Pseudomembranous oral candidiasis resolved with a mouthwash containing 0.05% chlorhexidine + 0.05% cetylpyridinium chloride.

A 50-year-old woman was referred to the clinic reporting oral discomfort during the previous month and plaques of a white removable slough. Diagnosis of pseudomembranous oral candidiasis was clinically confirmed. When the tongue and palatal mucosa were wiped with gauze, the soft yellowish-white slough detached revealing the erythematous surface beneath. The patient also presented paranoid schizophrenia and severe depression, pulmonary emphysema, and two vertebral hernias. She was a smoker (10 cigarettes per day) with xerostomia that was being treated with: bupropion, reboxetine, quetiapine, trazadone clotiapine, pregabalin, fentanyl (patches), and alprazolam. To minimize the risk of potential drug interactions, a mouthwash containing 0.05% chlorhexidine + 0.05% cetylpyridinium chloride was prescribed three times a day for two weeks. At the end of the two weeks, the candidiasis had abated.

Polyelectrolyte-surfactant-complex nanoparticles as a delivery platform for poorly soluble drugs: A case study of ibuprofen loaded cetylpyridinium-alginate system.

Previously, we reported on the surfactant cetylpyridinium chloride (CPC) as a crosslinker of alginate for the formation of stable polyelectrolyte-surfactant-complex nanoparticles. Here, we evaluate this system for increased solubility of a poorly soluble drug. The aim was to use CPC for solubilisation of ibuprofen and to use the micellar associates formed for alginate complexation and nanoparticle formation. We acquired deeper insights into the entropy led interactions between alginate, CPC and ibuprofen. Stable nanoparticles were formed across limited surfactant-to-polyelectrolyte molar ratios, with ~150 nm hydrodynamic diameter, monodispersed distribution, and negative zeta potential (-40 mV), with 34% ibuprofen loading. Their structure was obtained using small-angle X-ray scattering, which indicated disordered micellar associates when ibuprofen was incorporated. This resulted in nanoparticles with a complex nanostructured composition, as shown by transmission electron microscopy. Drug release from ibuprofen-cetylpyridinium-alginate nanoparticles was not hindered by alginate, and was similar to the release kinetics from ibuprofen-CPC solubilisates. These innovative carriers developed as polyelectrolyte-surfactant complexes can be used for solubilisation of poorly soluble drugs, where the surfactant simultaneously increases the solubility of the drug at concentrations below its critical micellar concentration and crosslinks the polyelectrolyte to form nanoparticles.

Capacidad antiséptica del digluconato de clorhexidina 0.05% y cloruro de cetilpiridinio 0.05%. Estudio clínico prospectivo y microbiológico / Antiseptic capacity of 0.05% Chlorhexidine digluconate and 0.05% Cetylpyridinium chloride. A prospective and microbiological clinical study

Introducción: El objetivo de este estudio consiste en evaluar la eficacia clínica y microbiológica de un colutorio a base de digluconato de clorhexidina (CHX) 0,05% y cloruro de cetilpiridinio (CPC) 0,05%, y otro colutorio sin propiedades antisépticas, empleados como coadyuvantes de los métodos de higiene oral. Material y métodos: Se llevó a cabo un estudio microbiológico que evaluó la capacidad de los colutorios para inhibir la formación y adherencia de un biofilm bacteriano de Streptococcus oralis mediante espectrofotometría, y un ensayo clínico, aleatorizado y doble ciego sobre una muestra de 48 pacientes, los cuales fueron asignados aleatoriamente a cada colutorio. A: CHX 0,05%, CPC 0,05% y lactato de cinc 0,14% y B: permethol 0.10% y provitamina B5 0.50%. El índice de placa (IP), el índice gingival modificado (IGM) y el índice de sangrado (IS) fueron evaluados con periodicidad mensual y trimestral. Resultados: El colutorio a base de CHX 0,05% y CPC 0,05% evidenció una elevada capacidad para inhibir la formación (P=0,013) y adherencia (P=0,001) del biofilm bacteriano Se observaron diferencias estadísticamente significativas en el IP inter-grupos a los tres meses de observación (P<0,001). También se observaron diferencias en el IGM al mes (P=0,034) y a los tres meses de observación (P<0,001); y en el IS al mes (P=0,004) y a los tres meses de observación (P=0,002). Conclusiones: El colutorio a base de CHX 0,05% y CPC 0,05% posee una capacidad superior para reducir la placa bacteriana y la gingivitis

Introduction: The aim of this study was to evaluate the clinical and microbiological efficacy of a mouthrinse containing 0.05% chlorhexidine digluconate (CHX) and 0.05% cetylpyridinium chloride (CPC), and another mouthrinse without antiseptic properties, used as adjuvants to oral hygiene methods. Material and methods: First a microbiological study using spectrophotometry was done to assess the ability of both mouthrinses to inhibit the formation and adhesion of an Streptococcus oralis biofilm. Then, a randomised, double-blind clinical trial was performed on a sample of 48 patients, who were randomly assigned to each mouthrinse. A: 0.05% CHX and 0.05% CPC, and B: 0.10% permethol and 0.50% provitamin B5. Plaque index (PI), modified gingival index (MGI) and bleeding index (BI) were assessed at one and three months. Results: The 0.05% CHX and 0.05% CPC mouthrinse showed a high capacity to inhibit the formation (P=0.013) and adhesion (P=0.001) of the bacterial biofilm. Statistically significant differences were observed in the inter-group PI after three months of monitoring (P<0.001). Differences were also observed in MGI after one month (P=0,034) and after three months of monitoring (P<0,001); and in BI after one month (P=0,004) and after three months of monitoring (P=0,002). Conclusions: The 0.05% CHX and 0.05% CPC mouthrinse has a good capacity to reduce bacterial plaque and gingivitis

Efficacy of 8 mg lidocaine and 2 mg cetylpyridinium chloride (CPC) fixed-combination lozenges on sore throat pain intensity compared with 1 mg lidocaine and 2 mg CPC fixed-combination lozenges in subjects with sore throat due to upper respiratory tract infection: a randomized double-blind parallel-group single-dose study.

BACKGROUND: Lozenges containing lidocaine and cetylpyridinium chloride (CPC) are commonly used for the treatment of sore throat. The lidocaine acts locally to provide pain relief and the CPC has an antiseptic effect. Mebucaine CL, a well-established fixed-combination sore throat lozenge, contains 1 mg lidocaine and 2 mg CPC. Single-agent lozenges containing 8 mg lidocaine have also been demonstrated to be significantly superior to placebo in confirmatory pain intensity assessments. This study compared a new lozenge formulation, containing 8 mg lidocaine and 2 mg CPC, with the currently marketed lozenge for the treatment and relief of sore throat symptoms in subjects diagnosed with a sore throat due to an upper respiratory tract infection (URTI). METHODS: In this double-blind parallel-group study, 250 adults with a sore throat due to an URTI were randomized to receive a single lozenge containing either 8 mg lidocaine + 2 mg CPC (n = 125) or 1 mg lidocaine + 2 mg CPC (n = 125). The primary efficacy endpoint of the study was the change in sore throat pain intensity (STPI) between baseline (immediately pre-treatment) and the 2-h post-dose assessment, measured on a 100 mm visual analog scale. STPI was measured at baseline and regular intervals up to 240 min after the lozenge was administered (evaluated in clinic). Any difficulty in swallowing and time to onset and duration of the analgesic effect were also assessed. RESULTS: No increase in efficacy was demonstrated with the higher dose of lidocaine. The difference in the 2-h post-dose change in STPI was not statistically significant between the treatments. There was only one statistically significant difference between the treatments in all of the efficacy outcomes assessed: pain relief scores at 4 h post-dose were higher with 1 mg lidocaine + 2 mg CPC than with 8 mg lidocaine + 2 mg CPC (P = 0.0461). The most commonly reported adverse event (AE) was a headache; the only other AE experienced by more than one subject was throat irritation. No severe adverse events were reported during the assessment period. CONCLUSIONS: The modest difference in the pattern of effectiveness between the two treatments observed in this study does not support use of the 8 mg lidocaine + 2 mg CPC lozenge. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01265446 . Registered on 20 December 2010.

Clinical and microbiological effects of the use of a cetylpyridinium chloride dentifrice and mouth rinse in orthodontic patients: a 3-month randomized clinical trial.

Objective: To assess the clinical, microbiological, and patient-based effects of using a cetylpyridinium chloride (CPC) toothpaste and mouth rinse in orthodontic patients. Design: Parallel randomized controlled, triple-blinded trial (participants, examiners, outcomes' assessors). A computer-generated list was used to allocate treatments. Central allocation was used for concealment. Participants: Thirty-one placebo (10 males, 21 females; mean age 15.2 ± 2.1) and 32 test patients (15 males, 17 females; mean age 15.0 ± 1.8) with fixed orthodontic appliance were included in the study. Interventions: Patients were randomly assigned to both brush and rinse with placebo or with CPC-based products. Products were purposely prepared in white opaque bottles. After screening and professional prophylaxis, patients received a baseline examination, and started to use the assigned products. Patients were monthly assessed during a 3-month period. Main outcome measures: Plaque (PlI) and gingival (GI) indexes. Secondary outcome variables: Calculus index, tooth staining, subgingival microbiological samples, patient-based variables (questionnaire, compliance, and remaining mouth rinse), side-effects (debonded braces or mucosal injuries). Results: Sixty-three patients were randomized, 13 patients were excluded from analysis because of early dropout, leaving 50 patients for intention to treat analysis. PlI in the upper jaw diminished (0.18; SD = 0.82) after 1 month in the test group, while it increased (0.26; SD = 0.62) in the placebo group (P = 0.024). Statistically significant higher GI values were observed in the placebo group at 1 month (mean increase = 0.05; SD = 0.33 versus mean decrease = 0.03; SD = 0.38) and 3 months (mean = 0.05; SD = 0.43 versus mean = 0.02; SD = 0.34). The taste of the test product was rated higher than the placebo at 2- and 3-month visits (P < 0.05). Non-significant changes were observed in microbiological parameters, overgrowth of opportunistic species or remaining secondary outcome variables, including side-effects. Conclusion: The use of CPC-based toothpaste and mouth rinse in orthodontic patients had limited effect in reducing plaque accumulation and gingival inflammation. Effects were little and highly variable. The use of the test products was not associated with relevant adverse effects. Trial registration: Trial registration: Local internal reference: P07/133.

High-Velocity Microsprays Enhance Antimicrobial Activity in Streptococcus mutans Biofilms.

Streptococcus mutans in dental plaque biofilms play a role in caries development. The biofilm's complex structure enhances the resistance to antimicrobial agents by limiting the transport of active agents inside the biofilm. The authors assessed the ability of high-velocity water microsprays to enhance delivery of antimicrobials into 3-d-old S. mutans biofilms. Biofilms were exposed to a 90° or 30° impact, first using a 1-µm tracer bead solution (109 beads/mL) and, second, a 0.2% chlorhexidine (CHX) or 0.085% cetylpyridinium chloride (CPC) solution. For comparison, a 30-s diffusive transport and simulated mouthwash were also performed. Confocal microscopy was used to determine number and relative bead penetration depth into the biofilm. Assessment of antimicrobial penetration was determined by calculating the killing depth detected by live/dead viability staining. The authors first demonstrated that the microspray was able to deliver significantly more microbeads deeper in the biofilm compared with diffusion and mouthwashing exposures. Next, these experiments revealed that the microspray yielded better antimicrobial penetration evidenced by deeper killing inside the biofilm and a wider killing zone around the zone of clearance than diffusion alone. Interestingly the 30° impact in the distal position delivered approximately 16 times more microbeads and yielded approximately 20% more bacteria killing (for both CHX and CPC) than the 90° impact. These data suggest that high-velocity water microsprays can be used as an effective mechanism to deliver microparticles and antimicrobials inside S. mutans biofilms. High shear stresses generated at the biofilm-burst interface might have enhanced bead and antimicrobial delivery inside the remaining biofilm by combining forced advection into the biofilm matrix and physical restructuring of the biofilm itself. Further, the impact angle has potential to be optimized both for biofilm removal and active agents' delivery inside biofilm in those protected areas where some biofilm might remain.

Antimicrobial efficacy of gutta-percha supplemented with cetylpyridinium chloride.

To develop a root canal filling material with high antimicrobial activity, we prepared gutta-percha supplemented with the cationic surfactant cetylpyridinium chloride (CPC). Thermoplastic gutta-percha was supplemented with 0.05%, 0.2%, or 0.8% CPC. The gutta-percha containing CPC was tightly packed at the bottom of a 24-well plate. Its antimicrobial activity against eight representative endodontic pathogens-including gram-positive and gram-negative bacteria and fungi-was evaluated by adding 0.5 mL of liquid samples containing pathogens to the wells. After 24 h of cultivation under appropriate conditions, microbial growth was analyzed by counting colony-forming units (CFU). Gutta-percha alone (without CPC) partially inhibited microbial growth, probably through the antimicrobial effect of some of its components, such as zinc oxide. Addition of CPC dose-dependently increased the antimicrobial efficacy of gutta-percha. Addition of 0.05%, 0.2%, and 0.8% CPC reduced the viable microbial number to below the lower limit of detection (20 CFU/mL) for all tested pathogens except Pseudomonas aeruginosa, which was detected in 0.8% CPC-containing gutta-percha, although the viable number significantly decreased. Gutta-percha with CPC might be useful for preventing microbial infections during root canal therapy. (J Oral Sci 58, 277-282, 2016).

Screening of Nanoemulsion Formulations and Identification of NB-201 as an Effective Topical Antimicrobial for Staphylococcus aureus in a Mouse Model of Infected Wounds.

Despite advances in antimicrobial therapies, wound infection remains a global public health concern. We aimed to formulate and assess various nanoemulsions (NEs) for potential effectiveness as stable antimicrobial agents suitable for topic application. A total of 106 NEs were developed that varied with respect to nonionic and cationic surfactants. Stability testing demonstrated that the NEs tested are broadly stable, with 97/106 formulations passing 2-week stability tests. Two NEs, NB-201 and NB-402, were selected to test antimicrobial activity in a wound model in mice. Skin abrasion wounds were infected with Staphylococcus aureus followed by NE treatment. Infected skin was then evaluated by measuring colony forming units. NB-201 reduced median bacterial counts by 4 to 5 log compared to animals treated with saline, whereas NB-402 reduced bacterial counts by 2 to 3 log. Additional stability tests on NB-201 demonstrated that NB-201 is stable in the presence of human serum, and is stable for at least 6 months at 5°C, 25°C, and 40°C. Finally, in in vitro studies, NB-201 was found to be effective against S. aureus at a higher dilution than the commercially available silver sulfadiazine. Altogether these results demonstrate that NB-201 is a stable and effective topical antimicrobial for the treatment of S. aureus.

Effectiveness of Oral Antiseptics on Tooth Biofilm: A Study in vivo.

AIM: To evaluate the effectiveness of five different mouthwashes through measurement of the plaque index. MATERIALS AND METHODS: Fifty subjects took part in this blind study, randomized into blocks of five groups according to the active ingredient of the mouthwash: CHX group (0.12% chlorhexidine gluconate), essential oils (EO) group, cetylpyridinium chloride (CPC) group, Tri group (triclosan) and Hamamelis virginiana (HV) group. All subjects were evaluated for a reduction in the bacterial plaque index at 7, 14 and 21 days. RESULTS: There was a significant reduction in the mean plaque index during the period of evaluation (p < 0.01), and the reduction during the period of evaluation was different between mouthwashes (p < 0.01). The reduction in the plaque index at the end of 21 days was, in decreasing order, CHX > EO > CPC > Tri > HV. CONCLUSION: The reduction in the plaque index during the period of evaluation was different between the types of mouth-wash. The mouthwash containing the active ingredient chlorhexidine was the most effective, followed by the essential oil, cetylpyridinium chloride, triclosan and H. virginiana.

Antimicrobial effectiveness of cetylpyridinium chloride and zinc chloride-containing mouthrinses on bacteria of halitosis and peri-implant disease.

PURPOSE: To clarify the antimicrobial efficacy of zinc chloride (ZnCl2) and cetylpyridinium chloride (CPC) by testing their impact on the growth of seven bacterial strains known to be involved in the pathophysiology of both peri-implant disease and halitosis-Staphylococcus aureus, Streptococcus mutans, Porphyromonas gingivalis, Prevotella intermedia, Fusobacterium nucleatum, Treponema denticola, and Tannerella forsythia. MATERIALS AND METHODS: A time-response growth curve was obtained. Commercial mouthrinses with CPC, ZnCl2, or both were added to the media in a final concentration of 0.25% CPC, 2.5% ZnCl2, and 2.5% ZnCl2 with 0.25% CPC. RESULTS: Both CPC and ZnCl2 effectively inhibited the growth of almost all bacterial strains tested except T denticola. ZnCl2 was generally more effective in suppressing bacterial growth than CPC. ZnCl2 with CPC showed the greatest inhibitory activities on almost all strains of bacterial growth except for P gingivalis and T denticola, followed by ZnCl2, then CPC, thus suggesting the possibility of a synergistic effect of the two agents. P gingivalis exhibited a different pattern because ZnCl2 showed the most significant inhibitory effect. CPC did not show growth inhibitory effects on T denticola, but ZnCl2 did. CONCLUSION: Zinc and CPC effectively inhibit bacterial growth that causes both halitosis and peri-implant disease. The effect is even more powerful when applied in combination.

Effectiveness of a Chlorhexidine Digluconate 0.12% and Cetylpyridinium Chloride 0.05% Solution in eliminating Candida albicans Colonizing Dentures: A Randomized Clinical in vivo Study.

BACKGROUND: Effective denture hygiene is important for patients suffering from denture stomatitis (DS). This study aimed to evaluate the efficacy of a solution containing 0.12% chlorhexidine (CHX) digluconate and 0.05% cetylpyridinium chloride (CPC) in eliminating Candida albicans colonizing dentures. MATERIALS AND METHODS: Forty denture wearers (11 men, 29 women; age range 40 to 80 years) with clinical evidence of DS were randomly divided into two groups, one test and one control. The dentures of the test group were treated by immersion in a solution of 0.12% CHX and 0.05% CPC while those of the control group were immersed in distilled water. Swabs were collected from the fitting surfaces of the upper dentures prior and post cleaner use and examined mycologically. RESULTS: Reduction in the number of colony-forming units (CFU) of Candida albicans after immersion of the dentures in a solution of 0.12% CHX and 0.05% CPC was significantly greater than that of the control group. CONCLUSION: A solution of 0.12% CHX and 0.05% CPC tested as a product of disinfection of the acrylic dentures showed significant results after immersion of 8 night hours for 4 days.

Interference of Antimicrobial Activity of Combinations of Oral Antiseptics Against Streptococcus mutans, Streptococcus sanguinis, and Lactobacillus acidophilus.

PURPOSE: The purpose of this study was to compare the effects of combinations of sodium fluoride and antiseptic compounds on the growth of Streptococcus mutans, Streptococcus sanguinis, and Lactobacillus acidophilus. METHODS: The agar diffusion assay was used to determine bacterial growth inhibition. RESULTS: Of the combinations tested, 0.1 percent sodium fluoride and five percent povidone iodine produced synergistic antibacterial effects against S. mutans and S. sanguinis. The combination of 10 percent povidone iodine and 0.5 percent sodium hypochlorite produced additive antibacterial effects against L. acidophilus. Interference was seen in some combinations such as 0.01 percent chlorhexidine and 0.25 percent sodium lauryl sulphate, 0.5 percent sodium hypochlorite and 10 percent povidone iodine, and 0.01 percent cetyl pyridium chloride and 0.1 percent sodium fluoride. However, 0.1 percent sodium fluoride combined with 0.01 percent chlorhexidine did not interfere with the antibacterial effects of chlorhexidine against S. mutans or S. sanguinis. CONCLUSIONS: Combinations of common antiseptics and fluoride compounds can produce interference, synergistic, or additive effects. The combination of 0.1 percent sodium fluoride and five percent povidone iodine had the greatest potential for suppression of S. mutans.

Implant decontamination with 2% chlorhexidine during surgical peri-implantitis treatment: a randomized, double-blind, controlled trial.

OBJECTIVE: The objective of this randomized, double-blind, controlled trial was to evaluate the clinical, radiographic, and microbiological effects of implant surface decontamination with a 2% chlorhexidine (CHX) solution in comparison with a 0.12% chlorhexidine + 0.05% cetylpyridinium chloride (CPC) solution during resective surgical peri-implantitis treatment. MATERIAL AND METHODS: Forty-four patients (108 implants) with peri-implantitis were treated with resective surgical treatment consisting of bone re-contouring, surface debridement and chemical decontamination, and apically repositioned flap. Patients were randomly allocated to decontamination with a 2% CHX solution (test group) or 0.12% CHX + 0.05% CPC (control group). Clinical and radiographic parameters were recorded before treatment (baseline), and at 3, 6, and 12 months after treatment. Microbiological parameters were recorded during surgery. RESULTS: Multilevel analysis showed no significant differences in bleeding, suppuration, probing pocket depth, and radiographic bone loss between control and test group over three follow-up measurements (3, 6, and 12 months) from baseline. Both decontamination procedures resulted in significant reductions in anaerobic bacterial counts on the implant surface, but no significant difference was noted between control and test group (mean log 3.37 ± 2.34 vs. 3.65 ± 2.87, P = 0.99). CONCLUSIONS: The use of a 2% CHX solution for implant surface decontamination during resective peri-implantitis therapy does not lead to improved clinical, radiographic, or microbiological results compared with a 0.12% CHX + 0.05% CPC solution. Overall, the additional use of CHX reduces anaerobic bacterial load on the implant surface better than mechanical debridement alone, but does not seem to enhance clinical treatment outcomes (ClinicalTrials.gov number NCT01852253).

Antifungal effect of electrospun nanofibers containing cetylpyridinium chloride against Candida albicans.

It is known that cetylpyridinium chloride (CPC) has in vitro and in vivo antifungal action against Candida albicans, with advantages over other common antiseptics. A CPC delivery-controlled system, transported in polymer nanofibers (PVP/PMMA), was developed to increase the bioavailability of the drug in contact with the oral mucosa. The objectives of this study were to determine if CPC in nanofiber has antifungal action against C. albicans, and in what concentration it must be incorporated, so that the fraction released can yield an inhibitory concentration. The nanofiber was prepared by electrospinning, and sterilized with gamma irradiation. Nanofiber disks with 0.05%, 1.25%, 2.5% and 5% CPC, with 5% miconazole (MCZ) and with no drug, as well as filter paper disks with 5% CPC, with 5% MCZ and with no drug were used in this study. A Candida albicans suspension (ATCC 90028) was inoculated in Mueller-Hinton Agar plates. The disks were placed on the plates and the inhibition zone diameters were measured 48h later. The nanopolymeric disks contracted in contact with the agar. All the concentrations of CPC incorporated in the nanofiber presented inhibitory action against C. albicans. Concentrations of 2.5% and 5% CPC presented a significant advantage over the nanofiber with no drug, proving the antifungal action of CPC. Under these experimental conditions, 5% CPC has greater inhibitory action against C. albicans than 5% MCZ, both in nanofiber and in filter paper. A modification made in the polymer to decrease the contraction rate may allow a larger inhibition zone to be maintained, thereby increasing the clinical usefulness of the polymer.

The effect of a mouthrinse containing chlorine dioxide in the clinical reduction of volatile sulfur compounds.

This study sought to evaluate the clinical effect of a mouthrinse containing 0.3% chlorine dioxide (ClO2) in reducing oral volatile sulfur compounds (VSC). Halitosis was induced by L-cysteine in 11 volunteers, and 4 solutions were compared: a test solution containing 0.3% ClO2, 0.07% cetylpyridinium chloride (CPC), and 0.05% sodium fluoride; a placebo; a solution containing 0.05% CPC; and a control solution of 0.2% chlorhexidine gluconate (CHX). VSC levels were assessed using a Halimeter, and 6 measurements were made from baseline to 3 hours postrinse. The VSC reduction rate of the test mouthrinse was superior to the placebo and the CPC solution. There was no difference between the test solution and the CHX solution in VSC reduction rates immediately postrinse, or at 2 and 3 hours postrinse; both solutions were statistically superior to the placebo and the CPC solution.

The antifungal properties of chlorhexidine digluconate and cetylpyrinidinium chloride on oral Candida.

INTRODUCTION: C. tropicalis and C. krusei have emerged as virulent species causing oral infections. Both have developed resistance to commonly prescribed azole antifungal agents. OBJECTIVE: The study aimed to determine the effect of mouth rinses containing chlorhexidine digluconate (CHX), cetylpyridinium chloride (CPC) and their combination (CHX-CPC) on the growth of these strains. METHODS: The minimal inhibition concentrations (MIC) of the mouth rinses were determined. The growth curves of the strains produced under the mouth rinse-treated and untreated conditions, as well as alterations to the morphology of the growth colonies and cells following the treatments were compared and analysed. RESULTS: The MICs of CPC compared to CHX mouth rinses were found to be lower for both Candida sp. In the mixed formulation, CPC doubled the inhibitory effect of CHX towards both Candida sp., while CHX quadrupled the activity of CPC towards C. tropicalis. The growth colonies also appeared coarse, wrinkled and dried. CONCLUSION: The profound effects shown may suggest the fungicidal activities of the mouth rinses incorporated with CHX, CPC or their combination on both C. tropicalis and C. krusei. Gargling using mouth rinses with such fungicidal activity would enhance a rapid reduction in the candidal population of patients with fungal infection.

Efficacy of antiplaque mouthwashes: a five-day clinical trial.

The aim of this study was to evaluate and compare the efficacy of antiplaque mouthwashes. Plaque levels were determined by applying a plaque-disclosing solution using the Turesky et al modification of the Quigley Hein plaque index. The control group (n = 6) brushed twice per day with fluoride toothpaste for one minute and rinsed with water, while the study groups (n = 6) brushed once per day with fluoride toothpaste for one minute, followed by rinsing with 5.0 mL of mouthwash diluted with 10.0 mL of water for 30 seconds. The control group brushed and rinsed with water twice per day. The results indicated that cetylpyridinium chloride in combination with sodium fluoride offered maximum plaque inhibition, followed by chlorhexidine gluconate and sodium monofluorophosphate, while plaque levels increased in the control group and with the combination of chlorhexidine gluconate and sodium fluoride. The only antiplaque agents to demonstrate a statistically significant difference from the control were cetylpyridinium chloride in combination with sodium fluoride, and chlorhexidine gluconate. Increasing the fluoride concentration had no impact on antiplaque activity.

Evaluation of oral antiseptic rinsing before sputum collection to reduce contamination of mycobacterial cultures.

To assess whether rinsing with oral antiseptics before sputum collection would reduce contamination of mycobacterial cultures, 120 patients with suspected tuberculosis were randomly assigned to rinse with chlorhexidine or cetylpyridinium mouthwash before collection. The culture contamination rate was significantly lower after rinsing with chlorhexidine before collection, especially for cultures grown in MGIT medium.