Antimicrobial Efficacy of the Use of Mouthwash with Cetylpiridinium Chloride for Aerosol Producing Procedures. A Systematic Review / Eficacia antimicrobiana del uso del enjuague bucal con cloruro de cetilpiridinio en procedimientos que generan aerosoles. Revisión sistemática

Abstract The present research aims to determine the antimicrobial efficacy of the mouthwashes based on cetylpyridinium chloride (CPC), before aerosol producing dental procedures. A data search was performed during August 2021 in five databases MEDLINE (PubMed), SCOPUS, SCIELO, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar. Randomized clinical trials (RCTs) were included based on the PICO question, comparing the efficacy of the mouthwashes based on cetylpyridinium chloride (CPC), versus other mouthwashes and water, before aerosol producing dental procedures, papers in English, Spanish and Portuguese were included without time limits. The risk of the included studies was evaluated with the tool RoB 2.0. Number of registration PROSPERO N° CRD42021275982. 120 papers were obtained in the preliminary search, discarding those that didn't comply with the selection criteria, leaving only 3 studies. These papers reported the use of cetylpyridinium chloride (CPC) was effective for the reduction of bacteria during the ultrasonic prophylactic procedure. The use of CPC mouthwashes previous to the dental treatment with ultrasonic prophylaxis showed only antibacterial capacity.

Resumen El presente trabajo de investigación tiene como objetivo determinar la eficacia antimicrobiana de los colutorios a base de cloruro de Cetilpiridinio (CPC), previo a tratamientos dentales que generen aerosol. Se realizó una búsqueda bibliográfica hasta agosto del 2021 en cinco bases de datos: MEDLINE (vía PubMed), SCOPUS, SCIELO, Cochrane Central Register of Controlled Trials (CENTRAL) y Google Scholar. Se incluyeron ensayos clínicos aleatorizados (ECAs), basándose en la pregunta PICOS, que compare la eficacia del colutorio a base de cloruro de Cetilpiridinio (CPC) con otro colutorio, placebo o agua, previo a un tratamiento dental que genere aerosol, en los idiomas español, inglés o portugués y sin límite de tiempo. El riesgo de los estudios incluidos se evaluó con la herramienta RoB 2.0. Número de registro PROSPERO N° CRD42021275982. Se obtuvo un total de 120 artículos en la búsqueda preliminar, descartando aquellos que no cumplían con los criterios de selección, quedando sólo 3articulos. Estos artículos informaron que el uso de CPC es efectivo para la reducción de bacterias durante el procedimiento de profilaxis con ultrasonido. El uso de los enjuagues bucales a base de CPC previo al tratamiento dental de profilaxis con ultrasonido sólo tiene eficacia antibacteriana.

Relación del uso de colutorios bucales con la disminución de la carga viral del SARS-CoV-2 en la práctica odontológica: tema de revision / Relationship of the use of mouthwashes with the decrease in the viral load of SARS-CoV-2 in dental practice: review topic

Resumen Actualmente, el odontólogo es uno de los profesionales de la salud con mayor riesgo de contagio de la COVID-19 debido a su contacto directo con la cavidad bucal. La alta exposición a los aerosoles, generados por los instrumentos rotatorios, en pacientes con la COVID-19, eleva el contacto con la carga viral del SARS-CoV-2 en los procedimientos de rutina. Se ha descrito que los colutorios bucales, previos a la atención odontológica, podrían ser soluciones efectivas para la reducción del contagio pese a su poca evidencia clínica. Los colutorios con cloruro de cetilpiridinio (CPC), peróxido de hidrógeno (H2O2), povidona yodada (PVP-I) y gluconato de clorhexidina (CHX) muestran un gran potencial para reducir la carga viral del SARS- CoV-2 en los aerosoles generados a partir de la saliva durante la consulta odontológica. Por lo expuesto, el presente artículo tuvo por objetivo hacer una revisión de la información científica actual sobre la relación del uso de los colutorios bucales con la disminución de la carga viral del SARS-CoV-2.

Abstract It is currently known that the dentist is one of the health professionals with the highest risk of contagion of COVID-19 due to its direct contact with the oral cavity. High exposure to aerosols generated by rotating instruments in COVID-19 patients increases contact with the SARS-CoV-2 viral load in routine procedures. It has been described that mouthwashes prior to dental care could be effective solutions to reduce contagion despite their little clinical evidence. Mouthwashes with cetylpyridinium chloride (CPC), hydrogen peroxide (H2O2), povidone-iodine (PVP-I) and chlorhexidine gluconate (CHX) show great potential to reduce the viralload of SARS-CoV-2 in the aerosols generated from saliva during the dental visit. Therefore, the objective of this article was to review the current scientific information on the relationship of the use of mouthwashes with the decrease in the viral load of SARS-CoV-2.

Cetylpyridinium Chloride as a Tool Against COVID-19

ABSTRACT: As a part of bringing knowledge to healthcare professional, our team searched in the literature the effectiveness of Cetylpyridinium Chloride over SARS-CoV-2. Objectives: Explore the efficacy of Cetylpyridinium Chloride as a mouthwash in the dental attention. Methods: A literature search was realized in PubMed (MEDLINE), with the focusing on the following words: "Cetylpyridinium Chloride", "COVID-19", "Mouthwash", up to June 30, 2020. Results: There is a few information of this biocide over lower and upper airway affection, and other microorganisms. The effect of Cetylpyridinium Chloride over SARS-CoV-2 has not been proved. Although different guidelines recommend oxidative agents as a mouthwash before dental attention. Conclusion: Cetylpyridinium chloride is a cationic biocide widely used as a disinfectant in dentistry and as a mouthwash. Nevertheless, more research is needed, to know the effectiveness of CPC over SARS-CoV-2.

RESUMEN: Como parte de entregar el conocimiento al personal medico, nuestro equipo ha realizado una búsqueda sobre la eficacia del Cloruro Cetilpiridinio (CPC) sobre el virus SARS-CoV-2. Objetivos: Explorar la eficacia del CPC como uso de colutorio en la atención dental. Material y Metodos: Busqueda en la literatura mediante Pubmed (MEDLINE), con enfoque en las palabras Cloruro Cetilpiridinio, COVID-19, Colutorio, hasta Junio 30,2020. Resultados: Existe escasa información sobre este biocida y su efecto en las vias respiratorias altas y bajas, como frente a otros microrganismos. El efecto de CPC sobre SARS-CoV- 2 no se ha visto del todo comprobado. Sin embargo diferentes protocolos de actuación dental recomiendan el uso de agentes oxidantes como colutorio previo a la atención dental. Conclusión: CPC es un biocida cationico ampliamente utilizado como desinfectante en la odontología. Sin embargo se necesita mayor evidencia cientifica para demostrar la eficiencia del CPC por sobre SARS-CoV-2.

In vitro antimicrobial effect of cetylpyridinium chloride on complex multispecies subgingival biofilm

Abstract Periodontopathogenic subgingival biofilm is the main etiological agent of periodontitis. Thus, a search for antimicrobials as adjuvant for periodontal treatment in the literature is intense. Cetylpyridinium chloride (CPC) is a well-known antimicrobial agent commonly used in mouthrinses. However, CPC effects on a complex biofilm model were not found over the literature. Therefore, the aim of this manuscript is to evaluate 0.075% CPC antimicrobial properties in a multispecies subgingival biofilm model in vitro. The subgingival biofilm composed by 31 species related to periodontitis was formed for 7 days, using the calgary device. The treatments with CPC and chlorhexidine (CHX) 0.12% (as positive control) were performed 2x/day, for 1 min, from day 3 until the end of experimental period, totaling 8 treatments. After 7 days of biofilm formation, biofilm metabolic activity was evaluated by a colorimetric reaction and biofilms microbial composition by DNA-DNA hybridization. Statistical analysis was performed using ANOVA with data transformed via BOX-COX followed by Dunnett post-hoc. Both CPC and CHX reduced biofilm metabolic activity in 60% and presented antimicrobial activity against 13 different species. Specifically, only CHX reduced levels of F.n. vicentii and P. gingivalis while only CPC reduced A. odontolyticus and A. israelli. CPC was as effective as CHX as antimicrobial through in vitro complex multispecies subgingival biofilm. However, future studies using in vivo models of experimental periodontal disease should be performed to prove such effect.

Resumo O biofilme subgengival periodontopatogênico é o principal agente etiológico da periodontite. Assim, a pesquisa de antimicrobianos como adjuvantes para o tratamento periodontal na literatura é intensa. Cloreto de cetilpiridínio (CPC) é um agente antimicrobiano comumente usado em enxaguatórios bucais. No entanto não foram encontrados na literatura estudos avaliando os efeitos do CPC em um modelo complexo de biofilme. Portanto, o objetivo deste artigo é avaliar as propriedades antimicrobianas do cloreto de cetilpiridinio 0,075% em um modelo de biofilme subgengival multiespécie in vitro. O biofilme subgengival composto por 31 espécies relacionadas à periodontite foi formado por 7 dias, utilizando o dispositivo calgary. Os tratamentos com CPC e clorexidina (CHX) 0,12% (controle positivo) foram realizados 2x/dia, por 1 min, do dia 3 até o final do período experimental, totalizando 8 tratamentos. Após 7 dias de formação do biofilme, a atividade metabólica do biofilme foi avaliada por reação colorimétrica e a composição microbiana dos biofilmes por hibridização DNA-DNA. A análise estatística foi realizada usando ANOVA com dados transformados via BOX-COX seguido do teste de Dunnett. Tanto o CPC como a CHX reduziram a atividade metabólica do biofilme em aproximadamente 60% e apresentaram atividade antimicrobiana contra 13 espécies diferentes. Especificamente, apenas os níveis de F.n. Vicentii e P. gingivalis foram reduzidos somente pelo tratamento com a CHX enquanto apenas o CPC reduziu A. odontolyticus e A. israelli. O CPC foi tão eficaz quanto o CHX como antimicrobiano através de biofilme subgengival complexo multiespecífico in vitro. No entanto, futuros estudos usando modelos in vivo de doença periodontal experimental devem ser realizados para comprovar tal efeito.

Determination of mexiletine hydrochloride by rose Bengal probe using dual-wavelength resonance light scattering technology / 药学学报

The resonance light scattering (RLS) spectral characteristics of the interaction between rose Bengal and mexiletine hydrochloride in the presence of cetylpyridinium bromide were investigated. A dual-wavelength resonance light scattering (DWO-RLS) method for the determination of mexiletine hydrochloride in drugs was established. In a weakly acidic solution, rose Bengal interacts with mexiletine hydrochloride and cetylpyridinium bromide to form a red ternary ion association complex, which led to a significantly enhanced resonance light scattering signal and produced two strong characteristic scattering peaks at 372 nm and 596 nm. In these two wavelengths the mass concentration of mexiletine hydrochloride was in the range of 0.004 to 0.65 mg·L-1 and had a good linear relationship with the resonance light scattering enhancement intensity (ΔIRLS), with detection limits of 0.003 2 mg·L-1 (372 nm) and 0.003 8 mg·L-1 (596 nm), respectively. When measured by the dual-wavelength resonance light scattering (DWO-RLS) technique, the detection limit was lower, only 0.001 8 mg·L-1. When the DWO-RLS method was applied to the determination of mexiletine hydrochloride in commercially available mexiletine hydrochloride tablets, and the recovery was 98.5%-103%, and the relative standard deviation was 2.0%-2.7%.

The effect of different mouth washes and text messages reminder in the oral health of orthodontic patients

Aim: The aim of this study was to investigate the effect of different mouth washes and to study the effect of text message reminder on the oral health status of orthodontic patients treated with fixed appliances. Methods: This study was a clinical trial with pre-test and post-test control group design, conducted on 24 patients undergoing fixed orthodontic treatment aged 15-30 years. The patients randomly divided into two groups; one received a weekly telephone text massage reminder for the instructions of brushing and rinsing while the second group did not receive any messages. Ortho-plaque index and gingival index were used to evaluate the patient's oral hygiene status. The reading indices after brushing only were regarded as a control, then the patients were instructed to use two mouth washes, one containing sodium fluoride with cetylpyridinium chloride, the second containing chlorhexidine digluconate with cetylpyridinium chloride and Aloe Vera. Each one was used routinely for 4 weeks with the same amount and method. The washout period between the two types mouth washes was 4 weeks with a standardized toothbrush and paste. Results: Ortho-plaque index values decreased over the time between first, second and third visits. However, this index raised up at the fourth visit and again dropdown at the fifth visit. Similar results were detected for gingival index. Also, significant interaction between messages and the assessments was recorded for gingival index with a significant difference between the group of text messages and without text messages group (p<0.05). Conclusions: The results of this study showed that the combination of sodium fluoride with cetylpyridinium chloride was more potent for plaque control, while chlorhexidine digluconate with cetylpyridinium chloride and Aloe Vera combination showed a better gingival improvement. Moreover, the text messages reminder could enhance, but not replace direct oral hygiene instruction in orthodontic patients

Determination of mexiletine hydrochloride in drugs by eosin Y Rayleigh light scattering / 国际药学研究杂志

Objective: To establish a simple,rapid and novel Rayleigh light scattering(RLS)method for rapid determination of mexiletine hydrochloride in drugs. Methods: In the presence of acid Tris-HCl medium and cetylpyri- dinium bromide,eosin Y reacted with mexiletine hydrochloride to form a ternary ion association complex with two charac- teristic scattering peaks by electrostatic attraction. The detection wavelengths were 368 and 586 nm. There was a linear relationship between the mexiletine hydrochloride concentration in a certain range and the Rayleigh light scattering en- hancement intensity(ΔIRLS)of the association complex. Single-wavelength Rayleigh scattering(SWO-RLS)method or dualwavelength Rayleigh light scattering(DWO-RLS)method was used to determine the content of mexiletine hydrochloride, and the mexiletine hydrochloride content was calculated according to the regression equation of standard curve. Results: The linear ranges of mexiletine hydrochloride were 0.005-0.65 mg/L(SWO-RLS method,368 nm),0.004-0.65 mg/L (SWO-RLS method,586 nm)and 0.004-0.65 mg/L(DWO-RLS method,368 nm+586 nm),respectisely. Detection lim- its were 0.0033(SWO-RLS method,368 nm),0.0040(SWO-RLS method,586 nm)and 0.0018 mg/L(DWO-RLS method, 368 nm+586 nm),respectisely. The recovery and relative standard deviation(RSD,n=5)for a SWO-RLS method were 98.6-103% and 1.4-1.8%,respectively(SWO-RLS method,368 nm). Conclusion: The method is simple,rapid, highly sensitive and high selectie.

The antibacterial activity and release of quaternary ammonium compounds in an orthodontic primer

The aim of this study was to evaluate the impact of 10 wt% benzalkonium chloride (TBBAC) or 10 wt% cetylpyridinium chloride (TBCPC) on the antimicrobial properties of the orthodontic adhesive primer, Transbond XT™ (TB). Antimicrobial activity was assessed using a zone of inhibition diffusion test and the release of the antimicrobial compounds was monitored by high performance liquid chromatography (HPLC). Shear bond strength (SBS) was tested using bovine enamel. Control, TB, specimens failed to demonstrate intrinsic antibacterial activity at 1, 7 and 14 days; whereas, TBBAC and TBCPC showed antibacterial effects at all times. HPLC analysis indicated no significant differences in the release behaviour of TBBAC and TBCPC (ttest, p > 0.05), except for the 7day release which was higher for TBBAC (p < 0.05). By 14 days the extents of release were 27 ± 2% and 25 ± 5% of the total initial loading for TBBAC and TBCPC, respectively. The incorporation of 10 wt% BAC or CPC in Transbond XT™ adhesive primer also resulted in superior shear bond strength at 7 and 14 days (Fisher's LSD, p < 0.05) with no significant change in the mode of bracket failure under shear stress (Pearson's chisquared, p > 0.05) (AU)

El objetivo de este estudio fue evaluar el impacto del cloruro de benzalconio al 10% en peso del peso (TBBAC) o de cloruro de cetilpiridinio al 10% del peso (TBCPC) con propiedades antimicrobianas presentes en el adhesivo acondicionador ortodóncico, Transbond XT ™ (TB). La actividad antimi crobiana se evaluó usando una zona de prueba de difusión de inhibición y la liberación de los compuestos antimicrobianos se controló mediante cromatografía líquida de alta resolución (HPLC). La resistencia de adhesión al corte (SBS) se probó usando esmalte bovino. Las muestras control, TB no lograron demostrar actividad antibacteriana intrínseca a 1, 7 y 14 días; mientras que TBBAC y TBCPC mostraron efectos antibac terianos en todo momento. El análisis por HPLC no indicó diferencias significativas en el comportamiento de liberación de TBBAC y TBCPC (prueba t, p> 0,05), excepto en la liberación a los 7 días que fue más alta para TBBAC (p <0,05). A los 14 días, los grados de liberación fueron de 27 ± 2% y de 25 ± 5% de la carga inicial total para TBBAC y TBCPC, respectivamente. La incorpora ción de 10% en peso de BAC o CPC en el imprimador adhesivo Transbond XT ™ también dio como resultado una resistencia superior corte a los 7 y 14 días (Fisher's LSD, p <0.05) sin cambios significativos en el modo de falla del bracket bajo tensión de corte (Pearson's chicuadrado, p> 0.05) (AU)

Efficacy of two mouthwashes with cetylpyridinium chloride: a controlled randomized clinical trial

Abstract This study aimed to evaluate the anti-plaque and anti-gingivitis effects of two mouthwashes containing cetylpyridinium chloride (CPC), in comparison to negative control mouthwash. One hundred and twenty subjects were randomly assigned to study groups: test (0.075% CPC and 0.28% zinc lactate), positive control (0.07% CPC) and negative control mouthwash without CPC. All volunteers were examined by a calibrated examiner for the Quigley-Hein Plaque Index (Turesky modification) and Löe-Silness Gingival Index (GI). Gingival severity was also measured by the percentage of sites with positive gingival bleeding. During six weeks, oral hygiene consisted of brushing twice daily with a toothbrush and toothpaste and rising with their assigned mouthwash. Plaque and gingival parameters were assessed at baseline, after four and six weeks of product use. Statistical analyses were performed separately for plaque and gingival indices, by ANOVA, paired t-test and ANCOVA (α < 0.05). After 4 and 6 weeks, all mouthwashes groups presented statistically significant reductions in plaque and gingival parameters as compared to baseline. In comparison to the positive control, the test group presented additional reductions in dental plaque of 19.8% and 16.8%, after 4 and 6 weeks, respectively. For GI, the additional reductions in the test group were 9.7% and 14.3%, at 4 and 6 weeks, respectively. The test group showed additional reduction of 35.3% and 54.5% in the gingival severity, at week 4 and 6, respectively. It is concluded that the mouthwash containing CPC and zinc lactate presents significant anti-plaque and anti-gingivitis effects as compared to positive and negative control mouthwashes.

Effectiveness of a pre-procedural mouthwash in reducing bacteria in dental aerosols: randomized clinical trial

Abstract The aim of this randomized, single blinded clinical trial was to evaluate the effect of a pre-procedural mouthwash containing cetylpyridinium chloride (CPC), zinc lactate (Zn) and sodium fluoride (F) in the reduction of viable bacteria in oral aerosol after a dental prophylaxis with ultrasonic scaler. Sixty systemically healthy volunteers receiving dental prophylaxis were randomly assigned to one of the following experimental groups (15 per group): (i) rinsing with 0.075% CPC, 0.28% Zn and 0.05% F (CPC+Zn+F), (ii) water or (iii) 0.12% chlorhexidine digluconate (CHX), and (iv) no rinsing. Viable bacteria were collected from different locations in the dental office on enriched TSA plates and anaerobically incubated for 72 hours. The colonies were counted and species were then identified by Checkerboard DNA–DNA Hybridization. The total number of colony-forming units (CFUs) detected in the aerosols from volunteers who rinsed with CPC+Zn+F or CHX was statistically significantly (p<0.05) lower than of those subjects who did not rinse or who rinsed with water. When all locations were considered together, the aerosols from the CPC+Zn+F and CHX groups showed, respectively, 70% and 77% fewer CFUs than those from the No Rinsing group and 61% and 70% than those from the Water group. The mean proportions of bacterial species from the orange complex were statistically significantly (p<0.05) lower in aerosols from the CPC+Zn+F and CHX groups compared with the others two groups. In conclusion, the mouthwash containing CPC+Zn+F, is effective in reducing viable bacteria in oral aerosol after a dental prophylaxis with ultrasonic scaler.

The antiplaque and bleeding control effects of a cetylpyridinium chloride and tranexamic acid mouth rinse in patients with gingivitis

PURPOSE: This study aimed to evaluate the effects of a cetylpyridinium chloride (CPC) and tranexamic acid (TXA) mouth rinse on patients with gingivitis. METHODS: This randomized, placebo-controlled, double-blind, parallel-group, clinical trial included 45 healthy adults with gingivitis, who were randomized into 2 groups. The experimental group used a 0.05% CPC and 0.05% TXA mouth rinse, and the control group used a placebo mouth rinse. The following clinical indices were assessed at baseline, at 3 weeks, and at 6 weeks: the Turesky-Quigley-Hein plaque index (QHI), the Löe-Silness gingival index (GI), and bleeding on marginal probing (BOMP). The subjects used the mouth rinse during the experimental period for 20 seconds, 4–5 times daily (10 mL each time). RESULTS: There were no significant differences in the clinical indices between the groups at baseline. In the experimental group (CPC+TXA), a statistically significant improvement was evident in the QHI, GI, and BOMP at 3 and 6 weeks. These results were similar to those observed in the control group at 3 and 6 weeks, although the change in BOMP was not statistically significant in that group. At 6 weeks, the experimental group had a significantly lower mean score for the QHI than the control group. CONCLUSIONS: This study demonstrated that a CPC and TXA mouth rinse exhibited significant antiplaque and anti-gingivitis efficacy, and had a positive effect on bleeding control when used daily for 6 weeks.

Effects of a mouthwash containing potassium nitrate, sodium fluoride, and cetylpyridinium chloride on dentin hypersensitivity: a randomized, double-blind, placebo-controlled study

PURPOSE: We evaluated the efficacy of a mouthwash containing potassium nitrate (KNO3) as its main component, along with sodium fluoride (NaF) and cetylpyridinium chloride (CPC). The primary endpoint was the relief of dentin hypersensitivity (DH) against the cold stimuli. The effects on other DH tests and periodontal inflammation were also evaluated. METHODS: We used a single-center, double-blind, placebo-controlled, randomized design. A total of 82 patients with DH (40 in the test group, 42 placebo controls) were analyzed using visual analog scales (VASs) for a cold test, a tactile test, a compressive air test, and self-reported pain during daily activities, as well as clinical parameters including plaque index, gingival index, modified sulcular bleeding index (mSBI), gingival recession, and probing depth, which were collected at baseline and after four and six weeks of mouthwash use. RESULTS: VAS scores for cold sensations, tactile sensations, the compressive air test, and self-reported pain significantly decreased from baseline during the six weeks in both groups (P<0.01), and no significant differences between the groups were found. In male patients (10 in the test group and 7 in the control group), both groups showed significant reductions in VAS scores for the cold test over the six weeks, and greater reductions were found in the test group than in the control group between four and six weeks (P=0.01) and between baseline and six weeks (P<0.01). In addition, the mSBI in the test group significantly decreased from baseline during the six weeks (P<0.01), and the changes at four and six weeks from baseline were significantly greater in the test group compared to the control group (P=0.03 and P=0.02, respectively). CONCLUSIONS: A mouthwash containing a mixture of KNO3, NaF, and CPC reduced DH and gingival inflammation, however, the efficacy was comparable to the control group.

The clinical effect of cetylpyridinium chloride in the treatment of oral candidiasis infection / 中国基层医药

Objective To observe the treatment effect of cetylpyridinium chloride gargle on the oral candidi-asis infection.Methods According to the selection of different drugs,88 cases with candidiasis infection were divided into the cetylpyridinium chloride gargle treatment group and the compound chlorhexidine gargle control (control group),44 cases in each group.The oral pain improvement,oral mucosal atrophy,swollen gums bleeding,microscopy positive rate,colony number and patients with oral erythema score,clinical efficacy and adverse reactions were observed and compared in the two groups.Results The total effective rate of the treatment group was 95.5%,which was significantly higher than 77.3% in the control group(χ2 =8.063,P =0.019),and the difference was statistically significant.After treatment,mucosal atrophy and erythema scores of the treatment group were significantly better than control group,and there were statistically significant differences (t =6.142,P =0.033;t =6.554,P =0.044).After treatment,the number of colonies and microscopic examination positive rate of the treatment group were better than those of the control group,and with statistical significance (χ2 =11.596,P =0.019;χ2 =6.994,P =0.031 ). Conclusion Cetylpyridinium chloride gargle in the treatment of oral candidiasis infection disease not only has signifi-cant effect and can effectively reduce the pain of patients with oral,reduce the incidence of adverse reaction,it is safe and reliable,it is worth popularization and application in oral candidiasis.

Eficacia del uso concomitante de dentífrico con Triclosán a 0.3 por ciento y copolímero PVM/MA a 2.0 por ciento, enjuague bucal a base de cloruro de cetilpiridinio a 0.05 por ciento y terapia de raspado/alisado radicular en pacientes con gingivitis / Efficacy of concomitant use of dentifrice with 0.3 per cent Triclosan and 2.0 per cent PVM/MA copolymer, 0.05 per cent cetylpyridinium chloride mouthrinse and scaling/root planning therapy in patients with gingivitis

Introducción: La placa dentobacteriana es el principal factor etiológico en el desarrollo y progresión de la gingivitis. Comúnmente se han sugerido productos de cuidado oral como cremas dentales y/o enjuagues bucales como adyuvante en la terapia mecánica. Objetivo: Evaluar la eficacia del uso combinado de un dentífrico a base de Triclosán a 0.3 por ciento y copolímero PVM/MA a 2.0 por ciento (Colgate Total 12®) y enjuague bucal a base de cloruro de cetilpiridinio a 0.05 por ciento (Colgate Plax®) en pacientes con gingivitis marginal crónica después de una terapia de raspado y alisado radicular comparado con un grupo control. Material y métodos: Se realizó un ensayo clínico controlado, aleatorizado y doble ciego en 50 pacientes sanos con diagnóstico sistemático de gingivitis marginal crónica. Se dividieron en grupo A experimental y grupo B control. Se evaluó índice gingival de Lõe y Silness e índice de placa de Quigley Hein modifi cado por Turesky al inicio y al fi nal del estudio; el periodo de estudio fue de seis semanas. Al inicio se realizó a cada paciente tratamiento de raspado y alisado radicular y se le instruyó sobre el uso correcto de los productos. Al concluir la sexta semana se tomaron mediciones finales bajo las mismas condiciones que las iniciales...

Introduction:Dental plaque is considered to be the main etiological factor in the development and progression of gingivitis. Oral care products such as toothpaste and mouthwash have commonly been rec-ommended as an adjunct to mechanical periodontal therapy. Objective:To evaluate the effi cacy of using a dentifrice containing 0.3% triclosan and 2.0% PVM/MA copolymer (Colgate Total 12®) in combination with a 0.05% cetylpyridinium chloride mouthwash (Colgate Plax®) in patients with chronic marginal gingivitis following scaling and root-planing therapy compared to a control group. Material and methods:A randomized double-blind controlled clinical study was performed on 50 systemically healthy patients diagnosed with chronic marginal gingivitis. These were divided into two groups: A (experimental) and B (control). The Lõe and Silness gingival index and the Turesky modifi ca-tion of the Quigley-Hein plaque index were recorded at baseline and after 6 weeks (the duration of the study). Patients were treated with scaling and root-planning, and all received instructions on the proper use of the oral care products. Final measurements were taken at the end of the six-week assessment under the same conditions as those at the time of the baseline assessment...

In vitro Antimicrobial Activity of Various Mouth Rinses against Streptococcus mutans, Lactobacillus casei, L. acidophilus and Candida albicans.

Aim: The aim of this in vitro study was to determine the antimicrobial activities of commonly used mouth rinses against different oral microorganisms. Methodology: Six commercially available mouth rinses (Colgate Total, Colgate Plax, Colgate Pro-argin, Oral-B Pro-expert, Listerine and Oderol) were used in this study. The antimicrobial activities of mouth rinses against Streptococcus mutans ATCC 25175, Lactobacillus casei RSKK 900, L. acidophilus ATCC 11975 and Candida albicans ATCC 10231 were evaluated by disc diffusion and minimum inhibitory concentration tests. Klorhex® was used as positive control. Experiments were repeated twice. Results: Colgate Total, Colgate Plax, Oral B Pro-expert and Oderol showed good antimicrobial activity against test microorganisms in comparison with Colgate Pro-argin and Listerine. Conclusion: Chlorhexidine and cetylpyridinium chloride containing mouth rinses were found more active than other products tested. Main motive of mouth rinses is removing the microorganisms from the mouth although their effectiveness depends on the formulation, concentration, quantity of ingredients and duration of rinsing.

Inhibitory effects of cetylpyridinium chloride buccal tablets on dental plaque / 实用口腔医学杂志

Objective:To investigate the effects of cetylpyridinium chloride buccal tablets(CCBT)on dental plaque control.Meth-ods:60 patients with gingivitis,mild or moderate,or chronic periodontitis were divided into control group(without drug treatment), CCBT group (treated with CCBT)and CHX group (treated with compound chlorhexidine gargle)according to the randomized con-trolled single-blind principle.Quigley-Hein plaque index (PI)and bleeding index (BI)of the subjects were recorded,tumor necro-sis factor (TNF-α)and interleukin (IL-1β)in gingival crevicular fluid (GCF)were measured by ELISA before and after 2 weeks'trial.Results:After 2-week treatment,PI and BI in CCBT and CHX groups decreased(P0.05). In control group PI was decreased(P005).Conclusion:CCBT is effective in inhibiting plaque accumulation and decreasing GCF TNF-αlevel.

Efficacy of alcohol-free cetylpyridinium chloride on periodontal disease in beagle dogs via drinking water additive and oral gel / 동물의과학연구지

This study was conducted in order to examine the effects of alcohol-free cetylpyridinium chloride drinking water additive and oral gel on clinical parameters related to periodontal disease in beagle dogs. This study was conducted with healthy 15 beagle dogs. Following a professional teeth cleaning procedure, dogs were divided into three groups. Dogs in the control group received nothing, those in the drinking water additive (DWA) group received 800 ml water with 15 ml of alcohol-free cetylpyridinium chloride drinking water additive daily, and those in the Oral gel (OG) group were treated with oral gel containing alcohol-free cetylpyridinium chloride and 0.05% chlorhexidine gluconate daily. Clinical parameters, including plaque index (PI), calculus index (CI), and gingivitis index (GI) were evaluated at two and four weeks. Dogs in the DWA and OG groups had significantly less plaque than dogs in the control group at two and four weeks (P<0.01, P<0.05). And, at four weeks, CI was significantly lower in the OG group compared to the control group (P<0.05). On GI, similar scores were recorded for all groups during the experimental period. No significant difference was observed between the DWA group and the OG group. The effect of alcohol-free cetylpyridinium chloride drinking water additive was similar to the result for alcohol containing cetylpyridinium chloride mouthwash reported in a previous study. The effect in control of periodontal disease was better in the OG group because of additional chlorhexidine gluconate. However, use of drinking water additive will be more convenient for owners; thus, it will be more effective for achievement of long-term results.

Mouthrinses: active ingredients, pharmacological properties and indications / Enxaguatórios bucais: princípios ativos, propriedades farmacológicas e indicações

Objective: To evaluate the formulations of 29 mouthrinses marketed in the city of Salvador, Bahia, Brazil, in 2011, with respect to active principles - antimicrobial-agents - and other components. Methods: Data collection was performed in commercial wide circulation. Product labels were evaluated, information recorded, and afterwards data were complemented by consulting the scientific literature. Results: Of the three chlorhexidine-containing mouthrinses, two contained 0.12% chlorhexidine gluconate or digluconate formulated in a free base concentration of chlorhexidine 0.067%, while the third did not report the concentration. Only two mouthwashes contained the antimicrobial agent triclosan at 0.03% concentration associated with PVA Gantrez copolymer at 0.2% concentration to stabilize it. Cetylpyridinium chloride is an antiseptic substance present in most mouthwashes available on the market, while products containing essential oils as active principles in their formulations, usually associate thymol, menthol, eucalyptol and methyl salicylate. Irrespective of the antibacterial agent, the mouthrinses typically have similar complementary substances, especially the addition of fluoride ions.Conclusion: There are a a wide variety of mouthrinses containing antimicrobial agents in a variety of different spectra on the Market, but no data are provided on other substances added to them. Among antimicrobial agents, the most frequently found in mouthwashes was cetylpyridinium chloride. It is important for the dentist to have adequate knowledge of the spectrum of action of each antimicrobial agent, in order to prescribe the most appropriate type in each case.

Objetivo: Avaliar a constituição de 29 enxaguatórios, comercializados na cidade do Salvador, Bahia, Brasil, em 2011, relacionado aos princípios ativos-agentes antimicrobianos - além dos demais componentes.Métodos: A coleta das informações foi realizada em estabelecimentos comerciais de ampla circulação. Para tanto foram avaliados os rótulos dos produtos, registradas as informações, seguindo-se de complementação dos dados mediante consultas à literatura científica. Resultados: Dos três enxaguatórios contendo clorexidina, dois contêm gluconato de clorexidina a 0,12% ou digluconato formulado para uma base livre de clorexidina na concentração de 0,067%, enquanto que o terceiro não informa a concentração. Apenas dois colutórios possuem o agente antimicrobiano triclosan na concentração de 0,03% associado ao copolímero PVA Gantrez na concentração de 0,2% para estabilizá-lo. O cloreto de cetilpiridínio é a substância anti-séptica que está presente na maioria dos enxaguatórios veiculados no mercado, enquanto que os produtos que contêm em suas formulações os óleos essenciais como princípios ativos, geralmente associam timol, mentol, eucaliptol e salicilato de metila. Independente do agente antibacteriano, os enxaguatórios em geral possuem substâncias complementares semelhantes, com destaque à adição o íon fluoreto. Conclusão: O mercado apresenta uma ampla variedade de enxaguatórios contendo relativa variedade de agentes antimicrobianos de diferentes espectros, contudo são limitadas as informações sobre as demais substâncias adicionadas aos mesmos; dentre os agentes antimicrobianos aquele encontrado com maior freqüência nos enxaguatórios é o cloreto de cetilpiridínio; é importante que o cirurgião-dentista tenha conhecimento adequado do espectro de ação de cada agente antimicrobiano a fim de prescrever o mais apropriado a cada caso.

Fate of sputum samples transported in bottles containing Cetylpyridinium Chloride and Sodium Chloride: A National Reference Laboratory Study.

The transportation of sputum samples may sometimes take more than one week which results in an increased contamination rate and loss of positive cultures. The current study was planned to analyze the recovery rate of mycobacteria from transported samples with and without Cetylpyridinium chloride (CPC). Addition of CPC is useful for isolation of M. tuberculosis from sputum subjected to long-term storage.

A preliminary study of the antibacterial potential of cetylpyridinium chloride in root canals infected by E. faecalis

The aim of this preliminary study was to verify the antibacterial potential of cetylpyridinium chloride (CPC) in root canals infected by Enterococcus faecalis. Forty human maxillary anterior teeth were prepared and inoculated with E. faecalis for 60 days. The teeth were randomly assigned to the following groups: 1: Root canal preparation (RCP) + 0.1% CPC with positive-pressure irrigation (PPI, Conventional, NaviTip®); 2: RCP + 0.2% CPC PPI; 3: RCP + 2.5% NaOCl PPI; 4: RCP + 2.5% NaOCl with negative-pressure irrigation system (NPI, EndoVac®); 5: Positive control; and 6: Negative control. Four teeth of each experimental group were evaluated by culture and 4 by scanning electron microscopy (SEM). In all teeth, the root canals were dried and filled with 17% EDTA (pH 7.2) for 3 min for smear layer removal. Samples from the infected root canals were collected and immersed in 7 mL of Letheen Broth (LB), followed by incubation at 37°C for 48 h. Bacterial growth was analyzed by turbidity of culture medium and then observed with a UV spectrophotometer. The irrigating solutions were further evaluated for antimicrobial effect by an agar diffusion test.The statistical data were treated by means, standard deviation, Kruskal-Wallis test and analysis of variance. Significance level was set at 5%. The results showed the presence of E. faecalis after root canal sanitization. The number of bacteria decreased after the use of CPC. In the agar diffusion test, CPC induced large microbial inhibition zones, similar to 2% chlorhexidine and large than 2.5% NaOCl. In conclusion, cetylpyridinium chloride showed antibacterial potential in endodontic infection with E. faecalis.

O objetivo deste estudo preliminar foi verificar o potencial antibacteriano de cloreto de cetilpiridínio (CCP) em canais radiculares infectados por E. faecalis. Quarenta dentes anteriores de humanos foram preparados e inoculados com E. faecalis por 60 dias. Os dentes foram aleatoriamente distribuídos como se segue: 1. Preparo do canal radicular (PCR) + CCP 0,1% com sistema de pressão positiva de irrigação (PPI, convencional, Navitip®); 2. PCR + CPC 0,2% PPI; 3. PCR + NaOCl 2,5% PPI, 4. PCR + NaOCl 2,5% com sistema de pressão negativa de irrigação (PNI, EndoVac®); 5 e 6. Controles positivos e negativos. Quatro dentes de cada grupo experimental foram avaliados por cultura e quatro por microscopia eletrônica de varredura (MEV). Em todos os dentes, os canais foram secos e preenchidos com EDTA 17% (pH 7,2) durante 3 min. As amostras dos canais radiculares infectados foram coletadas e imersas em 7 mL Letheen Broth (LB), seguido de incubação a 37° C durante 48 h. O crescimento bacteriano foi analisado pela turvação do meio de cultura, e mensurados por meio de um espectrofotometro (UV). As soluções irrigantes foram ainda avaliadas em teste de difusão em ágar. A análise estatística utilizou de média, desvio padrão,teste de Kruskal-Wallis e análise de variância. O nível de significância foi de 5%. Os resultados mostraram a presença de E. faecalis posterior ao processo de desinfecção do canal radicular. O cloreto de cetilpiridínio mostrou reduzir o número de bactérias. No teste de difusão em ágar, o CPC determinou inibição microbiana, com resultados semelhantes à CHX a 2% e maiores do que o hipoclorito de sódio a 2,5%. O cloreto de cetilpiridínio demonstrou potencial antibacteriano em infecção endodôntica por E. faecalis.