An Herbal Alternative to Control Nosocomial Pathogens in Aerosols and Splatter During Ultrasonic Scaling

Abstract Objective: To evaluate the efficacy of herbal mouthwash (Himalaya Hiora Regular) against methicillin-resistant Staphylococcus aureus and Acinetobacter baumanni during ultrasonic scaling. Material and Methods: Group B (n=25) received herbal mouthwash and Group A (n=25) received 0.12% chlorhexidine mouthwash respectively as a preprocedural rinse. The aerosols produced by the ultrasonic unit were collected on MeReSa and Leeds Acinetobacter Agar plates. The experimental setting included eight different locations covering all areas of the operatory. The plates exposed to aerosols for a period of 30 minutes were incubated aerobically at 37ºC for 48hrs and the colony forming units (CFU) were statistically analyzed Results: Herbal mouthwash (Himalaya Hiora Regular) showed a significant reduction in mean CFU of MRSA compared to 0.12% chlorhexidine. While herbal mouthwash was on par with 0.12% chlorhexidine in the reduction of A. baumannii Conclusion: Herbal mouthwash was found to be more effective against MRSA than 0.12% Chlorhexidine mouthwash as a pre-procedural rinse. Both herbal mouthwash and chlorhexidine mouthwash was found to be effective against A. baumannii. Herbal mouthwash may be a safe alternative to chlorhexidine against nosocomial pathogens like MRSA and A. baumannii.

Evaluation of the clinical effect of a probiotic mouthwash in the treatment of generalized marginal chronic gingivitis: randomized pilot study

Objective. to evaluate the clinical effect of a probiotic mouthwash in reducing generalized marginal chronic gingivitis using positive and negative control groups. methodology. four-week study conducted in San Luis Potosí, Mexico, from january to march 2017. participants were healthy, non-smokers with generalized marginal chronic gingivitis; age range 18-45 years. subjects were randomized and divided into three groups: group A: mouthwash based on 0.05 percent cetylpyridinium chloride (CPC) (positive control); group B: mouthwash based on probiotics (experimental); group C: placebo mouthwash (negative control). no oral hygiene practices or routines were modified; subjects were followed for 4 weeks. the primary outcome variable of interest was the Löe and Silness gingival index, and the secondary one, the Quigley Heinn plaque index modified by Turesky. results. of the 45 patients included, 19 (42.2 percent) were men and 26 (57.7 percent) women, mean age was 22.8±2.07. each group consisted of 15 subjects; all subjects completed the study. there was no statistically significant reduction in gingival inflammation when comparing the 3 treatment groups (p=0.540) with respect to the gingival index. A comparison was made before and after the treatment and in the 3 groups there was no reduction of the gingival inflammation. plaque reduction was not statistically significant when comparing the 3 groups (p=0.278). however, when doing intra-group comparison, it was found that the patients in group A had a reduction in plaque index (p<0.005), which was not observed in groups B (p=0.1103) and C (p=0.1508). conclusions. the use of a probiotic mouth mouthwash did not reduce gingival inflammation or the accumulation of dentobacterial plaque in a period of 4 weeks. there were no statistically significant differences between the study groups.

In vitro effects of alcohol-containing mouthwashes on human enamel and restorative materials

Abstract The objective of this study was to evaluate the in vitro effects, including surface morphological characteristics and chemical elemental properties, of different mouthwash formulations on enamel and dental restorative materials, simulating up to 6 months of daily use. Human enamel samples, hydroxyapatite, composite resin, and ceramic surfaces were exposed to 3 different mouthwashes according to label directions — Listerine® Cool Mint®, Listerine® Total Care, and Listerine® Whitening — versus control (hydroalcohol solution) to simulate daily use for up to 6 months. The samples were analyzed using scanning electron microscopy (SEM), infrared spectrophotometry (µ-Fourier transform infrared microscopy), energy-dispersive X-ray (EDX) spectroscopy, and color analysis before and after exposure. No relevant changes were observed in the morphological characteristics of the surfaces using SEM techniques. The physical and chemical aspects of the enamel surfaces were evaluated using mid-infrared spectroscopy, and EDX fluorescence was used to evaluate the elemental aspects of each surface. There was no variation in the relative concentrations of calcium and phosphorus in enamel, silicon and barium in composite resin, and silicon and aluminum in the ceramic material before and after treatment. No relevant changes were detected in the biochemical and color properties of any specimen, except with Listerine® Whitening mouthwash, which demonstrated a whitening effect on enamel surfaces. Long-term exposure to low pH, alcohol-containing, and peroxide-containing mouthwash formulations caused no ultra-structural or chemical elemental changes in human enamel or dental restorative materials in vitro.

Caries lesion remineralization with fluoride toothpastes and chlorhexidine - effects of application timing and toothpaste surfactant

Abstract Habitual toothbrushing with fluoridated toothpaste followed by rinsing with antibacterial mouthwashes is a method to maintain good oral hygiene and to diminish the occurrence and severity of dental caries and periodontal disease. However, our understanding of how antimicrobial agents in mouthwashes affect fluoride-mediated caries lesion remineralization is still poor. Objective: The objectives of this in vitro study were a) to determine the effects of the waiting period of chlorhexidine (CHX) rinsing after fluoride toothpaste use and b) to further determine the effect of the type of toothpaste surfactant [sodium dodecyl sulfate (SDS) or cocamidopropyl betaine (CAPB)] on caries lesion remineralization associated with CHX rinsing. Material and Methods: Caries lesions were formed in bovine enamel specimens and assigned to 10 treatment groups (n=18) based on Vickers surface microhardness (VHN). Lesions were then pH-cycled for 10 days with daily regimen comprised of twice daily toothpaste slurry treatments (1150 ppm fluoride, with SDS or CAPB), followed by CHX solution treatments [0, 15, 30 or 60 minutes following slurry treatment or no CHX treatment (negative control)]. VHN was measured again and the extent of lesion remineralization calculated (∆VHN). Results: ∆VHN with SDS-toothpaste was significantly lower than with CAPB-toothpaste, indicating more remineralization for the CAPB-toothpaste. ∆VHN with 0-minute waiting time was significantly lower than with 30-minute waiting time and with negative control. Conclusions: The absence of CHX as an adjunct to fluoride toothpastes led to greater remineralization of enamel lesions compared with the immediate use of CHX treatment for both SDS- and CAPB-toothpastes. CAPB-toothpastes indicated significantly greater remineralization than SDS-toothpastes, and can be suggested for patients at high risk of caries. A 30-minute waiting time for CHX treatment is recommended after brushing.

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.

Chlorhexidine with or without alcohol against biofilm formation: efficacy, adverse events and taste preference

Abstract In recent years, different chlorhexidine formulations have been tested, including an alcohol-free alternative, but the effect of this solution on early biofilm formation is not clear. A crossover, randomized, double-blind clinical trial was conducted to evaluate the effect of two chlorhexidine solutions against supra- and subgingival biofilm formation (NCT#02656251). Thirty-five participants were randomized and asked to rinse twice daily with 15 ml of an alcohol-containing 0.12% chlorhexidine solution, an alcohol-free 0.12% chlorhexidine solution, or placebo. The study was conducted in three experimental periods of 4 days each, with a 10-day washout between the periods. All the experimental periods followed the same protocol, except that the solutions were switched. Biofilm distribution was evaluated every 24 hours by the Plaque-Free Zone Index, during 96 hours. Adverse events were self-reported and sensory evaluation was performed using a hedonic scale. Compared to the placebo, the chlorhexidine solutions resulted in a significantly higher number of surfaces free of plaque over 96 hours (p < 0.01), and were able to prevent subgingival biofilm formation (p < 0.01). The alcohol-free chlorhexidine solution was associated with a lower incidence of adverse events, compared with alcohol-containing chlorhexidine (p < 0.05); it also received better sensory evaluation and acceptance by trial participants, compared with the alcohol-containing chlorhexidine (p = 0.007), and had a similar inhibitory effect on the formation of supra- and subgingival biofilms.

Antiseptics and microcosm biofilm formation on titanium surfaces

Abstract Oral rehabilitation with osseointegrated implants is a way to restore esthetics and masticatory function in edentulous patients, but bacterial colonization around the implants may lead to mucositis or peri-implantitis and consequent implant loss. Peri-implantitis is the main complication of oral rehabilitation with dental implants and, therefore, it is necessary to take into account the potential effects of antiseptics such as chlorhexidine (CHX), chloramine T (CHT), triclosan (TRI), and essential oils (EO) on bacterial adhesion and on biofilm formation. To assess the action of these substances, we used the microcosm technique, in which the oral environment and periodontal conditions are simulated in vitro on titanium discs with different surface treatments (smooth surface - SS, acid-etched smooth surface - AESS, sand-blasted surface - SBS, and sand-blasted and acid-etched surface - SBAES). Roughness measurements yielded the following results: SS: 0.47 µm, AESS: 0.43 µm, SB: 0.79 µm, and SBAES: 0.72 µm. There was statistical difference only between SBS and AESS. There was no statistical difference among antiseptic treatments. However, EO and CHT showed lower bacterial counts compared with the saline solution treatment (control group). Thus, the current gold standard (CHX) did not outperform CHT and EO, which were efficient in reducing the biofilm biomass compared with saline solution.

Protective effect of experimental mouthrinses containing NaF and TiF4 on dentin erosive loss in vitro

Objective This in vitro study assessed the anti-erosive effect of experimental mouthrinses containing TiF4 and NaF on dentin erosive loss.Material and Methods Bovine dentin specimens were randomly allocated into the groups (n=15): 1) SnCl2/NaF/AmF (Erosion Protection®/GABA, pH 4.5, positive control); 2) experimental solution with 0.0815% TiF4(pH 2.5); 3) 0.105% NaF (pH 4.5); 4) 0.042% NaF+0.049% TiF4 (pH 4.4); 5) 0.063% NaF+0.036% TiF4 (pH 4.5); 6) no treatment (negative control). Each specimen was cyclically demineralized (Sprite Zero, pH 2.6, 4x90 s/day) and exposed to artificial saliva between the erosive challenges for 7 days. The treatment with the fluoride solutions was done 2x60 s/day, immediately after the first and the last erosive challenges of the day. Dentin erosive loss was measured by profilometry (μm). The data were analyzed using Kruskal Wallis/Dunn tests (p<0.05).Results Mouthrinses containing TiF4or Sn/F were able to show some protective effect against dentin erosive loss compared to negative control. The best anti-erosive effect was found for experimental solution containing 0.0815% TiF4 (100% reduction in dentin loss), followed by 0.042% NaF+0.049% TiF4 (58.3%), SnCl2/NaF/AmF (52%) and 0.063% NaF+0.036% TiF4 (40%). NaF solution (13.3%) did not significantly differ from control.Conclusion The daily application of experimental mouthrinse containing TiF4and NaF has the ability to reduce dentin erosion, as well as Erosion Protection® and TiF4 alone.

The contribution of distance learning to the knowledge of nursing lecturers regarding assessment of chronic wounds / Contribuição da educação a distância para o conhecimento de docentes de enfermagem sobre avaliação de feridas crônicas / Contribución de la educación a distancia para el conocimiento de docentes de enfermería sobre evaluación de heridas crónicas

OBJECTIVE: to identify the contribution made by a refresher course on the assessment of chronic wounds, offered through the Moodle virtual learning environment (VLE), to the knowledge relating to this issue of nursing lecturers and nurses linked to higher education. METHOD: a prospective, quasi-experimental study, with data collection before and after the educational intervention. The study was undertaken in three stages using the Moodle VLE. The sample was made up of 28 participants who answered the pre-test on the knowledge, devised in accordance with international guidelines on chronic wounds. Afterwards, the refresher course was offered (intervention) and was accessed in accordance with individuals' schedules, during the established time period. At the end of the course, 26 participants answered the post-test. Those who did not participate in the post-tests were excluded from the study, as it is pairwise analysis of the sample. RESULT: the participants obtained, on average, 55.5% of correct answers in the pre-test on their knowledge, and 73.4% in the post-test, this difference being statistically significant. There was a negative correlation between the time of experience in lecturing and the performance in the test on their knowledge. CONCLUSION: the participation in the online refresher course contributed to improving the lecturers' performance in the test on their knowledge, in relation to the recommendations for assessing chronic wounds, based in scientific evidence. .

OBJETIVO: identificar a contribuição de um curso de atualização sobre a avaliação de feridas crônicas, oferecido pelo Ambiente Virtual de Aprendizagem (AVA) Moodle, para o conhecimento de docentes de enfermagem e enfermeiros vinculados ao ensino superior, acerca da temática. MÉTODO: estudo prospectivo, quase-experimental, com coleta de dados antes e após intervenção educativa. O estudo foi desenvolvido em três etapas, através do AVA Moodle. A amostra foi composta por 28 participantes, que responderam ao pré-teste de conhecimento, elaborado de acordo com diretrizes internacionais sobre feridas crônicas. Após, o curso de atualização foi oferecido (intervenção) e acessado conforme programação individual, durante prazo estabelecido. Ao término do curso, 26 participantes responderam ao pós-teste. Aqueles que não participaram do pós-teste foram excluídos do estudo, por tratar-se da análise pareada da amostra. RESULTADO: os participantes obtiveram, em média, 55,5% de acertos no pré-teste de conhecimento, e 73,4%, no pós-teste, sendo essa diferença estatisticamente significante. Houve correlação negativa entre o tempo de experiência na docência e o desempenho no teste de conhecimento. CONCLUSÃO: a participação no curso de atualização on-line contribuiu para melhor desempenho dos docentes no teste de conhecimentos, sobre as recomendações para avaliação de feridas crônicas, com embasamento em evidência científicas. .

OBJETIVO: identificar la contribución de un curso de actualización sobre la evaluación de heridas crónicas, ofrecido por el ambiente virtual de aprendizaje (AVA) Moodle, para el conocimiento de docentes de enfermería y enfermeros vinculados a la enseñanza superior, acerca de la temática. MÉTODO: estudio prospectivo, casi experimental, con recolección de datos antes y después de la intervención educativa. El estudio fue desarrollado en tres etapas a través del AVA Moodle. La muestra fue compuesta por 28 participantes, que respondieron a la preprueba de conocimiento, elaborada de acuerdo con directrices internacionales sobre heridas crónicas. Después, el curso de actualización fue ofrecido (intervención) y accedido conforme programación individual, durante un plazo establecido. Al término del curso, 26 participantes respondieron a la postprueba. Aquellos que no participaron de la postprueba, fueron excluidos del estudio, por tratarse de un análisis pareado de la muestra. RESULTADOS: los participantes obtuvieron, en promedio, 55,5% de aciertos en la preprueba de conocimiento, y 73,4%, en la postprueba, siendo esa diferencia estadísticamente significativa. Hubo correlación negativa entre el tiempo de experiencia en la docencia y el desempeño en la prueba de conocimiento. CONCLUSIÓN: la participación en el curso de actualización on-line contribuyó para mejorar el desempeño de los docentes en la prueba de conocimientos sobre las recomendaciones para evaluación de heridas crónicas, con base en evidencia científicas. .

Antiseptic mouthwashes: in vitro antibacterial activity / Antissépticos bucais: atividade antibacteriana

Mouthwashes are used as an adjunct to tooth brushing for improving breath and preventing oral diseases. The aim of this study was to compare the in vitro Maximum Inhibitory Dilution (MID) of 3 mouthwashes with different active ingredients against mutans streptococci (MS). The products analyzed were Periogard, Cepacol and Plax Fresh Mint. Theirantibacterial activity was assessed in duplicate in 96-well microtiter plates against 36 clinical isolates of MS. Each mouthwash was submitted to a serial two-fold dilution (1/2.5 to 1/5120) using double concentration of Tryptose Soy Broth with 1.0% yeast extract. The final volume in each well was 100mL plus 5 mL of a bacterial suspension, equivalent to 107 CFU/mL. They were incubated microaerobically at 37ºC for48 hours and the MIDs determined. MID was 1/320 forPeriogard and Cepacol, and 1/20 for Plax. Statisticalanalysis revealed that the MID of Periogard MID did not differ from that of Cepacol (p>0.05), and was higher than that of Plax (p<0.05). In conclusion, the antiseptic mouthwashes containing chlorhexidine (Periogard) and cetylpyridinium chloride (Cepacol) had higher in vitroantibacterial activity(MID) against MS than the antiseptic mouthwash containing triclosan (Plax), according to microbiological method employed.

Os antissépticos bucais são utilizados mundialmente como adjuvantes da escovação para melhoria do hálito e prevenção de doenças bucais infeciosas. O objetivo deste estudo foi comparar in vitro a Diluição Inibitória Máxima (DIM) de 3 antissépticos bucais com diferentes princípios ativos contra estreptococos do grupo mutans (EGM). Os produtos analisados foram Periogard, Cepacol e Plax FreshMint. A atividade antibacteriana foi avaliada em duplicata em placasde microtilulação de 96 poços contra 36 isolados clínicos de EGM. Cada antisséptico bucal foi submetido a diluição dupla seriada (1/2,5 a 1/5120) com o emprego de concentração dupla de TryptoseSoyBrothwith adicionado de 1,0% de extrato de levedura. O volume final em cada poço foi de 100 mL mais 5mL da suspensão bacteriana equivalente a 10 UFC/mL. A incubação foi realizada em microaerofilia a 37ºC por 48 horas e a DIM deteminada. Periogard e Cepacol apresentaram DIM de 1/320, e Plax de 1/20. Os resultados submetidos asanálises estatísticas revelaram que a DIM do Periogard não foi diferente do Cepacol(p>0,05) sendo maior que do Plax (p<0,05). Em conclusão, os antissépticos bucais contendo clorexidina (Periogard) e cloreto de cetilpiridínio (Cepacol) demonstraram maior atividade antibacteriana in vitro (DIM)contra os EGM do que o antisséptico bucal contendo triclosan (Plax) de acordo com o método microbiológico utilizado.

Antibacterial effect of water-soluble chitosan on representative dental pathogens Streptococcus mutans and Lactobacilli brevis

Dental caries is still a major oral health problem in most industrialized countries. The development of dental caries primarily involves Lactobacilli spp. and Streptococcus mutans. Although antibacterial ingredients are used against oral bacteria to reduce dental caries, some reports that show partial antibacterial ingredients could result in side effects. OBJECTIVES: The main objective is to test the antibacterial effect of water-soluble chitosan while the evaluation of the mouthwash appears as a secondary aim. MATERIAL AND METHODS: The chitosan was obtained from the Application Chemistry Company (Taiwan). The authors investigated the antibacterial effects of water-soluble chitosan against oral bacteria at different temperatures (25-37ºC) and pH values (pH 5-8), and evaluated the antibacterial activities of a self-made water-soluble chitosan-containing mouthwash by in vitro and in vivo experiments, and analyzed the acute toxicity of the mouthwashes. The acute toxicity was analyzed with the pollen tube growth (PTG) test. The growth inhibition values against the logarithmic scale of the test concentrations produced a concentrationresponse curve. The IC50 value was calculated by interpolation from the data. RESULTS: The effect of the pH variation (5-8) on the antibacterial activity of water-soluble chitosan against tested oral bacteria was not significant. The maximal antibacterial activity of water-soluble chitosan occurred at 37ºC. The minimum bactericidal concentration (MBC) of water-soluble chitosan on Streptococcus mutans and Lactobacilli brevis were 400 µg/mL and 500 µg/mL, respectively. Only 5 s of contact between water-soluble chitosan and oral bacteria attained at least 99.60% antibacterial activity at a concentration of 500 µg/mL. The water-soluble chitosan-containing mouthwash significantly demonstrated antibacterial activity that was similar to that of commercial mouthwashes (>99.91%) in both in vitro and in vivo experiments. In addition, the alcohol-free mouthwash exhibited no cytotoxicity and no oral stinging. To the best of our knowledge, this was the first study to combine in vitro and in vivo investigations to analyze the antibacterial properties of water-soluble chitosan-containing mouthwash. CONCLUSIONS: This study illustrated that water-soluble chitosan may be a viable alternative to commercial mouthwashes in the future.

Avaliação in vitro da atividade antimicrobiana dos componentes de um enxaguatório bucal contendo malva / In vitro antimicrobial activity of the components of a mouthwash containing malva sylvestris

Objetivo: Avaliar a atividade antimicrobiana in vitro dos componentes (tirotricina, quinosol e tintura de malva) de um enxaguatório bucal contendo malva (Malvatricin®) sobre Streptococcus mutans, Lactobacillus spp. e um pool de micro-organismos da cavidade bucal. Método: Para a verificação do potencial antimicrobiano do enxaguatório bucal contendo malva (Malvatricin®) e de seus diferentes componentes, a metodologia utilizada foi a da difusão em ágar-cilindro em placas. Utilizaram-se dez placas com ágar Brain Heart Infusion para cada micro-organismo e foram testadas as seguintes soluções: Malvatricin®, tirotricina, quinosol e tintura de malva. Como controle positivo foi utilizada uma solução de clorexidina 0,12%. As placas foram incubadas por 24 horas a 37°C em anaerobiose. Após 24 horas, mensuraram-se os diâmetros das zonas de inibição. Utilizou-se o teste de Kruskal-Wallis, seguido pelo teste de comparações múltiplas, quando indicado, para comparar o efeito de cada substância sobre os micro-organismos testados. O nível de significância adotado foi de 5%. Resultados: Sobre Streptococcus mutans, Lactobacillus e um pool de micro-organismos da cavidade bucal, Malvatricin® apresentou valores de medianas 23,47; 8,61 e 11,23, respectivamente. O quinosol apresentou resultado semelhante ao de Malvatricin®, mostrando-se efetivo para inibir o crescimento microbiano de todos os micro-organismos (27,17; 9,33; 12,53). A tirotricina (0; 5,66; 0) e a tintura de malva (0; 0; 4,29) apresentaram pouca ou nenhuma atividade antimicrobiana. A clorexidina apresentou as maiores zonas de inibição frente a todos os micro-organismos testados (30,06; 15,54; 20,89). Conclusão: Os resultados do presente estudo sugerem que, dentre os componentes presentes na composição do produto comercial Malvatricin®, a substância quinosol apresenta a maior atividade antimicrobiana frente aos micro-organismos testados. E que a atividade antimicrobiana verificada para o produto comercial provavelmente deva-se à ação da substância quinosol, presente em sua composição.

Objective: To evaluate the in vitro antimicrobial activity of the components (tyrothricin, hydroxyquinoline and Malva sylvestris tincture) of a mouthwash containing Malva sylvestris (Malvatricin®) against Streptococcus mutans, Lactobacillus spp. and a pool of oral microorganisms. Method: In order to verify the antimicrobial potential of the Malva sylvestris-containing mouthwash (Malvatricin®) and its different components, was used the cylinder-agar diffusion plate methodology. Ten plates with Brain Heart Infusion agar were used for each microorganism and the following solutions were tested: Malvatricin®, tyrothricin, hydroxyquinoline and Malva sylvestris tincture. The positive control was a 0.12% chlorhexidine solution. The plates were incubated for 24 hours at 37°C in anaerobiosis. After 24 hours, the diameters of bacterial growth inhibition zones were measured. The Kruskal-Wallis test and the multiple-comparisons test (when required) were used to compare the effect of each substance against the test microorganisms. The significance level was set at 5%. Results: Malvatricin® presented medians of 23.47, 8.61 and 11.23, respectively, against Streptococcus mutans, Lactobacillus spp. and a pool of oral microorganisms. Hydroxyquinoline showed similar result to Malvatricin®, being effective to inhibit the growth of all microorganisms (27.17, 9.33 and 12.53, respectively). Tyrothricin (0, 5.66, 0, respectively) and Malva sylvestris tincture (0, 0, 4.29, respectively) showed little or no antimicrobial activity. Chlorhexidine produced the largest inhibition zones against the tested microorganisms (30.06, 15.54, 20.89, respectively). Conclusion: The results from this study suggest that among all components of Malvatricin®, hydroxyquinoline presented the greatest antimicrobial activity against the tested microorganisms, and that the antimicrobial activity of the commercial product is likely due to the action of the hydroxyquinoline present in its composition

Effect of fluoride sodium mouthwash solutions on cpTI: evaluation of physicochemical properties

The effects of fluoride, which is present in different oral hygiene products, deserve more investigation because little is known about their impact on the surface of titanium, which is largely used in Implantology. This study evaluated the surface of commercially pure titanium (cpTi) after exposure to different concentrations of sodium fluoride (NaF). The hypothesis tested in this study was that different concentrations of NaF applied at different time intervals can affect the titanium surface in different ways. The treatments resulted in the following groups: GA (control): immersion in distilled water; GB: immersion in 0.05% NaF for 3 min daily; GC: immersion in 0.2% NaF for 3 min daily; GD: immersion in 0.05% NaF for 3 min every 2 weeks; and GE: immersion in 0.2% NaF for 3 min every 2 weeks. The experiment lasted 60 days. Roughness was measured initially and every 15 days subsequently up to 60 days. After 60 days, corrosion analysis and anodic polarization were done. The samples were examined by scanning electron microscopy (SEM). The roughness data were analyzed by ANOVA and there was no significant difference among groups and among time intervals. The corrosion data (i corr) were analyzed by the Mann-Whitney test, and significant differences were found between GA and GC, GB and GC, GC and GD, GC and GE. SEM micrographs showed that the titanium surface exposed to NaF presented corrosion that varied with the different concentrations. This study suggests that the use of 0.05% NaF solution on cpTi is safe, whereas the 0.2% NaF solution should be carefully evaluated with regard to its daily use.

Os efeitos do fluoreto, o qual está presente em diferentes produtos de higiene oral, necessita de maiores investigações, pois pouco se sabe sobre seus efeitos na superfície do titânio, o qual possui amplo uso na implantodontia. Este estudo objetivou avaliar a superfície do titânio comercialmente puro (cpTi) após exposição a diferentes concentrações de fluoreto de sódio (NaF). A hipótese testada neste estudo foi que diferentes concentrações de NaF aplicadas em diferentes intervalos de tempo seriam capazes de afetar diferentemente a superfície do titânio. Os tratamentos realizados foram: GA (controle): imersão em água destilada; GB: imersão diária por 3 min em NaF a 0,05%; GC: imersão diária por 3 min em NaF a 0,2%; GD: imersão quinzenal por 3 min em NaF a 0,05%; e GE: imersão quinzenal por 3 min em NaF a 0,2%. O tempo do experimento foi de 60 dias. A análise da rugosidade foi efetuada inicialmente e a cada 15 dias. Após 60 dias foi realizada análise de corrosão e polarização anódica. As amostras foram analisadas em MEV. Os dados de rugosidade foram analisados por ANOVA e não houve diferença estatisticamente significante entre grupos e entre tempos. Os dados de corrosão (i corr) foram analisados pelo teste de Mann-Whitney e foram encontradas diferenças significantes entre GA e GC, GC e GB, GC e GD, GC e GE. A MEV evidenciou que a superfície do titânio exposto ao NaF apresentou corrosão variando de acordo com a concentração. Com base nos dados encontrados conclui-se que o uso de solução NaF a 0,05% em cpTi é seguro, enquanto a solução NaF 0,2% para uso diário deve ser cuidadosamente avaliada.

The influence of mouthrinses and simulated toothbrushing on the surface roughness of a nanofilled composite resin

The aim of this study was to determine the influence of mouthrinses on the surface roughness of a nanofilled composite resin after toothbrushing. One hundred nanofilled composite resin specimens were prepared and randomly distributed into two groups-brushed and non-brushed-and then assigned to five subgroups, according to the mouthrinse solutions (n = 10): Colgate Plax Fresh Mint, Oral B, Cepacol, Colgate Plax, and artificial saliva. Each sample was immersed in 20 mL of the mouthrinses for 1 minute, 5 days per week, twice a day, for a 3-week period. The control group used in the study was one in which the specimens were not subjected to brushing and remained only in artificial saliva. Toothbrushing was performed once a week for 1 minute, for 3 weeks. Surface roughness measurements (Ra) were performed after the immersion period and toothbrushing, by means of a profilometer. Data were analyzed by two-way ANOVA and Tukey's test. Analysis revealed that the association between toothbrushing and Colgate Plax Fresh Mint produced the lowest surface roughness (p < 0.05). All other groups tested (Oral B, Cepacol, Colgate Plax, artificial saliva) exhibited no statistically significant differences between surfaces, whether subjected to toothbrushing or not (p < 0.05). It was concluded that the surface roughness of the nanofilled composite resin tested can be influenced by the mouthrinse associated with toothbrushing.

In vitro evaluation of the whitening effect of mouth rinses containing hydrogen peroxide

The aim of this study was to evaluate the bleaching effect of two mouth rinses containing hydrogen peroxide. Thirty premolars were randomly divided into two groups (n = 15): Listerine Whitening (LW) and Colgate Plax Whitening (PW). The teeth were fixed on a wax plate and with acrylic resin, at a distance of 5 mm between each other, exposing the buccal surfaces. All teeth were stored in artificial saliva for 45 days, being removed twice a day to be immersed for 1 min in each mouthwash, followed by 10-second washing in tap water. The pH of each product was measured. Digital images of each tooth were captured under standardized conditions. These images were cut in areas previously demarcated and analyzed in Adobe Photoshop 7.0 using the CIEL*a*b* color space system. Data were statistically analyzed by a paired t test and an independent samples t test (p < 0.05). The pH values were 5.6 and 3.4 for LW and PW, respectively. Both treatment groups showed a decrease in the b* parameter (p < 0.01), but a decrease of a* was observed only for PW (p < 0.01). While the LW group showed an improvement in lightness (L*) (p = 0.03), the PW group had a decrease in the L* parameter (p = 0.02). Within the limitations of this study, it is possible to conclude that both products caused some degree of whitening; however, extreme care should be taken when using Colgate Plax Whitening, since its decline in luminosity might be due to its lower pH.

Color stability, surface roughness and microhardness of composites submitted to mouthrinsing action

OBJECTIVE:The purpose of this study was to evaluate the effect of mouth rinse solutions on color stability, surface roughness and microhardness of two composite resins. MATERIAL AND METHODS: Fifty test specimens of each composite (Filtek Z250 and Z350; 3M ESPE) were made using a teflon matrix (12x2 mm). Color, surface roughness and Knoop microhardness baseline measurements of each specimen were made and specimens (n=10) were immersed in 5 mouth rinse solutions: G1: distilled water (control), G2: Plax Classic, G3: Plax alcohol-free; G4: Periogard, and G5: Listerine. Final measurements of color, roughness and microhardness were performed and the results submitted to statistical analysis (2-way ANOVA, Bonferroni ’s test; p<0.05). RESULTS: The most significant color change was observed for Z250 when immersed in Listerine (p<0.05). Z350 showed greater color change when immersed in Plax alcohol-free (p<0.05), but with no significant difference for Listerine (p>0.05). With regard to roughness, both composites showed significant changes when immersed in Listerine in comparison with Plax alcohol-free (p<0.05). Microhardness of Z350 was shown to be significantly changed when the composite was immersed in Plax alcohol-free (p<0.05). CONCLUSION: Composite changes depended on the material itself rather than the mouth rinse solution used.

Mechanism of oil-pulling therapy - In vitro study.

Background: Oil pulling has been used extensively as a traditional Indian folk remedy without scientific proof for many years for strengthening teeth, gums and jaws and to prevent decay, oral malodor, bleeding gums and dryness of throat and cracked lips. Aim: The aim of this study was to evaluate the antibacterial activity of sesame oil and lignans isolated from sesame oil on oral microorganisms and to check whether saponification or emulsification occurs during oil-pulling therapy. Materials and Methods: The in vitro study was carried out in three different phases: (1) Antibacterial activity of the lignans and sesame oil were tested by minimum inhibitory concentration assay by agar dilution method and agar well diffusion method, respectively. (2) Increase in free fatty acid level of oil and the quantity of sodium hydroxide (NaOH) used up in the titration are good indicators of saponification process. This was assessed using analytical tests for vegetable oils. (3) Swished oil was observed under light microscope to assess the status of the oil, presence of microorganisms, oral debris and foreign bodies. Results: Sesamin and sesamolin isolated from sesame oil did not have any antibacterial effect against oral microorganisms like Streptococcus mutans, Streptococcus mitis and Streptococcus viridans. Emulsification of sesame oil occurs during oil-pulling therapy. Increased consumption of NaOH in titration is a definite indication of a possible saponification process. Conclusion: The myth that the effect of oil-pulling therapy on oral health was just a placebo effect has been broken and there are clear indications of possible saponification and emulsification process, which enhances its mechanical cleaning action.

Proposal for the teaching of the chemical control of supragingival biofilm

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.

Antimicrobial activities of the volatile oils of Ocimum Bacilicum L. and Ocimum Gratissimum l. [lamiaceae] against some aerobic dental isolates

Essential or volatile oils of plants have been variously reported to have many medicinal applications. Their probable uses against oral microbes have received little attention. Oral swabs obtained from eighteen dental patients at the University of Benin teaching Hospital, Benin City, Nigeria, led to the isolation of twenty nine bacteria. Using standard methods, the microorganisms were identified as Streptococcus viridians [16, representing 55.17%], Staphylococcus albus [9, 31.04%], Klebisiella pneumonia [2, 6.90%], Pseudomonas aeruginosa [1, 3.45%] and Proteus vulgaris [1, 3.45%]. The antimicrobial activities of the volatile oils of Ocimum basilicum L. and O. gratissimum L. were evaluated on the twenty nine organisms using agar diffusion and agar dilution methods. In the susceptibility tests, the volatile oils of O. basilicum and O. gratissimum independently inhibited the growth of Klebisiella pneumonia at a concentration of 0.51% in the agar, Streptococcus viridians and Staphylococcus albus at 1.10% and Pseudomonas aeruginosa at 10.0%. Proteus vulgaris was inhibited at 0.53% by the volatile oil of O. gratissimum and 0.67% by O. basilicum. Separate incorporation of the volatile oils into tooth pastes [2 and 5%], the volatiles oils showed antibacterial activities comparable to a commercial tooth paste [which contains O. basilicum 0.01% among others] against most resistant organisms. As components of mouth washes, the volatile oils completely inhibited the growth of organisms at a concentration of 0.5%

Clorhexidine como antimicrobiano / Clorhexidine as an antimicrobial agent

La función de la placa dental en la etiología de la gingivitis y periodontitis es bien establecida para la literatura. Agentes antiplaca empleados en dentífrico, geles, enjuagatorios u otro vehículo pueden aumentar el control de placa supragingival y la prevención de la enfermedad periodontal. Para ejercer actividad antiplaca y antimicrobiana clínicamente, el agente debe ser formulado en un vehículo compatible químicamente para dar óptima liberación y para mostrar substantividad para percepción de los receptores locales de donde puedan ser liberados en una forma biológicamente activa. El uso de estos agentes ofrece al dentista muchas elecciones terapéuticas, pero cuando un producto químico es seleccionado para un paciente, debe ser considerada la verdadera necesidad, eficacia, efectos adversos y costo - beneficio. Por otro lado no puede dejar de llevar en consideración su función como agentes coadyuvantes en la terapia mecánica