RESUMO
This study investigated the antimicrobial activity of surface pre-reacted glass ionomer eluate (S-PRG) against oral microcosm biofilms collected from the oral cavity of patients. Dental biofilm samples were collected from three volunteers to form microcosm biofilms in vitro. Initially, screening tests were carried out to determine the biofilm treatment conditions with S-PRG eluate. The effects of a daily treatment for 5 min using three microcosm biofilms from different patients was then evaluated. For this, biofilms were formed on tooth enamel specimens for 120 h. Biofilms treated with 100% S-PRG for 5 min per day for 5 days showed a reduction in the number of total microorganisms, streptococci and mutans streptococci. SEM images confirmed a reduction in the biofilm after treatment. Furthermore, S-PRG also reduced lactic acid production. It was concluded that S-PRG eluate reduced the microbial load and lactic acid production in oral microcosm biofilms, reinforcing its promising use as a mouthwash agent.
Assuntos
Biofilmes , Boca , Biofilmes/efeitos dos fármacos , Humanos , Boca/microbiologia , Streptococcus mutans/efeitos dos fármacos , Streptococcus mutans/crescimento & desenvolvimento , Anti-Infecciosos/farmacologia , Antissépticos Bucais/farmacologia , Ácido Láctico/farmacologia , Cimentos de Ionômeros de Vidro/farmacologia , Cimentos de Ionômeros de Vidro/química , Resinas Acrílicas/farmacologia , Resinas Acrílicas/química , Streptococcus/efeitos dos fármacos , Streptococcus/fisiologia , Propriedades de Superfície , Dióxido de SilícioRESUMO
INTRODUCTION: Visual imaging of subsurface caries lesions is of vital interest in dentistry, which can be obtained by invasive radiography technique as well as by available non-destructive imaging approaches. Thus, as a first step toward the development of a new innovative approach, Spectral-domain optical coherence tomography (SD-OCT) was applied to detect the lesion depth in comparison to the established reference technique (transverse microradiography [TMR]). METHODS: Bovine enamel specimens were demineralized for 5 days, following previous studies. For OCT, the resulting artificial lesions were scanned three-dimensionally (SD-OCT) and semi-automated measured (CarLQuant). For TMR, specimens were sectioned and the lesion depth was manually determined (Inspektor Research System). RESULTS: The range of lesion depth detected with OCT was 24.0-174.0 µm (mouth rinse study), 18.0-178.0 µm (toothpastes study) and with TMR 59.2-198.0 µm (mouth rinse study), 33.2-133.4 µm (toothpastes study). We found a strong correlation between both methods in terms of lesion depth (Spearman rankwith outlierp < 0.001, Rho = 0.75, Spearman rankwithout outlierp = 0.001, Rho = 0.79). The two methods produce similar results (Passing-Bablok regression, 1.16). As deeper is the lesion, the smallest is the difference between both methods as indicated by Bland-Altman-plots. CONCLUSION: Especially in the case of deep lesions, the values obtained by both methods are in agreement, and OCT can potentially substitute TMR to detect and assess lesion depth with the benefit of being non-destructive.
Assuntos
Cárie Dentária , Esmalte Dentário , Microrradiografia , Tomografia de Coerência Óptica , Tomografia de Coerência Óptica/métodos , Animais , Bovinos , Cárie Dentária/diagnóstico por imagem , Cárie Dentária/patologia , Microrradiografia/métodos , Esmalte Dentário/diagnóstico por imagem , Esmalte Dentário/patologia , Imageamento Tridimensional/métodos , Desmineralização do Dente/diagnóstico por imagem , Desmineralização do Dente/patologiaRESUMO
This study evaluated the antimicrobial and anticaries effects of toothpaste containing hydroxyapatite nanoparticles (nanoHAP - 5 or 10%), xylitol (2 or 3%) and propolis (1 or 2%), associated or not with 1500 ppm fluoride (F). An in vitro model was used with microcosm biofilm produced from a pool of human saliva and McBain saliva (1:50) in the first 8 h of culture on 162 bovine enamel specimens. At the end of the experimental period, analyses of metabolic activity, colony forming units (CFU) and transverse microradiography (TMR) were performed. This study showed a possible decrease in demineralization and increase in remineralization by the commercial toothpaste (1500 ppm F) and for the experimental toothpaste containing the highest concentration of all agents, combined with F. In addition, a reduction in antimicrobial activity possibly caused by propolis and xylitol, mainly in relation to cariogenic bacteria, was observed.
Assuntos
Anti-Infecciosos , Ascomicetos , Cárie Dentária , Nanopartículas , Própole , Desmineralização do Dente , Animais , Bovinos , Humanos , Fluoretos/farmacologia , Cremes Dentais/farmacologia , Cariostáticos/farmacologia , Própole/farmacologia , Xilitol/farmacologia , Durapatita/farmacologia , Desmineralização do Dente/prevenção & controle , Biofilmes , Anti-Infecciosos/farmacologia , Cárie Dentária/prevenção & controleRESUMO
The effect of different artificial saliva formulations on biofilm activity and viability, and on enamel demineralization for head and neck cancer (HNC) patients was evaluated. Irradiated enamel samples were treated (1 min) with BioXtra® or with experimental formulations containing carboxymethylcellulose plus inorganic constituents alone (AS) or containing 0.1 mg mL-1 CaneCPI-5 (AS + Cane), 1.0 mg mL-1 hemoglobin (AS + Hb) or combination of both (AS + Cane + Hb). Phosphate-buffered-saline and chlorhexidine (0.12%) were negative and positive control, respectively. Biofilm was produced from the saliva of five male HNC patients, under 0.2% sucrose exposure for 5 days, and daily treated with the formulations (1 min). No significant effects were observed for the different experimental treatments. BioXtra® significantly reduced lactobacilli, demonstrating antibacterial potential for this group. Chlorhexidine was an effective treatment to significantly reduce all parameters, being an important antimicrobial and anticaries agent. Future in vitro studies must be performed using a new approach for the design of the experimental formulations.
Assuntos
Anti-Infecciosos , Cárie Dentária , Neoplasias de Cabeça e Pescoço , Desmineralização do Dente , Antibacterianos/farmacologia , Anti-Infecciosos/farmacologia , Biofilmes , Carboximetilcelulose Sódica/farmacologia , Clorexidina/farmacologia , Humanos , Masculino , Fosfatos/farmacologia , Saliva/microbiologia , Saliva Artificial/farmacologia , Sacarose/farmacologia , Desmineralização do Dente/microbiologiaRESUMO
OBJECTIVE: This study evaluated the antibiofilm and anti-caries effects of an experimental mouth rinse containing aqueous extract of Matricaria chamomilla L. METHODS: Microcosm biofilm was produced on bovine enamel, from pooled human saliva mixed with McBain saliva, under 0.2 % sucrose exposure, for 5 days. The biofilm was daily treated using (1â¯mL/1â¯min): Vochysia tucanorum Mart. (2.5â¯mg/mL); Myrcia bella Cambess. (1.25â¯mg/mL); Matricaria chamomilla L. (20â¯mg/mL); Malva sylvestris (Malvatricin® Plus-Daudt); 0.12 % Chlorhexidine (PerioGard®-Palmolive, Positive control) and PBS (Negative control). The % dead bacteria, biofilm thickness, EPS biovolume, lactic acid concentration, the CFU counting (total microorganisms, Lactobacillus sp., total streptococci and Streptococcus mutans/S. sobrinus) were determined. Enamel demineralization was measured by TMR. RESULTS: All mouth rinses induced bacterial death compared to PBS (pâ¯<â¯0.0001). The biofilm thickness varied from 12⯱â¯2⯵m (chlorhexidine) to 18⯱â¯2⯵m (V. tucanorum) (ANOVA/Tukey, pâ¯<â¯0.0001). The EPS biovolume varied from 7(4)% (chlorhexidine) to 30(20)% (PBS) (Kruskal-Wallis/Dunn, pâ¯<â¯0.0001). The lactic acid production was reduced by M. sylvestris (1.1⯱â¯0.2â¯g/L) and chlorhexidine (0.6⯱â¯0.2â¯g/L) compared to PBS (2.6⯱â¯1.3â¯g/L) (ANOVA, pâ¯<â¯0.0001). Malva sylvestris and chlorhexidine showed significant low CFU for total microorganisms, Lactobacillus sp. and total streptococci. Only chlorhexidine significantly reduced S. mutans/S. sobrinus. CFUs for total streptococci and Lactobacillus sp, were also significantly reduced by M. chamomilla L. Malva sylvestris (63.4 % of mineral loss reduction), chlorhexidine (47.4 %) and M. chamomilla L. (39.4 %) significantly reduced enamel demineralization compared to PBS (ANOVA/Tukey, pâ¯<â¯0.0001). CONCLUSION: M. chamomilla L. has lower antibiofilm action, but comparable anti-caries effect to those found for chlorhexidine, under this model. CLINICAL RELEVANCE: This study shows that the antibiofilm and anti-caries potential may vary between the commercial and experimental mouth rinses containing natural agents, with promising results for those containing Matricaria chamomilla L. and Malva Sylvestris.
Assuntos
Cárie Dentária , Matricaria , Desmineralização do Dente , Animais , Biofilmes , Cariostáticos , Bovinos , Clorexidina/farmacologia , Esmalte Dentário , Humanos , Antissépticos Bucais/farmacologia , Streptococcus mutansRESUMO
This work evaluated the effects of commercial toothpastes and mouth rinses containing natural/herbal agents on biofilm viability, extracellular polysaccharide (EPS) production and on enamel demineralization in vitro. Microcosm biofilm was produced on bovine enamel for 5 days and treated daily with: Orgânico natural® (toothpaste/mouth rinse), Boni Natural Menta & Malaleuca® (toothpaste/mouth rinse), Propolis & Myrrh® (toothpaste), Colgate Total 12 Clean Mint® (toothpaste, positive control), Malvatricin® Plus (mouth rinse), PerioGard® (mouth rinse, positive control) or PBS (negative control). Tom's Propolis & Myrrh® and Colgate Total 12® toothpastes and Malvatricin® Plus and PerioGard® mouth rinses significantly reduced biofilm viability (p < 0.05). Only PerioGard® had significant effects on biofilm thickness and EPS. Despite the indication that Tom's Propolis & Myrrh® significantly reduced lesion depth, only Colgate Total 12® significantly reduced mineral loss. Malvatricin® Plus significantly reduced mineral loss and lesion depth, as did PerioGard®. Some herbal products, Malvatricin® Plus and Tom's Propolis & Myrrh®, showed anticaries effects.
Assuntos
Biofilmes/efeitos dos fármacos , Esmalte Dentário/efeitos dos fármacos , Antissépticos Bucais/farmacologia , Desmineralização do Dente/prevenção & controle , Cremes Dentais , Animais , Bovinos , Clorexidina/farmacologia , Fluoreto de SódioRESUMO
This study evaluated the effect of titanium tetrafluoride (TiF4) varnish on the development of dentin carious lesions. Bovine root dentin samples were treated for 6 h with: (A) 4% TiF4 varnish (2.45% F); (B) 5.42% sodium fluoride (NaF) varnish (2.45% F); (C) 2% chlorhexidine (CHX) gel - positive control; (D) placebo varnish; or (E) untreated - negative control (n = 4 × biological triplicate, n = 12). Treated dentin samples were exposed to human saliva mixed with McBain saliva (1:50) for the first 8 h in 24-well plates. Thereafter, the medium was removed, and McBain saliva containing 0.2% sucrose was applied for 16 h. From days 2 to 5, McBain saliva with sucrose was replaced daily (37°C, 5% CO2). The demineralization was measured using transverse microradiography, while the effect on biofilm was analyzed using viability, extracellular polysaccharide (EPS), and lactic acid production assays. The data were statistically analyzed (p < 0.05). All treatments (fluorides and CHX) significantly reduced the biofilm viability compared to placebo varnish and negative control. However, none of them was able to reduce the colony-forming unit counting for total microorganism, total streptococci, and Streptococcus mutans. NaF significantly reduced the number of Lactobacillus sp. compared to negative control. No effect was seen on lactic acid production neither on EPS synthesis, except that CHX significantly reduced the amount of insoluble EPS. Both fluorides were able to reduce dentin demineralization compared to placebo varnish and negative control; TiF4 had a better effect in reducing mineral loss and lesion depth than NaF. Therefore, TiF4 varnish has the best protective effect on dentin carious lesion formation using this model.
Assuntos
Biofilmes/efeitos dos fármacos , Dentina/efeitos dos fármacos , Fluoretos/uso terapêutico , Titânio/uso terapêutico , Desmineralização do Dente/prevenção & controle , Animais , Cariostáticos , Bovinos , Dentina/patologia , Fluoretos Tópicos , Humanos , Técnicas In Vitro , Ácido Láctico , Lactobacillus/efeitos dos fármacos , Fluoreto de Sódio/uso terapêutico , Streptococcus mutans/efeitos dos fármacosRESUMO
The purpose of this study was to evaluate the antimicrobial (anti-biofilm) and anti-caries (enamel demineralization prevention) effects of Malva sylvestris (Malvatricin® Plus) compared with known antimicrobial mouthrinses. Microcosm biofilm was produced on enamel, using inoculum from pooled human saliva mixed with McBain saliva (0.2% sucrose) for 14 days. The biofilm was treated with mouthrinses for 1 min day-1. Oral-B® Complete, Listerine® Zero and Malvatricin® Plus had the greatest effect on the reduction of biofilm viability (p < 0.0001). On the other hand, lactic acid production was reduced significantly with PerioGard®, Noplak® Max and Listerine® Zero compared with the control (p < 0.0001). No significant differences were found among the mouthrinses with respect to the colony-forming unit counting (total microorganisms, total streptococci, mutans streptococci and lactobacilli) and extracellular polysaccharide production. Enamel demineralization was reduced significantly with PerioGard®, Noplak® Max and Malvatricin® Plus compared with the control (p < 0.0001). Malva sylvestris has a comparable anti-caries effect to chlorhexidine mouthrinses.
Assuntos
Bactérias/efeitos dos fármacos , Biofilmes/efeitos dos fármacos , Esmalte Dentário/microbiologia , Malva/química , Antissépticos Bucais/farmacologia , Desmineralização do Dente/prevenção & controle , Antibacterianos/farmacologia , Clorexidina/farmacologia , Combinação de Medicamentos , Humanos , Lactobacillus/efeitos dos fármacos , Antissépticos Bucais/química , Salicilatos/farmacologia , Saliva , Streptococcus/efeitos dos fármacos , Streptococcus mutans/efeitos dos fármacos , Terpenos/farmacologia , Desmineralização do Dente/microbiologiaRESUMO
The objective of this study was to evaluate the antimicrobial and anti-caries effects of two plant extracts. The first chapter dealt with a review of the literature whose objective was to discuss the antimicrobial potential of Brazilian natural agents on the biofilm related to dental caries and gingivitis/periodontal disease. The research of the articles was carried out using PubMed. We found a total of 23 papers. Most of the studies were performed using planktonic microorganisms or under clinical trials. Nineteen articles were focused on cariogenic bacteria. From these nineteen articles, eleven were also about periodontopathogenic bacteria. Four studies addressed only periodontopathogenic bacteria. The most tested Brazilian natural agents were green propolis, essential oils of Lippia sidoides and Copaifera sp. Most of the tested agents showed similar results when compared to positive control (essential oils and extracts) or better effect than negative control (green propolis). More studies involving protocols closer to the clinical condition and the use of response variables that allows understanding the mechanism of action of natural agents are necessary before the incorporation of these natural agents into dental products. The second chapter aimed to test the effect of the hydroalcoholic extracts of Myracrodruon urundeuva All. and Qualea grandiflora Mart. leaves on the viability of the microcosm biofilm and on the prevention of enamel demineralization. The microcosm biofilm was produced on bovine enamel, using human saliva pool mixed with McBain saliva (0.2% sucrose) for 14 days. The biofilm was treated daily with the extracts for 1 min. M. urundeuva at 100, 10 and 0.1 µg/ml and Q. grandiflora at 100 and 0.1 µg/ml reduced cell viability similarly to the positive control and significantly more than negative control. M. urundeuva at 1000, 100 and 0.1 µg/ml were able to reduce the counting formation unit-CFU counting of lactobacilli sp. and Streptococcus mutans, while Q. grandiflora at 1000 and 1.0 µg/ml significantly reduced the S. mutans CFU counting. On the other hand, the natural extracts did not reduce the production of extracellular polyssacharides, lactic acid and the development of enamel caries lesions. The third chapter aimed to evaluate the effect of hydroalcoholic extracts of M. urundeuva and Q. grandiflora (alone or combined) on the viability of S. mutans biofilm and the prevention of enamel demineralization. S. mutans strain (ATCC 21175) was reactivated in BHI broth. Minimum inhibitory concentration, minimum bactericidal concentration, minimum biofilm inhibitory concentration and minimum biofilm eradication concentration were determined to choose the concentrations to be tested under the biofilm model. S. mutans biofilm (5x105 CFU/ml) was produced on bovine enamel using McBain saliva with 0.2% sucrose for 3 days. The biofilm was treated daily with the extracts for 1 min. M. urundeuva (isolated or combined) at concentrations equal or higher than 0.625 mg/ml was able to reduce the bacteria viability, whereas Q. grandiflora extract alone showed antimicrobial effect at 5 mg/ml only (p<0.05). On the other hand, none of the extracts was able to reduce the development of enamel caries lesions. Despite the tested natural extracts have antimicrobial effect; they are unable to prevent caries in enamel.(AU)
O objetivo foi avaliar os efeitos antimicrobiano e anti-cárie de dois extratos de plantas. O primeiro capítulo se referiu a uma revisão da literatura cujo objetivo foi discutir o potencial antimicrobiano dos agentes naturais brasileiros sobre o biofilme relacionado à cárie dentária e à gengivite/doença periodontal. A pesquisa dos artigos foi realizada usando o PubMed. Foram encontrados 23 trabalhos. A maioria dos estudos foi realizada utilizando microorganismos na fase planctônica ou ensaios clínicos. Dezenove artigos foram focados em bactérias cariogênicas. Dos dezenove artigos, onze também eram sobre bactérias periodontopatogênicas. Quatro estudos abordaram apenas bactérias periodontopatogênicas. Os agentes naturais brasileiros mais testados foram própolis verde, óleos essenciais de Lippia sidoides e Copaifera sp. Os agentes testados apresentaram resultados similares quando comparados ao controle positivo (óleos essenciais e extratos) ou melhor efeito que o controle negativo (própolis verde). Mais estudos próximos da condição clínica e o uso de variáveis de resposta que permitam entender o mecanismo de ação são necessários, para permitir a incorporação desses agentes naturais em produtos odontológicos. O segundo capítulo teve como objetivo testar o efeito dos extratos hidroalcoólicos de Myracrodruon urundeuva All. e Qualea grandiflora Mart. sobre a viabilidade do biofilme microcosmo e na prevenção da desmineralização do esmalte. O biofilme microcosmo foi produzido em esmalte bovino, utilizando pool de saliva humana misturada à saliva de McBain (0,2% de sacarose) durante 14 dias. O biofilme foi tratado diariamente com os extratos durante 1 min. M. urundeuva a 100, 10 e 0,1 µg/ml e Q. grandiflora a 100 e 0,1 µg/ml reduziram a viabilidade dos microrganismos de forma semelhante ao controle positivo e significativamente maior do que o controle negativo. M. urundeuva a 1000, 100 e 0,1 µg/ml foi capaz de reduzir a contagem de Unidade formadora de colônia-UFC para Lactobacilos totais e Streptococcus mutans, enquanto a Q. grandiflora a 1000 e 1,0 µg/ml reduziu significativamente a contagem de UFC para S. mutans. Os extratos naturais não conseguiram reduzir a produção de polissacarídeos extracelulares-PEC, ácido lático e o desenvolvimento da lesão cariosa em esmalte. O terceiro capítulo teve como objetivo avaliar o efeito dos extratos hidroalcoólicos de M. urundeuva. e Q. grandiflora (sozinhos ou combinados) sobre a viabilidade do biofilme de S. mutans e na prevenção da desmineralização do esmalte. Cepa de S. mutans (ATCC 21175) foi reativada em caldo BHI. Concentração inibitória mínima, concentração bactericida mínima, concentração inibitória mínima de biofilme e concentração de erradicação mínima de biofilme foram determinadas para escolher as concentrações a serem testadas sob o modelo de biofilme. O biofilme de S. mutans (5x105 CFU/ml) foi produzido em esmalte bovino, utilizando saliva de McBain com 0,2% de sacarose durante 3 dias. O biofilme foi tratado diariamente com os extratos durante 1 min. M. urundeuva (isolada ou combinada) nas concentrações iguais ou superiores a 0,625 mg/ml foi capaz de reduzir a viabilidade das bactérias, enquanto que o extrato da Q. grandflora apresentou efeito antimicrobiano somente a 5 mg/ml (p<0,05). Nenhum dos extratos reduziu o desenvolvimento da lesão da cárie. Apesar dos extratos naturais terem efeito antimicrobiano, são incapazes de prevenir o desenvolvimento da lesão cariosa em esmalte.(AU)
Assuntos
Humanos , Animais , Bovinos , Anacardiaceae/química , Anti-Infecciosos/farmacologia , Biofilmes/efeitos dos fármacos , Esmalte Dentário/microbiologia , Magnoliopsida/química , Extratos Vegetais/farmacologia , Desmineralização do Dente/prevenção & controle , Testes de Sensibilidade Microbiana , Microrradiografia , Reprodutibilidade dos Testes , Saliva/microbiologia , Streptococcus mutans/efeitos dos fármacos , Streptococcus mutans/crescimento & desenvolvimento , Fatores de TempoRESUMO
The aim of this study was to evaluate the antimicrobial and anticaries effects of different commercial mouthrinses. The first chapter is about a review of literature whose the aim was to discuss the antimicrobial potential of different mouthrinses in respect to the control of dental caries and periodontal disease. The search of papers was conducted using PubMed and the keywords: "antimicrobial agent" or "antiplaque agent," "dental biofilm" and "dental caries" or "periodontal disease" or "gingivitis". We found a total of 22 papers (2011-2015). The main active agents tested were: CHXChlorhexidine, CPC-cetylpyridinium chloride and EO-Essential oils (alcohol/or alcohol-free). CHX was compared to EO in 6 studies, showing superiority in 3 studies, similarity in 1 study and inferiority in 2 studies. CPC has shown lower effect in plaque reduction compared to CHX and EO. More clinical studies are needed for better understanding the mechanism of action and the differences in performance among the antiplaque agents. The second chapter has as aim to compare the antimicrobial and anticaries effects of six commercial mouthrinses (PerioGard®, Noplak® Max, Oral-B® Complete, Listerine® Zero, Malvatricin® Plus and Cepacol® Plus Advanced) under a microcosm biofilm model formed on enamel. A microcosm biofilm was produced on bovine enamel, using inoculum from pooled human saliva mixture with McBain saliva (with 0.2% sucrose), for 14 days. The biofilm was treated with the mouthrinses daily (1 min). The bacterial viability (% death), lactic acid production (mmol/l), the colony-forming unit (CFU) counting for total microorganisms, lactobacilli, total streptococci and mutans streptococci (log10 CFU/mL) and the extracellular polysaccharides production (EPS, mg/g) were quantified in the biofilm. The degree of enamel demineralization was analyzed using transverse microradiography-TMR (%min vol. µm). Oral-B® Complete, Listerine® Zero and Malvatricin® Plus had the greatest effect on the reduction of biofilm viability (69-75% dead cells vs. 13% in the control, p<0.0001). On the other hand, the lactic acid production was significantly reduced by PerioGard®, Noplak® Max and Listerine® Zero compared to control (69% reduction, p<0.0001). There were no significant differences among the mouthrinses in respect to the CFU counting and EPS production. The enamel demineralization was significantly reduced by PerioGard®, Noplak® Max and Malvatricin® Plus compared to control (74% reduction, p<0.0001). Therefore, the commercial mouthrinses have different antimicrobial and anticaries effects. The mouthrinses containing chlorexidine or Malva sylvestris (with F, triclosan and xylitol) had the best anticaries effect under this model.(AU)
O objetivo deste estudo foi avaliar os efeitos antimicrobiano e anticárie de diferentes enxaguatórios bucais comerciais. O primeiro capítulo se refere a uma revisão da literatura cujo objetivo foi discutir o potencial antimicrobiano de diferentes enxaguatórios em relação ao controle de cárie dentária e doença periodontal. A pesquisa dos artigos foi realizada usando o PubMed e as palavras-chave: "agente antimicrobiano" ou "agente antiplaca", "biofilme dental" e "cárie dentária" ou "doença periodontal" ou "gengivite". Encontramos um total de 22 artigos (2011-2015). Os principais agentes ativos testados foram: Clorexidina-CHX, cloreto de cetilpiridínio- CPC e óleos essenciais OE (álcool / ou sem álcool). A CHX foi comparada ao OE em 6 estudos, mostrando superioridade em 3 estudos, similaridade em 1 estudo e inferioridade em 2 estudos. CPC mostrou menor efeito na redução da placa em comparação com CHX e OE. Mais estudos clínicos são necessários para uma melhor compreensão do mecanismo de ação e as diferenças no desempenho entre os agentes antiplaca. O segundo capítulo teve como objetivo avaliar os efeitos antimicrobiano e anticárie de seis enxaguatórios comerciais (PerioGard®, Noplak® Max, Oral-B® Complete, Listerine® Zero, Malvatricin® Plus e Cepacol® Plus Advanced) sobre um modelo de biofilme de microcosmo formado no esmalte. O biofilme de microcosmo foi produzido em esmalte bovino, utilizando o inóculo da mistura de saliva humana com saliva de McBain (com 0,2% de sacarose), durante 14 dias. O biofilme foi tratado com enxaguatórios diariamente (1 min). A viabilidade bacteriana (% de morte), a produção de ácido láctico (mmol/l), as unidades formadoras de colônias (UFC) foram contadas para microrganismos totais, lactobacilos, estreptococos totais e Streptococcus mutans (log10 UFC/mL) e a produção de polissacarídeos extracelulares (PEC, mg/g) foram quantificados no biofilme. O grau de desmineralização do esmalte foi analisado utilizando a microrradiografia transversal-TMR (%min vol. µm). Oral-B® Complete, Listerine® Zero e Malvatricin® Plus tiveram o maior efeito na redução da viabilidade do biofilme (69-75% de morte celular vs 13% no controle, p<0,0001). Por outro lado, a produção de ácido lático foi significativamente reduzida por PerioGard®, Noplak® Max e Listerine® Zero comparado ao controle (redução de 69%, p<0,0001). Não houve diferenças significativas entre os enxaguatórios em relação à contagem de UFC e à produção de PEC. A desmineralização do esmalte foi significativamente reduzida pelo PerioGard®, Noplak® Max e Malvatricin® Plus em comparação ao controle (redução de 74%, p<0,0001). Portanto, os enxaguatórios bucais comerciais têm diferentes efeitos antimicrobiano e anticárie. Os enxaguatórios contendo clorexidina ou Malva sylvestris (com F, triclosan e xilitol) tiveram o melhor efeito anticárie neste modelo.(AU)