Abstract
The necessitate for frequent application of Chlorhexidine (CHX), and other side effects has encouraged the search for option that are more suitable for patients as nanosilver mouthwash (NS). So the aim of this study was to determine the effects of a mouthwash made with nanosilver on dental plaque microbial counts and compare it with commercially available Chlorhexidine. Sixty-two plaque-induced gingivitis patients were allocated into two groups and asked to rinse with 10 ml of NS and CHX, immediately after brushing, for 1 min, in the morning and evening. Sub gingival plaque microbial counts were taken at baseline, two weeks, and finally at four weeks for each patient. Subsequently, the samples were collected, transferred and cultured in blood agar in anaerobic media. The colonies were counted and expressed as CFUs. The statistical analysis between CFUs variables within groups was calculated and the variation significance was calculated by performed t-test. It is very obvious that the values of CFU decreased significantly (p<0.001) as the time of use nanosilver until reaching the highest value when the time of use was 4 weeks [70.3±47 to 32.4±24.6 (2 weeks), and 14.2±9.9 (4 weeks) with inhibition of growth rate after 2 weeks was 46% and after 4 weeks was 79.7%. The effect of commercially available CHX mouthwash was approximately similar to the effect of NS mouthwash used. In conclusion, both Group I and Group II showed similar effect on inhibition anaerobic periodontal pathogens counts and gingival health. There was significant inhibitory effect on microbial counts where NS mouth-wash had shown better results than CHX, but there was no significant difference between the nanosilver mouth wash and the Chlorhexidine mouthwash.
 Peer Review History: 
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 Received file 
 
 Average Peer review marks at initial stage: 5.5/10
 Average Peer review marks at publication stage: 8.0/10
 Reviewer(s) detail:
 Name: Dr. Mohamed Salama
 Affiliation: Modern University for Technology & Information, Egypt
 E-mail: salama47@yahoo.com
 
 Name: Dr. Tamer Elhabibi
 Affiliation: Suez Canal University, Egypt
 E-mail: tamer_hassan@pharm.suez.edu.eg
 Comments of reviewer(s): 
Highlights
Various methods have been used to investigate the equivalence of the mouthwash in killing the bacteria, including polymerase chain reaction (PCR), culture procedures, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC)[18,19,20]
It was very obvious that the values of CFU decreased significantly (p
The current study results is different from positive result for NS over CHX that reported by Kariminik et al.,[27] which showed that NS mouthwash was more effective than CHX in killing bacteria
Summary
Over a period of time it has been observed that the cost for the preservative dentistry is similar to and possibly less than the cost of introduction and replacing dental restorations. An antibacterial agent that is effective and acceptable to adults and children will be a useful supplement to current techniques for the prevention of caries[2]. The last 10 years review papers suggest that at the current level of exposure nanosilver may not be hazardous to humans and may result in low internal exposure[6,7,8]. In this circumstance, a study was undertaken to ascertain the effects of a mouthwash prepared with nanosilver on the dental plaque, gingival inflammation, and microbial counts in adults, and to compare the effect of it with commercially available Chlorhexidine mouthwash
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