fluorescence upon exposure to an antimicrobial formulation was subsequently imaged by time-lapse confocal laser scanning microscopy. When an antimicrobial mouthrinse containing chlorhexidine digluconate was administered, a gradual loss of green fluorescence was observed that began at the periphery of cell clusters where they adjoined the flowing bulk fluid and progressed inward over a time period of several minutes. Image analysis was performed to quantify a penetration velocity of 4 μm/min. An enzyme-based antimicrobial formulation led to a gradual, continually slowing loss of fluorescence in a pattern that was qualitatively different from the behavior observed with chlorhexidine. Ethanol at 11.6% had little effect on the biofilm. None of these treatments resulted in the removal of biomass from the biofilm. Most methods to measure or visualize antimicrobial action in biofilms are destructive. Spatial information is important because biofilms are known for their structural and physiological heterogeneity. The CAM staining technique has the potential to provide information about the rate of antimicrobial penetration, the presence of tolerant subpopulations, and the extent of biomass removal effected by a treatment.
The aim of this study was to evaluate the effectiveness of three different antiseptic mouthrinse solutions on the saliva samples obtained from the individuals, who had high caries activity rate.
The efficacy of three antiseptic mouthrinses were evaluated in a study with healthy volunteers. The three antiseptic solutions used in this study were 0.1% octenidine dihydrochloride (Octenisept, Schülke&Mayr, UK), 0.12% chlorhexidine digluconate (Kloroben, Drogsan, Turkey) and an antimicrobial enzymatic rinse (Biotene, Laclede, Inc, USA). A total of 27 adult volunteer subjects were participated in the study. The subjects were stratified into three balanced group. Then the mouth rinses were used by each group according to the manufacturer’s directions. The subjects were restricted for 60 minutes for food intake after using the prescribed mouthrinse. The saliva samples were collected from the volunteers at 1, 10 and 60 minutes after their usage in tubes. The tubes were kept in +4°C in a fridge till the evaluation. 10−3 and 10−5 dilutions were prepared for each solution and S. mutans were evaluated according to total number of colony forming unit (CFU) per ml. The dilutions were spreaded on the surface of Brucella agar plates for anaerobic incubation for 48 hours. The dilutions were 100, 10−3 and 10−5 of the solutions Kloroben, Biotene, Octenisept, and the time factor were 0, 1, 10 and 60 minutes. The statistical analyses were performed by Duncan and Bonferroni tests.
Octenisept was found to be more effective over S. mutans than the other mouthrinse solutions (P<.05).
All mouthrinse solutions except Biotene were effective on oral microorganisms.
Mouthrinse solutions; Saliva; S. mutans
The penetration and overall efficacy of six mouthrinse actives was evaluated by using an in vitro flow cell oral biofilm model. The technique involved preloading biofilm cells with a green fluorescent dye that leaked out as the cells were permeabilized by a treatment. The loss of green color, and of biomass, was observed by time-lapse microscopy during 60 min of treatment under continuous flow conditions. The six actives analyzed were ethanol, sodium lauryl sulfate, triclosan, chlorhexidine digluconate (CHX), cetylpyridinium chloride, and nisin. Each of these agents effected loss of green fluorescence throughout biofilm cell clusters, with faster action at the edge of a cell cluster and slower action in the cluster center. The time to reach half of the initial fluorescent intensity at the center of a cell cluster, which can be viewed as a combined penetration and biological action time, ranged from 0.6 to 19 min for the various agents. These times are much longer than the predicted penetration time based on diffusion alone, suggesting that anti-biofilm action was controlled more by the biological action time than by the penetration time of the active. None of the agents tested caused any removal of the biofilm. The extent of fluorescence loss after 1 h of exposure to an active ranged from 87 to 99.5%, with CHX being the most effective. The extent of fluorescence loss in vitro, but not penetration and action time, correlated well with the relative efficacy data from published clinical trials.
Systematic review of 6-month RCT that evaluated the antigingivitis and antiplaque properties of dentifrices or mouth rinses in adults 18 years and older. A total of 50 studies identified that met inclusion criteria. Subject characteristics not otherwise specified.
Mouthrinse use or Dentifrice use
Main Outcome Measure
Gingivitis, as measured by the Gingival Index (GI) or Modified Gingival Index (MGI) and Plaque accumulation (as measured by Turesky modification of the Quigley-Hein Index)
The meta-analytic results were expressed as the standardized mean effect (i.e., active agent minus control divided by the standard deviation). This was used as a measure of the relative strength of the active agent, and the summary results presented as the Standardized Difference (Std.Diff.).
As measured by the GI, mouthrinses containing 0.12 % chlorhexidine (Std.Diff. = 0.563), or essential oils (Std.Diff. = 0.306), had a significant antigingivitis effect. Dentifrices containing triclosan with 2% Gantrez copolymer (Std.Diff. = 0.858), or stannous fluoride (Std.Diff. = 0.441) also had a significant antigingivitis effect.
As measured by the MGI, essential oils (Std.Diff. = 0.762) had a significant antigingivitis effect.
Mouthrinses containing cetylpyridium chloride had significant antigingivitis effects in several individual studies, but no meta-analytic conclusion was reached due to “both statistical heterogeneity and a variety of formulations evaluated.”
Mouthrinses containing 0.12 % chlorhexidine or essential oils, and dentifrices containing triclosan with 2% Gantrez copolymer or stannous fluoride, , each have significant antigingivitis effects in adults after six months of use.
The aim of this study was to compare the effects of four different mouthrinse containing propolis solutions and mouthrinse containing 0.2% chlorhexidine (CHX) on oral microorganisms and human gingival fibroblasts.
Four different solutions of propolis were prepared and propylene glycol and alcohol were used as solvents for each propolis sample. Mouthrinse containing propolis was prepared at four different concentrations as 10%, 5%, 2.5% and 1%. Besides, CHX was used as control group. The antibacterial effects of five solutions on oral microorganisms were tested and their cytotoxic effects on human gingival fibroblasts were evaluated by agar diffusion test.
At this concentrations effectiveness of mouthrinse containing propolis samples on oral microorganisms were not found as effective as CHX. On the contrary, samples found less cytotoxic on human gingival fibroblasts than CHX.
Standardized preparations of propolis can be used as a mouthrinse at appropriate concentrations. To obtain a standardized chemical composition, advanced researches are needed.
Mouthrinse; Propolis; Chlorhexidine; Antibacterial activity; Cell culture
This study compared the effects of carbamide peroxide (CP) and chlorhexidine (CHX) on oral biofilm in vitro. Collagen-coated hydroxyapatite discs were inoculated with subgingival plaque. After 3 weeks, the emergent biofilms were subjected to 1-, 3-, and 10-min exposures of a 1% CHX gel, a 5% CP gel and rinse, and a 10% CP gel and rinse. Subsequently, the biofilms were stained using a two-colour fluorescent dye kit for confocal laser scanning microscopy, and the volume ratio of dead bacteria to all bacteria was analysed. Compared to a non-treated gel control, the active agents killed bacteria on all the discs, with higher concentration and longer exposure times killing more bacteria. The rinse form disrupted the biofilm quicker than the gel form. Overall, 10% CP showed more disruption of biofilm and a greater proportion of killed bacteria than 1% CHX (p<0.05).
antibacterial; biofilm; carbamide peroxide; confocal laser scanning microscopy
Anti-microbial agents have been used as a chemotherapeutic agent to improve oral health. This in vitro study was carried out to determine antimicrobial efficacy of different toothpastes and mouthrinses against the oral pathogens.
A total of five toothpastes and five mouthrinses were tested for their antimicrobial activity against three oral pathogens namely, Streptococcus mutans (MTCC 890), Escherichia coli (MTCC 579) and Candida albicans (MTCC 854) by well agar diffusion assay. Statistical Analysis was performed using a statistical package, SPSS windows version 15, by applying mean values using analysis of variance (ANOVA) with post-hoc least square differences (LSD) method(α = 0.05).
Toothpaste formulation A showed maximum zones of inhibition against the test organism, Escherichia coli (P<60;0.001) compared to all other toothpastes formulations. Against Streptococcus mutans and Candida albicans, the zones of inhibition were less in comparison to E.coli but were significantly different at higher dilutions (1:8, 1:16 P<60;0.05) for toothpaste formulation A.
Mouthrinses formulation H showed maximum efficacy against the test organism, Escherichia coli (P<60;0.001) compared to all other mouthrinse formulations. Against Streptococcus mutans, mouthrinses formulations F, G and J showed significant antimicrobial activity (P<60;0.05) compared to formulation H and I.
In the present study, it has been demonstrated that triclosan containing toothpastes formulations are more effective in control of oral microflora compared to non-triclosan containing synthetic toothpastes. Among mouthrinses formulations, chlorhexidine was found to be more effective than or as effective as triclosan against the organisms tested.
Antimicrobial activity; Antimicrobial agents; Chlorhexidine gluconate; Mouthrinse; Toothpaste; Triclosan
Background: Chlorhexidine is well known for its antiplaque effect. However, the mouthrinse based chlorhexidine antiplaque efficiency may vary according to the formulation of the final product. The aim of the present study was to compare anti-plaque effectiveness of two commercial mouthrinses: 0.12 % Chlorhexidine alcohol base (CLX-A) versus a diluted 0.1% Chlorhexidine non-alcohol base with 0.1% of Formaldehyde (CLX-F).
Material and Methods: the study was a seven day randomized, double-blind, placebo-controlled trial including 30 volunteers. At the start, all participants received a dental prophylaxis. Over 7 days experimental non-brushing period, during which subjects abstained from all forms of mechanical oral hygiene, one group test rinsed twice daily with 15ml of an alcohol base 0.12% Chlorhexidine mouthrinse. The second group test used 15ml of alcohol free 0.1% Chlorhexidine mouthrinse base 0.1% formaldehyde twice daily. The negative control group used a placebo. Plaque indexes were recorded in all volunteers prior to treatment at Day 0, 1 and 7.
Results: After 7 days, the mean plaque index for the first group was 0.76±0.38 compared with a mean plaque index of 1.43±0.56 for the second group. The difference in plaque scores between the groups was statistically significant.
Conclusion: the results of this study showed that rinsing with an alcohol base 0.12% Chlorhexidine mouthrinse is significantly different from rinsing with an alcohol free 0.1% Chlorhexidine mouthrinse on plaque inhibition.
Key words:Chlorhexidine, dental plaque, mouthrinse, alcohol, formaldehyde.
Mexican-American children have a higher caries prevalence than the US average. The Mothers and Youth Access (MAYA) study was a randomized clinical trial initiated to address this problem.
Comparison of the efficacy of two prevention interventions in reducing early childhood caries (ECC).
All 361 randomized mother-child dyads received oral health counseling. Beginning at 4 months postpartum, intervention mothers received chlorhexidine (CHX) mouthrinse for 3 months beginning 4 months postpartum and children received fluoride varnish (FV) every 6 months from age 12–36 months. Control group children received FV if precavitated lesions developed. Salivary mutans streptococci (MS) and lactobacilli were assessed.
No significant difference in children’s 36-month caries incidence between groups; 34% in each group developed caries ((d2+fs) > 0). About half of control group developed precavitated lesions and received therapeutic FV. Maternal MS levels declined during CHX use, but increased when discontinued.
Maternal postpartum CHX regimen, oral health counseling, and preventive child FV applications were not more efficacious than maternal counseling with child therapeutic FV for precavitated lesions for ECC prevention. FV for young children with brief maternal CHX use and oral health counseling may need to be combined with additional or longer-term therapies to significantly reduce ECC in high-risk populations.
Epidemiology; Fluoride; Perinatal; Oral Health; Infant; Early Childhood Caries; Randomized Clinical Trial; Chlorhexidine; Prevention
Background: Chemotherapeutic agents have been shown to be useful adjuncts to daily oral home care in the control of plaque and gingivitis. The objective of the study was to evaluate effect of two oral rinses; Chlorohexidine and Listerine on Plaque and Gingivitis.
Materials and Methods: A doubled blind study was done on 150 patients visiting OPD of oxford general hospital for 2 months to compare the efficiency of two commercially available mouth rinses i.e. chlorohexdine (0.2%) & Listerine on plaque & gingivitis, along with a Placebo.
Results: At the end of 28 weeks chlorohexdine & listerine significantly reduced plaque growth & gingivitis compared to a Placebo however chlorohexdine was more effective than Listerine.
Conclusion: Chlorehexidine (0.2%) and a phenolic mouth rinse significantly reduced plaque growth and gingival inflammation compared to a placebo mouthrinse, however chlorhexidine rinse was more effective against plaque regrowth than the phenolic rinse.
How to cite this article: Goutham BS, Manchanda K, Sarkar AD, Prakash R, Jha K, Mohammed S. Efficacy of two commercially available Oral Rinses - Chlorohexidine and Listrine on Plaque and Gingivitis - A Comparative Study. J Int Oral Health 2013; 5(4):56-61.
Mouthrinse; Plaque; Gingivitis; Oral Hygiene
The key to good oral health is hidden in nature. Natural herbs like neem, tulsi, pudina, clove oil, ajwain, triphala and many more has been used since ages either as a whole single herb or as a combination against various oral health problems like bleeding gums, halitosis, mouth ulcers and preventing tooth decay. The aim of the study was to compare the efficacy of a commercially available herbal mouthrinse (Herboral) with that of chlorhexidine gluconate which is considered to be a gold standard as an anti-plaque agent.
Materials and Methods:
A randomized, two-group, parallel study as a ‘de novo’ plaque accumulation model was carried out on 50 subjects (23 males and 27 females). At baseline, all participants received a professional prophylaxis and were randomly assigned to the test (Herbal mouthrinse) and control (Chlorhexidine Gluconate) group. On the following three days, all subjects rinsed with 10 ml of the allocated mouthrinse twice daily for 1 min. They were asked to refrain from use of any other oral hygiene measures during the study. At the end of the experimental period, plaque was assessed and a questionnaire was filled by all subjects.
Chlorhexidine (mean plaque score=1.65) inhibited plaque growth significantly more than the herbal mouthrinse (mean plaque score=1.43, P<0.001). The results of the questionnaire showed that Herboral was preferred by patients for its taste, its convenience of use and taste duration (aftertaste). However, Chlorhexidine was considered to be more effective in reducing plaque as compared to Herboral.
Herbal mouthrinse was found to be a potent plaque inhibitor, though less effective than Chlorhexidine Gluconate. However, it can serve as a good alternative for the patients with special needs as in case of diabetics, xerostomics, and so on.
Chlorhexidine; herbal; mouthrinse; plaque control
Dental biofilms are characterized by structural and functional heterogeneity. Due to bacterial metabolism, gradients develop and diverse ecological microniches exist. The aims of this study were (i) to determine the metabolic activity of microorganisms in naturally grown dental biofilms ex vivo by measuring dissolved oxygen (DO) and pH profiles with microelectrodes with high spatial resolution and (ii) to analyze the impact of an antimicrobial chlorhexidine (CHX) treatment on microbial physiology during stimulation by sucrose in real time. Biofilms were cultivated on standardized human enamel surfaces in vivo. DO and pH profiles were measured in a flow cell system in sterile human saliva, after sucrose addition (10%), again after alternative treatment of the sucrose exposed biofilms with CHX (0.2%) for 1 or 10 min or after being killed with paraformaldehyde (4%). Biofilm structure was visualized by vitality staining with confocal microscopy. With saliva as the sole nutrient source oxygen consumption was high within the superficial biofilm layers rendering deeper layers (>220 μm) anoxic. Sucrose addition induced the thickness of the anaerobic zone to increase with a concurrent decrease in pH (7.1 to 4.4). CHX exposure reduced metabolic activity and microbial viability at the biofilm surface and drove metabolic activity deeper into the biofilm. CHX treatment led to a reduced viability at the biofilm surface with minor influence on overall biofilm physiology after 1 min; even after 10 min there was measurable respiration and fermentation inside the biofilm. However, the local microenvironment was more aerated, less acidogenic, and presumably less pathogenic.
To clinically evaluate the perioperative use of 0.2% chlorhexidine gluconate for the prevention of alveolar osteitis, to assess the patient compliance to chlorhexidine and to prepare a comprehensive treatment plan to prevent alveolar osteitis after removal of an impacted third molar extraction.
A prospective study was done on 50 patients with bilaterally impacted lower third molars which were indicated for extraction. Extraction of impacted mandibular third molar on one side was done without using any mouthrinse. While extracting the third molar on the other side, patients were instructed to use chlorhexidine 0.2% mouth rinse for 8 days, 1 day preceding and 7 days following the surgery. They were instructed to use chlorhexidine 0.2% (Rexidine) mouth rinse for 30 s twice a day (before breakfast and after dinner) with 15 ml of the rinse with 1:1 dilution with clean water. All the patients were evaluated for pain, presence or absence of clot and condition of the alveolar bone for the diagnosis of dry socket.
Incidence of dry sockets was 8%, when patients did not use 0.2% chlorhexidine gluconate perioperatively which is statistically significant.
It appeared that the incidence of dry socket can be reduced significantly by using 0.2% chlorhexidne gluconate mouth rinse perioperatively (twice daily, 1 day before and 7 days after surgical extraction.
Impacted mandibular third molars; Alveolar osteitis; 0.2% chlorhexidine gluconate; Mouthrinse
Background and aims
The use of fluoride mouthrinses has been proved to be one of the most effective ways to prevent tooth decay. A community based program using F+ rinse at school has also proved to be well-controlled and efficient. The aim of this investigation was to evaluate fluoride uptake level of a locally prepared NaF rinse used in Iran’s school program during 2005.
Materials and methods
A total of 30 freshly extracted sound human premolars were collected and divided into two groups of 15. Each tooth then underwent two steps of sectioning; first the root was amputated from CEJ and then a longitudi-nal section was performed in bucco-lingual direction to provide two similar samples of the same tooth. A specific hemi-circular area on either of the experimental halves was treated by NaF rinse from USA or a locally prepared NaF used in school programs. Two subsequent biopsies were taken from each half using acid etch enamel biopsy technique. Fluoride and calcium content of the specimens were measured in order to evaluate fluoride uptake level and biopsy depth effect, respectively. Col-lected data were recorded in the forms provided and statistical analysis, mostly descriptive, was performed for comparison.
Based on the data collected, it appears that the use of F+ rinse would clearly improve enamel quality by a rise in fluoride concentration. Statistical analysis using a paired t-test and repeated measure method revealed that with 95% confi-dence fluoride concentration increases at both levels of biopsy with no statistically significant differences between the samples treated with two rinses.
There seem to be reasonable potential for the clinical use of Iranian brand fluoride mouthrinse. There was no significant difference between the level of uptake from NaF from USA and the Iranian product in 2 layers of enamel biopsy.
Enamel biopsy; fluoride; mouthrinse; NaF; uptake
The goal of this study was to evaluate the clinical anitplaque and antigingivitis effects of a mouthrinse containing cetylpyridinium chloride (CPC), triclosan and dipotassium glycyrrhizinate (DPZ) in patients with gingivitis and mild periodontitis.
Thirty-two subjects were randomized into 2 groups. The test group used a mouthrinse containing 0.05% CPC, 0.02% triclosan and 0.02% DPZ, while the control group used a placebo mouthrinse. At baseline, 2 weeks and 4 weeks, the papillary bleeding index (PBI), Turesky-Quigley-Hein plaque index (PI) and Löe-Silness gingival index (GI) were assessed. During the experimental period, the patients used the mouthrinse for 30 seconds, 4 to 5 times/day (10 mL/time) within 30 minutes after toothbrushing.
No adverse effects appeared in either the experimental or the control group. Regarding PBI, PI and GI values, statistical significance was detected between values at baseline and 2 weeks for both groups (P<0.05). In the experimental group, statistically significantly lower values were detected at 4 weeks compared to at 2 weeks. However, in the control group, no statistically significant difference was detected between the values at 2 weeks and 4 weeks. Additionally, the mean value after 4 weeks for the control group was slightly higher than the mean value after 2 weeks for the control group.
This study for 4 weeks demonstrated that mouthrinses containing CPC, triclosan and DPZ may contribute to the reduction of supragingival plaque and gingivitis.
Cetylpyridinium; Dental plaque index; Glycyrrhizic acid; Prevention mouthrinse; Triclosan
The aim of this study was to examine the effect of temperature on fluoride uptake by enamel specimens from a 0.05% NaF-fluoridated mouthrinse (Oral-B Advantage; Oral-B Laboratories, Newbridge, UK).
Enamel specimens were prepared from extracted human maxillary central incisors. A fluoride-specific ion electrode was used to measure the uptake from a 2 ppm fluoride solution containing 50.0 mL of distilled water, total ion strength adjustment buffer, and fluoridated rinse at 3 different temperatures (room temperature, 25°C; human body temperature, 37°C; hyper-fever temperature, 43°C). One-way analysis of variance and least significant difference were used to assess intragroup and intergroup differences (P<.05).
The study found that both the amount and the rate of fluoride uptake increased significantly with increase in temperature. This effect was particularly noticeable at 43°C.
The temperature of the NaF mouthrinse may easily and safely be increased beyond room temperature by placing a container of the NaF mouthrinse in a bowl of hot water, allowing greater fluoride penetration into the enamel from the mouthrinse when used at home as a routine prophylactic agent.
Fluoride uptake; temperature; enamel; mouthrinse
We examined the effect of three clinically used antimicrobials on Streptococcus mutans UA159 biofilm detachment under flow conditions. Sodium fluoride (NaF) and chlorhexidine at MIC levels promoted biofilm detachment and inhibited detachment when concentrations were higher than the MIC and reduced detached-cell viability only at high concentrations. Ampicillin at all concentrations tested inhibited detachment and reduced the percentage of viable biofilm-detached cells. All the three antimicrobial treatments reduced biofilm live/dead cell ratios.
An in situ study evaluated the remineralization potential of 225 ppm fluoride (F) rinses with and without a calcium phosphate agent (TCP-Si-Ur) on eroded enamel.
20 human patients participated in this IRB approved study. Enamel blocks extracted from 20 human molars were assigned to each of the three study phases (G1, G2, G3). Each block was eroded using 1% citric acid (pH = 2.5), with a slice cut from each block to establish baseline lesion parameters (ie, integrated mineral loss ΔZ, and lesion depth LD) using transverse microradiography (TMR). Participants and assigned blocks were randomly divided into three 28-day phases. The blocks were mounted into modified orthodontic brackets and bonded to the buccal surface of one of the subject’s mandibular molars. The appliance remained in the subject’s mouth for 28 days. Prior to each study phase, participants observed a one-week-washout period using a fluoride-free dentifrice. In each phase, participants brushed with the fluoride-free dentifrice for 1 min, followed by one of the following coded treatments: G1: 225 ppm F + 40 ppm TCP-Si-Ur rinse (1 min); G2: 225 ppm F rinse (1 min); G3: no rinse (saliva-only). After each phase, appliances were removed and specimens were analyzed using TMR.
TMR data (ie, ΔZ and LD) revealed all three groups significantly remineralized eroded enamel (paired t-tests, P < 0.001). Net mineralization (% change in ΔZ, LD) were as follows (mean (std.dev): G1: 44.1 (22.6), 30.5 (27.0); G2: 30.0 (7.4), 29.4 (10.5); G3: 23.8 (16.4), 25.7 (15.5). Furthermore, G1 was found to cause significantly more remineralization than G2 (P = 0.039) and G3, (P = 0.002).
Mouthrinse containing 225 ppm F plus TCP-Si-Ur provided significantly greater remineralization relative to 225 ppm F only or saliva alone.
TCP-Si-Ur; fluoride; antierosion; tricalcium phosphate; double-blind
To determine whether the oral health benefits of recommending twice daily brushing and rinsing with an essential oil mouthrinse (EOM) are perceived and measurable by dentists and also perceived by their patients at a 3-month recall visit.
This is a monadic, open label, uncontrolled study involving 766 generally healthy Italian subjects aged 19–66 years, with mild to moderate levels of gingivitis, no pockets of more than 4 mm, and at least 20 scorable teeth. Eight dentists scored subjects for plaque and gingivitis at baseline and at 90 days using simplified 4-point plaque and gingivitis indices. All subjects brushed twice daily, immediately followed by rinsing for 30 sec with 20 ml of an essential oil mouthrinse (Listerine®).
735 subjects completed the study (95.9%). Average score reductions were 51.9% and 45.7% for plaque and gingivitis, respectively. About 62% and 70% were judged by the dentists as improved for plaque control and gingival health. 85% of subjects judged the EOM as efficacious.
The oral health benefits of brushing and rinsing twice daily with an essential oil mouthrinse are perceived by patients and professionals alike and measurable by dentists at a 3-month recall visit.
oral hygiene; gingivitis; mouthrinses; essential oils
Cellulose, the most abundant biological macromolecule, is an extracellular, linear polymer of glucose molecules. It represents an essential component of plant cell walls but is also found in algae and bacteria. In bacteria, cellulose production frequently correlates with the formation of biofilms, a sessile, multicellular growth form. Cellulose synthesis and transport across the inner bacterial membrane is mediated by a complex of the multi-spanning catalytic BcsA subunit and the membrane-anchored, periplasmic BcsB protein. Here we present the crystal structure of a complex of BcsA and BcsB from Rhodobacter sphaeroides containing a translocating polysaccharide. The structure of the BcsA-B translocation intermediate reveals the architecture of the cellulose synthase, demonstrates how BcsA forms a cellulose-conducting channel, and suggests a model for the coupling of cellulose synthesis and translocation in which the nascent polysaccharide is extended by one glucose molecule at a time.
Minocycline-rifampin-impregnated central venous catheters (M/R CVCs) have been shown to be efficacious in reducing catheter-related bloodstream infections (CRBSI) and inhibiting the biofilm adherence of resistant Gram-positive and Gram-negative pathogens, with the exception of Pseudomonas aeruginosa and Candida spp. To expand the spectrum of antimicrobial activity, a novel second-generation M/R catheter was developed by adding chlorhexidine (CHX-M/R). CVCs and peripherally inserted central catheters (PICCs) were impregnated with CHX-M/R and compared with first-generation M/R catheters, CHX-silver sulfadiazine-treated CVCs (CHX/SS-CVCs), chlorhexidine-treated PICCs, and uncoated catheters. A biofilm catheter colonization model was used to assess the efficacy of catheters against methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus faecium (VRE), P. aeruginosa, Candida albicans, and Candida glabrata. CHX-M/R-impregnated CVCs were the only antimicrobial catheters that completely inhibited the biofilm colonization of all resistant bacterial and fungal organisms tested at all time intervals, and they were significantly superior to uncoated catheters (all P values were ≤0.003). Furthermore, CHX-M/R-coated CVCs had a significantly more effective and prolonged (up to 3 weeks) antimicrobial activity against MRSA and P. aeruginosa than M/R, CHX/SS, and uncoated CVCs (P < 0.0001). Similarly, CHX-M/R-coated PICCs were also superior to M/R-coated and CHX-coated PICCs in preventing biofilms of MRSA, VRE, P. aeruginosa, and Candida species (P value = 0.003 for all). Our study shows that novel CHX-M/R-coated catheters have unique properties in completely inhibiting biofilm colonization of MRSA, VRE, P. aeruginosa, and fungi in a manner superior to that of M/R- and chlorhexidine-treated catheters.
Objective: Many dental diseases are attributable to biofilms. The screening of antimicrobial substances, in particular, requires a high sample throughput and a realistic model, the evaluation must be as quick and as simple as possible. For this purpose, a colorimetric assay of the tetrazolium salt XTT (sodium 3'-[1-[(phenylamino)-carbony]-3,4-tetrazolium]-bis(4-methoxy-6-nitro)benzene-sulfonic acid hydrate) converted by saliva biofilms is recommended. Cleavage of XTT by dehydrogenase enzymes of metabolically active cells in biofilms yields a highly colored formazan product which is measured photometrically.
Materials and method: The suitability of the XTT assay for detecting the vitality of ex vivo saliva biofilms was tested to determine the efficacy of chlorhexidine and ozone versus saliva biofilms grown on titanium discs.
Results: The XTT method lends itself to testing the vitality of microorganisms in saliva biofilms. The sensitivity of the arrays requires a specific minimum number of pathogens, this number being different for planktonic bacteria and those occurring in biofilms. The antibacterial effect after treatment with chlorhexidine or ozone was measured by XTT conversion that was significantly reduced. The antimicrobial efficacy of 60 s 0.5% and 0.1% chlorhexidine treatment was equal and comparable with 60 s ozone treatment.
Conclusion: The XTT assay is a suitable method to determine the vitality in saliva biofilms, permitting assessment of the efficacy of antimicrobial substances. Its quick and easy applicability renders it especially suitable for screening.
biofilm model; saliva; S. mutans; ozone; chlorhexidine; XTT assay
To investigate the effect of chlorhexidine applications in various forms and concentrations on adhesion and failure modes of metal brackets in vitro.
Material and methods
Ninety bovine enamel specimens were allocated to six groups (n=15). Metal brackets were bonded on all specimens after chlorhexidine pre-treatments forming the following groups: (1) untreated specimens (control); (2) 40% varnish (EC40, Biodent BV, Netherlands), remnants removed with brushing mimicking patient cleaning; (3) 40% varnish (EC40), remnants removed with brushing mimicking professional cleaning; (4) 1% varnish (Cervitec Plus, Ivoclar vivadent, Schaan, Liechtenstein), remnants not removed; (5) brushed with% 1 gel (Corsodyl, GlaxoSmithKline, Münchenbuchsee, Germany), remnants not removed; (6) immersed in 0.07% mouthrinse (Corsodyl, GlaxoSmithKline, Münchenbuchsee, Germany), remnant not rinsed. Debonding of brackets was performed using a universal testing machine. Data were analysed using one-way ANOVA and post-hoc Scheffé test.
Group 4 performed significantly inferior than all the other groups and the control. Group 4 presented the highest number of adhesive failures at the enamel-resin interface whereas in other groups no failures at adhesive-resin interface was observed.
Presence of chlorhexidine varnish prior to bracket bonding adversely affects adhesion. Concentration of chlorhexidine pre-treatment has no influence on shear bond strength.
Chlorhexidine; Adhesion; Shear bond strength
To determine the cytotoxicity of three commercial mouthrinses Klorhex, Andorex and Tanflex on buccal epithelial cells using micronucleus (MN) test.
Materials and Methods
28 patients with aged 16–24 undergone three mouthrinses’ application were analyzed before and after one week exposure. Physiologic saline was used for the control group. The MN incidence was scored in the buccal epithelial of each participants. The difference in pre- and post-treatment after one week incidence of MN and plaque (PI) and gingival indices (GI) was compared by non-parametric statistical tests.
The micronuclei incidence increased in Klorhex, Tanflex and Andorex groups after exposure to mouth rinses (P<.05). But when compared with the control group, there was not any difference between Andorex and control group (P>.05). In the other study groups, MN incidence was significantly increased after 7 days treatment (P<.05). GI scores of all groups were decreased significantly (P<.05). PI scores were decreased only in the Klorhex group (P<.05).
Our primary findings support the presence of possible cytotoxic effects of the mouthrinses on gingival epithelial cells.
Mouthrinses; Cytotoxicity; Micronucleus test