Vaginal Ovule Loaded with Bismuth Lipophilic Nanoparticles and Cetylpyridinium Chloride Inhibits Human Cervical Carcinoma and Candida albicans Growth.

Bismuth lipophilic nanoparticles (BisBAL NPs) and cetylpyridinium chloride (CPC) are antineoplastic and antimicrobial in vitro. As a next pre-clinical step, a clinically viable dosage form for vaginal application was developed. Compendial pharmacopeial tests (mass uniformity, disintegration, and compressive mechanics) and inductively coupled plasma optical emission spectroscopy were conducted on in-house developed glycerinated gelatin (60:15 v/w) vaginal ovules containing BisBAL NP-CPC. The antimycotic activity of BisBAL NP-CPC vaginal ovules was analyzed using disk diffusion and cell viability XTT assays. The antitumor properties of BisBAL NP-CPC vaginal ovules were assessed by cell viability MTT tests. BisBAL NP-CPC and drug-free vaginal ovules deposited into ex vivo porcine vaginas disaggregated without signs of adverse cytotoxicity within the timespan of clinical efficacy. BisBAL NP-CPC vaginal ovules demonstrated antifungal efficacy comparable to miconazole: C. albicans growth inhibition haloes in diffusion tests were 23 ± 0.968 mm (n = 3) for BisBAL NP-CPC and 20.35 ± 0.899 mm (n = 3) for miconazole. Likewise, BisBAL NP-CPC vaginal ovules reduced HeLa cell growth by 81%, outperforming the clinical reference of 500 µM 5-fluouracil, which induced a 70% growth inhibition. BisBAL NP-CPC incorporated into glycerinated gelatin vaginal ovules constitute an innovative drug delivery system for topical antimycotic and anti-cervical carcinoma treatments.

Incorporation of zinc into cetylpyridinium chloride mouthwash affects the composition of multispecies biofilms.

This study evaluated the effect of a mouthwash containing 0.075% cetylpyridinium chloride and 0.28% zinc lactate (CPC + Zn) in a multispecies biofilm model. A 7-days 33-species biofilm, formed on Calgary device, was 1-min treated with: 0.12% chlorhexidine (CHX), culture medium (negative control), 0.075% cetylpyridinium chloride (CPC) or CPC + Zn, 2x/day, from day 3 until day 6. The metabolic activity and the microbial composition were evaluated by colorimetric method and checkerboard DNA-DNA hybridization, respectively. The three antimicrobials (CPC, CPC + Zn and CHX) reduced metabolic activity, total biofilm count and several species counts, including Porphyromonas gingivalis, Fusobacterium nucleatum, Parvimonas micra, Campylobacter gracilis and Streptococcus mutans. However, only CPC + Zn reduced counts of the pathogen Prevotella intermedia and did not interfere with the levels of some beneficial species in relation to the negative control. The treatment of multispecies subgingival biofilm with CPC + Zn was effective in controlling periodontal pathogens and favored the colonization of health-associated bacterial species.

Cetylpyridinium Chloride as a Tool Against COVID-19 / Cloruro de Cetilpiridinio como Herramienta para Combatir el COVID-19

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

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

Novel Colloidal Nanocarrier of Cetylpyridinium Chloride: Antifungal Activities on Candida Species and Cytotoxic Potential on Murine Fibroblasts.

Nanocarriers have been used as alternative tools to overcome the resistance of Candida species to conventional treatments. This study prepared a nanocarrier of cetylpyridinium chloride (CPC) using iron oxide nanoparticles (IONPs) conjugated with chitosan (CS), and assessed its antifungal and cytotoxic effects. CPC was immobilized on CS-coated IONPs, and the nanocarrier was physico-chemically characterized. Antifungal effects were determined on planktonic cells of Candida albicans and Candida glabrata (by minimum inhibitory concentration (MIC) assays) and on single- and dual-species biofilms of these strains (by quantification of cultivable cells, total biomass and metabolic activity). Murine fibroblasts were exposed to different concentrations of the nanocarrier, and the cytotoxic effect was evaluated by MTT reduction assay. Characterization methods confirmed the presence of a nanocarrier smaller than 313 nm. IONPs-CS-CPC and free CPC showed the same MIC values (0.78 µg mL-1). CPC-containing nanocarrier at 78 µg mL-1 significantly reduced the number of cultivable cells for all biofilms, surpassing the effect promoted by free CPC. For total biomass, metabolic activity, and cytotoxic effects, the nanocarrier and free CPC produced statistically similar outcomes. In conclusion, the IONPs-CS-CPC nanocarrier was more effective than CPC in reducing the cultivable cells of Candida biofilms without increasing the cytotoxic effects of CPC, and may be a useful tool for the treatment of oral fungal infections.

[Antifungal activity of mouthwashes against Candida albicans and Rhodotorula mucilaginosa: An in vitro study]. / Actividad antifúngica de los enjuagues bucales frente a Candida albicans y Rhodotorula mucilaginosa: un estudio in vitro.

BACKGROUND: Candida albicans and Rhodotorula mucilaginosa are yeasts of clinical importance in the oral cavity. In immunocompromised patients they can cause some pathologies that must be controlled with antimicrobials. AIMS: To evaluate and compare the antimicrobial efficacy of commercially available mouthrinses against strains of C. albicans and R. mucilaginosa. METHODS: The six mouthwashes studied in vitro were formulated (alone or in combination) with chlorhexidine (CHX) 0.12%, CHX 0.1%, CHX 0.05%, cetylpyridinium chloride (CPC) 0.075%, CPC 0.05%, and essential oils. Ten C. albicans and R. mucilaginosa isolates each were studied. The agar diffusion method (Mueller Hinton II), with incubation at 32°C was used to evaluate the antifungal activity. RESULTS: The results of this study indicate that mouthwashes with CHX 0.1%, CHX 0.12%, CHX 0.05% + CPC 0.05%, CHX 0.12% + CPC 0.05% and CPC 0.075% have an antifungal effect against C. albicans and R. mucilaginosa. CHX 0.1% led to the broadest inhibition zone for C. albicans and R. mucilaginosa (25.65±2.39mm and 40.05±3.31mm). Essential oils did not show any antifungal activity. Statistical analysis showed no statistical difference between mouth rinses CHX 0.1%, CHX 0.12% and CHX 0.12% + CPC 0.05% (p=0.0001) against C. albicans and R. mucilaginosa. CONCLUSIONS: Mouthwashes with CHX showed higher antifungal activity against C. albicans and R. mucilaginosa than other mouthwashes studied.

Cetylpyridinium chloride blocks herpes simplex virus replication in gingival fibroblasts.

Infections with herpes simplex viruses are lifelong and highly prevalent worldwide. Individuals with clinical symptoms elicited by HSVs may suffer from occasional or recurrent herpetic lesions in the orofacial and genital areas. Despite the existence of nucleoside analogues that interfere with HSV replication, such as acyclovir, these drugs are somewhat ineffective in treating skin lesions as topical formulations only reduce in one or few days the duration of the herpetic ulcers. Cetylpyridinium chloride (CPC) is a quaternary ammonium compound present in numerous hygiene products, such as mouthwashes, deodorants, aphtae-treating formulations and oral tablets as an anti-septic to limit bacterial growth. Some reports indicate that CPC can also modulate host signaling pathways, namely NF-κB signaling. Because HSV infection is modulated by NF-κB, we sought to assess whether CPC has antiviral effects against HSVs. Using wild-type HSV-1 and HSV-2, as well as viruses that are acyclovir-resistant or encode GFP reporter genes, we assessed the antiviral capacity of CPC in epithelial cells and human gingival fibroblasts expanded from the oral cavity and its mechanism of action. We found that a short, 10-min exposure to CPC added after HSV entry into the cells, significantly limited viral replication in both cell types by impairing viral gene expression. Interestingly, our results suggest that CPC blocks HSV replication by interfering with the translocation of NF-κB into the nucleus of HSV-infected cells. Taken together, these findings suggest that formulations containing CPC may help limit HSV replication in infected tissues and consequently reduce viral shedding.

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

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

Effect of Liquid Crystalline Systems Containing Antimicrobial Compounds on Infectious Skin Bacteria.

This study aimed (i) to prepare liquid crystalline systems (LCS) of glyceryl monooleate (GMO) and water containing antibacterial compounds and (ii) to evaluate their potential as drug delivery systems for topical treatment of bacterial infections. Therefore, LCS containing CPC (cetylpyridinium chloride) (LCS/CPC) and PHMB (poly(hexamethylene biguanide) hydrochloride) (LCS/PHMB) were prepared and the liquid crystalline phases were identified by polarizing light microscopy 24 h and 7 days after preparation. The in vitro drug release profile and in vitro antibacterial activity of the systems were assessed using the double layer agar diffusion method against Staphylococcus aureus, methicillin-resistant S. aureus, Staphylococcus epidermidis, Escherichia coli, and Enterococcus faecalis. The interaction between GMO and the drugs was evaluated by a drug absorption study. Stable liquid crystalline systems containing CPC and PHMB were obtained. LCS/PHMB decreased the PHMB release rate and exerted strong antibacterial activity against all the investigated bacteria. In contrast, CPC interacted with GMO so strongly that it became attached to the system; the amount released was not sufficient to exert antibacterial activity. Therefore, the studied liquid crystalline systems were suitable to deliver PHMB, but not CPC. Accordingly, it was demonstrated that GMO interacts with each drug differently, which may interfere in the final efficiency of GMO/water LCS.

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

The aim of this study was to evaluate the impact of 10 wt% benzalkonium chloride (TB-BAC) or 10 wt% cetylpyridinium chloride (TB-CPC) on the antimicrobial properties of the orthodontic adhesive primer, Transbond XTT (TB). Antimicrobial activity was assessed using a zone of inhibition diffusion test and the release of the antimicrobial compounds was monitored by high performance liquid chromatography (HPLC). Shear bond strength (SBS) was tested using bovine enamel. Control, TB, specimens failed to demonstrate intrinsic antibacterial activity at 1, 7 and 14 days; whereas, TB-BAC and TB-CPC showed antibacterial effects at all times. HPLC analysis indicated no significant differences in the release behaviour of TB-BAC and TB-CPC (t-test, p > 0.05), except for the 7-day release which was higher for TB-BAC (p < 0.05). By 14 days the extents of release were 27 ± 2% and 25 ± 5% of the total initial loading for TB-BAC and TB-CPC, respectively. The incorporation of 10 wt% BAC or CPC in Transbond XTT adhesive primer also resulted in superior shear bond strength at 7 and 14 days (Fisher s LSD, p < 0.05) with no significant change in the mode ofbracket failure under shear stress (Pearson's chi-squared, p > 0.05).

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

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

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

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

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

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

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

The efficacy of two oral hygiene regimens in reducing oral malodour: a randomised clinical trial.

OBJECTIVES: This study compared the efficacy of two oral hygiene regimens in reducing oral malodour and the proportions of bacterial species involved in the production of volatile sulphur compounds. MATERIAL AND METHODS: Seventy subjects who participated in a halitosis-induction phase and achieved an organoleptic score of ≥ 3.0 [time point 0 (T0)] randomised into two groups: brushing with regular fluoride toothpaste alone (control group) or brushing with regular fluoride toothpaste followed by rinsing with a 0.075% cetylpyridinium chloride (CPC) mouthwash (CPC group). Subjects followed their assigned oral hygiene regimen for 21 days. Then, they underwent an organoleptic examination and measurement of volatile sulphur compounds (VSCs) using a portable gas chromatograph, 12 hours after their last oral hygiene procedure (T1) and 4 hours after an on-site oral hygiene (T2). Microbiological samples (supragingival biofilm, tongue coating and saliva) were analysed using checkerboard DNA-DNA hybridisation. RESULTS: Both therapies statistically significantly improved the organoleptic scores (P < 0.05), but the VSC levels and/or concentrations were reduced only in the CPC group (P < 0.05). In subjects rinsing with CPC, oral malodour scores were reduced by 49% at the 4-hour assessment (T2) compared with those not rinsing (P < 0.05). Red-complex pathogens were reduced more effectively in the CPC group than in the control group. CONCLUSIONS: Brushing followed by rinsing with a 0.075% CPC mouthwash provided statistically significantly greater reductions in oral malodour, measured organoleptically and instrumentally, and in the proportions of red-complex species when compared with brushing alone.

Oral hygiene protocols in intensive care units in a large Brazilian city.

This study investigated oral hygiene protocols for patients in intensive care units (ICUs) in 25 of 30 hospitals in Belo Horizonte, Brazil, using a questionnaire. Although all hospital representatives said there was a protocol for the maintenance of patients' oral hygiene, it was observed that there was no standardization. Only 2 hospitals had dentists on the ICU staff. Cetylpyridinium chloride was the most frequently used antiseptic, even in patients under mechanical ventilation.

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

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

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

Determination of the maximum inhibitory dilution of cetylpyridinium chloride-based mouthwashes against staphylococcus aureus: an in vitro study

The aim of this in vitro study was to determine the maximum inhibitory dilution (MID) of four cetylpyridinium chloride (CPC)-based mouthwashes: CPC+Propolis, CPC+Malva, CPC+Eucaliptol+Juá+Romã+Propolis (Natural Honey®) and CPC (Cepacol®), against 28 Staphylococcus aureus field strains, using the agar dilution method. Decimal dilutions ranging from 1/10 to 1/655,360 were prepared and added to Mueller Hinton Agar. Strains were inoculated using Steers multipoint inoculator. The inocula were seeded onto the surface of the culture medium in Petri dishes containing different dilutions of the mouthwashes. The dishes were incubated at 37ºC for 24 h. For readings, the MID was considered as the maximum dilution of mouthwash still capable of inhibiting microbial growth. The obtained data showed that CPC+Propolis had antimicrobial activity against 27 strains at 1/320 dilution and against all 28 strains at 1/160 dilution, CPC+Malva inhibited the growth of all 28 strains at 1/320 dilution, CPC+Eucaliptol+Juá+Romã+Propolis inhibited the growth of 2 strains at 1/640 dilution and all 28 strains at 1/320 dilution, and Cepacol® showed antimicrobial activity against 3 strains at 1/320 dilution and against all 28 strains at 1/160 dilution. Data were submitted to Kruskal-Wallis test, showing that the MID of Cepacol® was lower than that determined for the other products (p<0.05). In conclusion, CPC-mouthwashes showed antimicrobial activity against S. aureus and the addition of other substances to CPC improved its antimicrobial effect.