Cetylpyridinium Chloride Mouthrinse Research Articles

Antimicrobial effects of a new brushing solution concept on a multispecies in vitro biofilm model growing on titanium surfaces

To evaluate the antibiofilm and antibacterial effects of a new brushing solution concept, in a validated peri-implant biofilm model. A multispecies in vitro biofilm model, including Streptococcus oralis, Actinomyces naeslundii, Veillonella parvula, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis and Fusobacterium nucleatum, was used. To evaluate the antibiofilm capacity, titanium discs (Ti-SLA) were immersed in 1ml of the tested solution (one tablet dissolved in warm water) for 2min, prior and every 24h during a 3-day biofilm development. Negative (water) and positive (0.12% chlorhexidine/0.05% cetylpyridinium chloride mouth rinse) controls treated discs were run in parallel. To evaluate the antibacterial effects, planktonic cells and 72-h biofilms on sterile Ti-SLA discs were exposed (2min) to the mentioned treatments. Biofilm structure was analysed by confocal laser scanning microscopy (CLSM) and scanning electron microscopy (SEM). Bacterial load was measured by quantitative polymerase chain reaction and by culture in planktonic cells. The tested product showed antibiofilm effects, impacting on the 48-h and 72-h biofilm thickness and significantly reducing viability of all bacterial species, except A. actinomycetemcomitans. Antibacterial effects were observed against the six bacterial species in planktonic state and in 72-h biofilms, especially for F. nucleatum and A. actinomycetemcomitans. The tested brushing solution demonstrated antibacterial and antibiofilm properties, mainly against the peri-implant pathogens included in the validated in vitro biofilm model used.

A Systematic Review of the Potential Effects of Lippia sidoides on Dental Plaque and Periodontal Diseases.

Lippia sidoides is a typical shrub from Brazil that has been used in traditional medicine. This is a systematic review on the effect of L.sidoides for controlling dental plaque, gingivitis, and periodontitis. A database search through May 2021 in Medline/PubMed, SCOPUS, BVS, and Web of Science identified 711 reports of which 17 met our inclusion criteria. Five randomized controlled trials and three animal studies were included that compared L.sidoides-based products (toothpaste, mouthrinse, and gel) to cetylpyridinium chloride, chlorhexidine, and placebo products. Among the human studies, a significant antiplaque effect after treatment with L.sidoides-based products was observed in three studies and an antigingivitis effect in two studies, similar to chlorhexidine-based products. One study found superior dental plaque reduction compared to cetylpyridinium chloride mouthrinse. Only one study testing a L.sidoides gel found no antiplaque effect. Among the animal studies, an L.sidoides mouthrinse significantly reduced calculus in two studies, inflammatory infiltrate in one study, and plaque bacteria and gingivitis in one study. An L.sidoides gel significantly reduced alveolar bone loss and inflammatory response in one study in which mice were submitted to ligature-induced periodontal disease. In general, L.sidoides-based products were effective in reducing dental plaque and calculus formation, as well as clinical signs of gingivitis. As most studies present methodological limitations, these results should be interpreted carefully. Further clinical trials with greater methodological accuracy and control of biases are necessary for the use of L.sidoides-based products in humans to be viable in clinical practice.

Superiority of an essential oil mouthrinse when compared with a 0.05% cetylpyridinium chloride containing mouthrinse: a six-month study

To evaluate the antiplaque/antigingivitis effectiveness of an essential oils containing mouthrinse as compared to a 0.05% cetylpyridinium chloride mouthrinse. Generally healthy subjects with mild to moderate levels of plaque and gingivitis participated in a 6-month, examiner-blind, single centre, randomised, parallel-group controlled clinical trial. They were randomised into three mouthrinse groups--control (C), 0.05% cetylpyridinium chloride (CPC), or a fixed combination of essential oils (EO). Subjects received a dental prophylaxis at baseline and rinsed twice daily in addition to their usual oral hygiene for six months. Plaque Index and Modified Gingival Index were determined at 3 and 6 months. At 6 months, the EO group exhibited statistically significantly lower mean scores for MGI and PI than CPC (32.4% and 56.2% reductions, respectively). Compared to control, EO provided statistically significantly lower mean MGI and PI scores (36.3% and 69.7 %, respectively). The CPC group showed statistically significantly lower mean MGI and PI scores than the C group (5.8% and 30.7%, respectively). This study demonstrated the superiority of an EO rinse compared to a 0.05% CPC rinse in reducing plaque and gingivitis and confirmed that the daily use of an EO containing mouthrinse can provide a clinically significant benefit in reducing plaque and gingivitis.

The effect of cetylpyridinium chloride mouthrinse as adjunct to toothbrushing compared to placebo on interproximal plaque and gingival inflammation-a systematic review with meta-analyses.

The present study aimed to systematically review the literature about the interproximal anti-plaque and anti-gingivitis efficacy of cetylpyrydinium chloride (CPC) mouthrinse compared to placebo solution. Three databases (PUBMED, SCOPUS, and EMBASE) were searched for randomized clinical trials that compared the interproximal anti-plaque and anti-gingivitis effect of CPC and placebo mouthrinses as an adjunct to toothbrushing, after a minimum of 6 weeks. Individuals with any periodontal diagnosis were considered. Two meta-analyses were performed for the Turesky modification of the Quigley-Hein plaque index and the Löe and Silness gingival index. For both analyses, the mean differences (MD) between baseline and 6-weeks were calculated using a random-effect model. Eight studies were included. All included studies showed significant improvement in at least one of the parameters, favoring the CPC mouthrinse when compared to placebo. The meta-analysis demonstrated that groups that used CPC displayed a significantly greater reduction in the plaque index score (MD; 95% confidence interval [95%CI]: - 0.70; - 0.83 to - 0.57) and in the gingival index (MD; 95%CI: - 0.38; - 0.47 to - 0.28) when compared to placebo. However, high heterogeneity was observed in both analyses (I2 = 89% and I2 = 98%, respectively). When considering interproximal surfaces, CPC is efficacious both in plaque and gingival inflammatory parameters, demonstrating the potential to compensate for the limitations of interproximal plaque control. CPC may be a good alternative to compensate interproximal plaque removal, improving interproximal gingivitis.

Efficacy of a 0.03% chlorhexidine and 0.05% cetylpyridinium chloride mouth rinse in reducing inflammation around the teeth and implants: a randomized clinical trial.

To evaluate the efficacy of a 0.03% chlorhexidine (CHX) and 0.05% cetylpyridinium chloride (CPC) mouth rinse, as an adjunct to professional plaque removal (PPR) and mechanical hygiene, in the treatment of peri-implant mucositis (PiM) and gingivitis. Patients displaying PiM in, at least, one implant were included in this randomized, double-blinded, clinical trial. Subjects received PPR (at baseline and 6-month visits) and were instructed to rinse, twice daily, during 1year with the tested mouth rinse or a placebo. Clinical and patient-reported outcomes were recorded at baseline and 6 and 12months. Fifty-four patients were included in the study and 46 attended the final visit. In the teeth and implants with inflammation, a higher reduction in BOP was observed in the test group. Statistically significant differences between groups were only observed in the lingual sites of the teeth with gingivitis (mean difference = 11.96%; 95% confidence interval [1.09; 22.83]; p = 0.03). Overall, compliance and satisfaction were good, even though staining were higher for the test group (p < 0.05). The combined use of mechanical debridement with a 0.03% CHX and 0.05% CPC mouth rinse may have adjunctive benefits in the management of gingivitis, and it is associated with a higher degree of staining. The control of gingivitis can be improved, after professional mechanical debridement, with toothbrushing and the supplementary use of a 0.03% CHX and 0.05% CPC mouth rinse at home. NCT03533166.

Clinical effects of the adjunctive use of a 0.03% chlorhexidine and 0.05% cetylpyridinium chloride mouth rinse in the management of peri-implant diseases: A randomized clinical trial.

To evaluate the efficacy of a 0.03% chlorhexidine and 0.05% cetylpyridinium chloride mouth rinse, as an adjunct to professionally and patient-administered mechanical plaque removal, in the treatment of peri-implant mucositis (PiM). Patients displaying PiM in, at least, one implant were included in this randomized, double-blinded, clinical trial. Subjects received professional prophylaxis (baseline and 6months) and were instructed to regular oral hygiene practices and to rinse, twice daily, with the test or placebo mouth rinses, during one year. Clinical, radiographic and microbiological outcomes were evaluated at baseline, 6 and 12months. Disease resolution was defined as absence of bleeding on probing (BOP). Data were analysed by repeated measures ANOVA, Student's t and chi-square tests. Fifty-four patients were included and 46 attended the final visit (22 in control and 24 in test group). In the test group, there was a 24.49% greater reduction in BOP at the buccal sites (95% confidence interval [3.65-45.34%]; p=0.002) than in controls. About 58.3% of test implants and 50% controls showed healthy peri-implant tissues at final visit (p>0.05). The use of the test mouth rinse demonstrated some adjunctive benefits in the treatment of PiM. Complete disease resolution could not be achieved in every case.

The antiplaque and bleeding control effects of a cetylpyridinium chloride and tranexamic acid mouth rinse in patients with gingivitis.

PurposeThis study aimed to evaluate the effects of a cetylpyridinium chloride (CPC) and tranexamic acid (TXA) mouth rinse on patients with gingivitis.MethodsThis randomized, placebo-controlled, double-blind, parallel-group, clinical trial included 45 healthy adults with gingivitis, who were randomized into 2 groups. The experimental group used a 0.05% CPC and 0.05% TXA mouth rinse, and the control group used a placebo mouth rinse. The following clinical indices were assessed at baseline, at 3 weeks, and at 6 weeks: the Turesky-Quigley-Hein plaque index (QHI), the Löe-Silness gingival index (GI), and bleeding on marginal probing (BOMP). The subjects used the mouth rinse during the experimental period for 20 seconds, 4–5 times daily (10 mL each time).ResultsThere were no significant differences in the clinical indices between the groups at baseline. In the experimental group (CPC+TXA), a statistically significant improvement was evident in the QHI, GI, and BOMP at 3 and 6 weeks. These results were similar to those observed in the control group at 3 and 6 weeks, although the change in BOMP was not statistically significant in that group. At 6 weeks, the experimental group had a significantly lower mean score for the QHI than the control group.ConclusionsThis study demonstrated that a CPC and TXA mouth rinse exhibited significant antiplaque and anti-gingivitis efficacy, and had a positive effect on bleeding control when used daily for 6 weeks.

Evaluation of new chlorhexidine- and cetylpyridinium chloride-based mouthrinse formulations adjunctive to scaling and root planing: pilot study.

To compare the effect of two newly formulated chlorhexidine (CHX) and cetylpyridinium chloride (CPC) mouthrinses after scaling and root planing (SRP) in terms of clinical, microbiological, patient-based variables and adverse events, with a positive control with the same active components, already marketed and tested. A pilot, randomized clinical trial, double-blind, parallel design with 1-month follow-up was conducted. Chronic periodontitis patients requiring non-surgical periodontal therapy were enrolled and randomly assigned to: (i) SRP and test-1 (new reformulation: 0.12% CHX and 0.05% CPC); (ii) SRP and test-2 (new formulation: 0.03% CHX and 0.05% CPC); or (iii) SRP and positive control (commercial product: 0.12% CHX and 0.05% CPC). All variables were evaluated at baseline and 1 month after SRP. Quantitative variables were compared by means of anova or Kruskal-Wallis test and qualitative variables by chi-square or McNemar tests. Thirty patients (10 per group) were included. After 1 month, there were significant differences among groups in plaque levels (P = 0.016) as test-1 showed less sites with plaque than test-2 (31.15% [standard error-SE 2.21%] versus 49.39% [SE 4.60%), respectively). No significant differences were found for global patient perception of the product or in adverse effects. Test groups showed better results in levels and proportions (P = 0.022) of Capnocytophaga spp. Within the limitations of this pilot study, it can be concluded that the newly formulated 0.12% CHX and 0.05% CPC mouthrinse showed larger plaque level reductions, without showing more adverse effects, when compared to the other two mouthrinses, after SRP.

Cetylpyridinium chloride mouth rinses alleviate experimental gingivitis by inhibiting dental plaque maturation.

Oral rinses containing chemotherapeutic agents, such as cetylpyridinium chloride (CPC), can alleviate plaque-induced gingival infections, but how oral microbiota respond to these treatments in human population remains poorly understood. Via a double-blinded, randomised controlled trial of 91 subjects, the impact of CPC-containing oral rinses on supragingival plaque was investigated in experimental gingivitis, where the subjects, after a 21-day period of dental prophylaxis to achieve healthy gingivae, received either CPC rinses or water for 21 days. Within-subject temporal dynamics of plaque microbiota and symptoms of gingivitis were profiled via 16S ribosomal DNA gene pyrosequencing and assessment with the Mazza gingival index. Cetylpyridinium chloride conferred gingival benefits, as progression of gingival inflammation resulting from a lack of dental hygiene was significantly slower in the mouth rinse group than in the water group due to inhibition of 17 gingivitis-enriched bacterial genera. Tracking of plaque α and β diversity revealed that CPC treatment prevents acquisition of new taxa that would otherwise accumulate but maintains the original biodiversity of healthy plaques. Furthermore, CPC rinses reduced the size, local connectivity and microbiota-wide connectivity of the bacterial correlation network, particularly for nodes representing gingivitis-enriched taxa. The findings of this study provide mechanistic insights into the impact of oral rinses on the progression and maturation of dental plaque in the natural human population.

Malodor reductions and improved oral hygiene by toothbrushing and mouthrinsing

This clinical study compared the effects of an antibacterial regimen, comprising a triclosan toothpaste and a 0.075% cetylpyridinium chloride (CPC) mouthrinse, on malodor, self-reported malodor, and oral hygiene measures such as dental plaque, gingivitis, and bleeding relative to brushing with a fluoride toothpaste. At baseline, 36 subjects were evaluated for malodor (9-point organoleptic scale [OLT]), dental plaque (Turesky modification of Quigley-Hein; PI), gingivitis (Lφe-Silness; GI) and bleeding (Ainamo and Bay; BI) and randomized to (1) tooth brushing with fluoride toothpaste, or (2) a regimen comprising tooth brushing with a triclosan toothpaste and mouth rinsing with CPC mouthrinse. After the first use of assigned treatments, subjects were evaluated for malodor 2 h after breakfast (OLT-2 h) and used provided treatments for the next 14 days. On the 7 th and 14 th days, subjects refrained from oral hygiene for 12 h before evaluations (OLT, PI, GI, and BI) and then performed oral hygiene at the dental clinic. Subjects were evaluated for malodor 2 h after breakfast (OLT-2 h) and self-assessed their malodor on a 100 mm visual analog scale (VAS). Treatment groups demonstrated no significant differences in OLT, PI, GI, BI at baseline (P > 0.05). OLT-2 h scores after the first use of regimen and after tooth brushing alone were 5.94 and 6.21, respectively, and were statistically significantly different (P < 0.05). Correspondingly, the regimen demonstrated progressive reductions in OLT and OLT-2 h on the 7 th and 14 th day evaluations (5.81, 4.88, and 5.09, 4.20, respectively) and were significantly lower than after tooth brushing alone (6.49, 6.18, and 6.35, 5.99, respectively) (P < 0.05). From the 7 th to 14 th days, the regimen also demonstrated progressively lower PI, GI, BI, and self-reported malodor (VAS scores) which were significantly lower than tooth brushing alone (P < 0.05). Results from this study demonstrated that a regimen comprising a triclosan toothpaste and CPC mouthrinse demonstrated significant malodor reductions 2 h after the first use and progressively increasing reductions in malodor, dental plaque, gingivitis, bleeding and self-reported malodor from the 7 th to 14 th days than tooth brushing alone.

Inhibition of de novo plaque growth by a new 0.03% chlorhexidine mouth rinse formulation applying a non-brushing model: a randomized, double blind clinical trial.

The aim of this study was to investigate the plaque inhibitory effect of a new 0.03% chlorhexidine digluconate (CHX) and 0.05% cetylpyridinium chloride (CPC) mouthrinse formulation and to explore patients' experience and side effects after its use. This short-term, randomized, double blind, parallel, clinical trial enrolled 150 periodontally healthy patients. These volunteers were randomly allocated to one of following mouthrinse groups (n=50/group): 0.12% CHX+0.05% CPC (Perio-Aid® Treatment alcohol-free), 0.03% CHX+0.05% CPC new test formulation or to the placebo group. Clinical parameters (plaque, gingival, and stain indexes) and microbiological samples were taken at baseline, before supragingival cleaning, and after 4days of undisturbed plaque growth, rinsing twice/day with one of the mouthrinses. Plaque reduction was similar for the 0.12% CHX (-0.52±0.55) and 0.03% CHX (-0.47±0.49) groups. Both showed significant reductions in plaque accumulation compared to the placebo (p<0.001). The new formulation had less of a negative impact on taste perception when compared to the 0.12% CHX solution. The new CHX mouthrinse was also able to control bacterial loads and reduce some periodontopathogens. This study indicated that the new 0.03% CHX+0.05% CPC formulation exerted clinical efficacy similar to that achieved by an already-marketed 0.12% CHX+0.05% CPC mouthrinse, but with slightly fewer side effects. Lower CHX mouthrinse formulations could be effective in the inhibition of plaque regrowth with reduced unpleasant subjective side effects.

The effect of various oral hygiene products on the microbial flora in patients undergoing orthodontic treatment

Context Orthodontic devices lead to significantly greater plaque accumulation and gingival inflammation resulting in a change of gingival flora from cocci and rods to motile organisms like spirochetes. Aims The aim was to study the effect of various oral hygiene products on the microbial flora in patients undergoing orthodontic treatment. Materials and Methods The microbial composition of 40 patients, divided into four groups of 10 patients each, was evaluated. Group I patients were prescribed nonfluoridated dentifrice which act as the control group, Group II patients were given fluoridated dentifrice while in Group III and Group IV fluoridated mouth rinse and cetylpyridinium chloride mouth rinse, respectively, along with nonfluoridated toothpaste was prescribed. The plaque sample was collected at the start of orthodontic treatment, after 30 days, 60 days and 90 days for all the patients. The microscopic slides were prepared and observed under dark field microscopy at the magnification of ×1000 and microbes were classified as cocci, spirochetes, fusiforms, filaments, and rods. Results After applying analysis of variance and Tukey honest significant difference test, it was observed that after 30 days, only the proportion of filaments was found to be significantly higher in Group I. After 60 days, Group I had significantly lower proportion of cocci and a higher proportion of rods as compared to other groups. After 90 days, Group I had significantly higher count of rods, filaments, fusiforms, and spirochetes as compared to Groups III and IV. Conclusion Less amount of the microbial shift to the pathogenic organisms was seen in the patients in whom mouthwashes along with tooth brushing were prescribed.

Efficacy of a new mouth rinse formulation based on 0.07% cetylpyridinium chloride in the control of plaque and gingivitis: a 6‐month randomized clinical trial

To assess the efficacy of a 0.07% cetylpyridinium chloride (CPC) mouth rinse in the control of plaque and gingival inflammation during a 6-month period. Adult subjects with moderate gingivitis were selected [≥40% bleeding on marginal probing (BOMP)]. After retrieving microbiological samples and evaluating the clinical parameters (plaque, BOMP and stain indexes), a professional prophylaxis was performed and subjects were randomly assigned to the test (CPC mouth rinse) or to the placebo group. Subjects were re-assessed after 3 and 6 months. A total of 67 patients (35 test, 32 placebo) were included in the analysis. At 6 months, intra-group significant plaque reductions were observed in the test group (0.691, p < 0.001), but not in the placebo (0.181, p = 0.653). At 6 months, the mean BOMP values were lower in the test group (p = 0.052). Changes between baseline and 6 months were significantly higher in the test group both for plaque (p = 0.002) and BOMP (p = 0.037) when compared with the placebo. A microbiological impact was observed in the test group, especially for Prevotella intermedia. The evaluated 0.07% CPC-based mouth rinse, used three times per day adjunctively to mechanical tooth cleaning, prevents plaque accumulation and gingival inflammation, as compared to the placebo, for at least 6 months.

Antimicrobial efficacy of 0·05% cetylpyridinium chloride mouthrinses

This study evaluated the antimicrobial activity of two commercially available 0·05% cetylpyridinium chloride (CPC) mouthrinses with or without alcohol and examined its antimicrobial activity on oral bacterial species including fresh clinical isolates compared to a chlorhexidine mouthrinse and a control fluoride mouthrinse without CPC. Two different approaches were used to evaluate antimicrobial activity. First, the minimum inhibitory concentration (MIC) was determined for each mouthrinse against a panel of 25 micro-organisms including species associated with dental caries, gingivitis and periodontitis. Second, supragingival dental plaque obtained from 15 adults was incubated with the four mouthrinses to evaluate antimicrobial activity on micro-organisms in oral biofilms. Both CPC mouthrinses exhibited lower MIC's, that is, greater antimicrobial activity, against oral Gram-negative bacteria especially periodontal pathogens and species implicated in halitosis such as Aggregatibacter actinomycemcomitans, Campylobacter rectus, Eikenella corrodens, Porphyromonas gingivalis, Prevotella intermedia and Solobacterium moorei than the control mouthrinse. Ex-vivo tests on supragingival plaque micro-organisms demonstrated significantly greater antimicrobial activity by the CPC mouthrinses (>90% killing, P<0·001) and the chlorhexidine rinse (>98% killing, P<0·05) compared to the control fluoride mouthrinse. Whilst the chlorhexidine mouthrinse was most effective, mouthrinses containing 0·05% CPC formulated with or without alcohol demonstrated broad-spectrum antimicrobial activity against both laboratory strains and supragingival plaque bacteria compared to a control mouthrinse without CPC. These in vitro and ex-vivo studies provide a biological rationale for previous clinical studies demonstrating the efficacy of CPC mouthrinses in reducing supragingival plaque and plaque-associated gingivitis.

Short term clinical effectiveness of a 0.07% cetylpyridinium chloride mouth rinse in patients undergoing fixed orthodontic appliance treatment

To test the short term clinical effectiveness of commercially available 0.07%.cetylpyridinium chloride mouth rinse in patients undergoing fixed orthodontic treatment as compared to a placebo mouth rinse and patients using toothbrush and toothpaste. Forty-five subjects for this double blind study were assigned randomly into three groups of 15 each. Gingival inflammation, plaque accumulation, and bleeding on probing, were recorded at baseline (10days after prophylaxis), and at the end of one month in all the three groups and compared. Paired t test showed significant differences in bleeding index for pre and post treatment recordings for cetylpyridinium group. Modified gingival index showed no significant difference in the cetylpyridinium group. For plaque index significant difference was found for cetylpyridinium and control groups. Cetylpyridinium mouth rinse 0.7% was found to be effective in reducing the bleeding and plaque index scores. It was not effective in reducing the modified gingival index scores. Cetylpyridinium mouth rinse 0.07% improves the oral hygiene of orthodontic patients when used as an adjunct to normal oral hygiene measures.

Plaque inhibitory effect of a 0.05% cetyl-pyridinium chloride mouth-rinse in a 4-day non-brushing model

Results from clinical studies evaluating the efficacy of the adjunctive use of cetyl-pyridinium chloride (CPC) containing oral hygiene products have shown wide variability, probably due to differences in formulations. The objective of this study was to determine the inhibitory plaque effect of a 0.05% CPC mouth rinse in de novo plaque formation in a 4-day non-brushing experimental model. The study was designed as a short-term double-blind randomized cross-over experimental model aimed to compare three products: a negative control (similar to the test product, without active ingredients), a positive control (with 0.12% chlorhexidine and CPC) and the test product (with 0.05% CPC) in terms of plaque index, gingival inflammation and microbiological variables. Plaque levels after 4 days were 2.88 for the positive control, 3.86 for the negative control and 3.60 for the test. Differences among groups on day 4 were statistically significant (P < 0.001). Gingival index showed comparable values at baseline (P = 0.745), and significant increases were observed, with the exception of the positive control. Total colony forming units showed comparable values at baseline (P = 0.125) and significant increases were observed only in the negative control. The tested 0.05% CPC mouth-rinse is capable of inhibiting plaque formation.

Efficacy of a low‐concentration chlorhexidine mouth rinse in non‐compliant periodontitis patients attending a supportive periodontal care programme: a randomized clinical trial

To assess the clinical and microbiological efficacy of a 0.05% chlorhexidine and 0.05% cetyl-pyridinium chloride mouth rinse in supportive periodontal care (SPC) in patients with inadequate plaque control. The study was a randomized, double-blinded, placebo-controlled clinical trial in patients with moderate to severe chronic periodontitis under SPC with an inadequate plaque control (Turesky index >1). After supragingival prophylaxis and oral hygiene reinforcement, participants rinsed twice a day for 3 months with the test or placebo solutions, in addition to conventional hygiene. Primary clinical outcome variables included plaque and gingival indices. As secondary outcomes, periodontal and microbiological variables were studied. ancova and chi(2) tests were used to compare the variables. Forty-seven patients (22 placebo and 25 test group) participated. After 3 months, plaque levels increased in the placebo group, while diminished in the test group (p<0.001). Similar effects were found for bleeding on probing. The other clinical parameters did not show significant differences. Microbiological variables demonstrated inter-group significant reductions in subgingival counts of Fusobacterium nucleatum and Prevotella intermedia and a decrease of the total bacterial counts in saliva. The tested mouth rinse demonstrated efficacy in reducing plaque and gingivitis, as well as in decreasing the microbial load in saliva and gingival sulcus.

The plaque inhibitory effect of a CPC mouthrinse in a 3-day plaque accumulation model - a cross-over study

To test the plaque inhibitory effect of an experimental 0.07% cetylpyridinium chloride (CPC) mouthrinse in a 3-day plaque accumulation model in a cross-over design. A total of 30 subjects (non-dental students), ≥18 years of age, were randomly assigned to use one of three different mouthrinses three times a day. After 3 days, the subjects returned for the clinical assessments and received a questionnaire to evaluate their attitude towards the product used by them. The cross-over procedure was repeated twice to have all subjects use all products. A total of 29 subjects completed the protocol and this resulted in a statistically significant difference between the three groups (P < 0.001) with regard to plaque scores. Over three sessions, the mean plaque scores were 2.17 for the control product, 1.14 for the CPC group and 1.12 for the 0.1% Hexetidine product (positive control). Results of the questionnaire show that, compared with hexetidine, the taste of the CPC was appreciated better, and less oral sensations were observed following rinsing. The CPC mouthrinse proved to be effective in inhibiting 'de novo' plaque formation to an extent similar to that of a 0.1% hexetidine product. Compared with hexetidine, the taste of the CPC was appreciated better and less oral sensations were observed following rinsing.

A randomized, double-blind clinical study to assess the antimicrobial effects of a cetylpyridinium chloride mouth rinse on dental plaque bacteria

Background: Studies with cetylpyridinium chloride (CPC) mouth rinses that range from 1 use to 6 months of use have documented the clinical efficacy of these formulations on supragingival plaque and gingivitis. Objective: The objective of the present study was to compare the effects of a commercially available mouth rinse containing 0.05% CPC versus a fluoride mouth rinse on the anaerobic bacteria found in dental plaque. Antimicrobial effects on the organisms of the supragingival plaque, a natural biofilm, were determined after 1 use and after 14 days of use of each mouth rinse. Methods: After enrollment, adult subjects from China completed a 1-week washout period and provided baseline samples of supragingival plaque for analysis of anaerobic bacteria. Subjects were randomly assigned to receive a commercially available mouth rinse formulated with 0.05% CPC or a fluoride mouth rinse. Subjects were assigned to each group according to a computer-generated randomization sequence. They were instructed to rinse with 20 mL of either the CPC or the fluoride mouth rinse for 30 seconds. Microbiologic analyses of dental plaque samples were conducted 12 hours after the first use of assigned mouth rinse. Subjects were instructed to continue twice-daily rinsing with their assigned mouth rinse for the next 14 days in addition to brushing their teeth with a commercial fluoride toothpaste. Dental plaque samples for microbiologic analyses were collected on day 15; this was done 12 hours after the final use of the assigned mouth rinses. A dentist conducted oral examinations before each sample collection to evaluate hard and soft tissue health over the course of the study. Results: The study included 117 adults (62 females, mean age, 28.70 years; 55 males, mean age, 30.41 years). Subjects rinsing with the CPC mouthwash (n = 58; mean age, 29.41 years) reported significant reductions in anaerobic bacteria versus those issued the fluoride rinse (n = 59; mean age, 29.61 years) 12 hours after 1 use and 12 hours after 14 days of use ( P < 0.001). The mean percent reduction in anaerobic bacteria between the CPC mouth rinse and the fluoride mouth rinse was 29.98% after 1 use and 57.90% after 14 days of use. All enrolled subjects completed the study without any adverse events. Conclusion: Use of the CPC mouth rinse was associated with significant reductions in the anaerobic bacteria of supragingival plaque compared with fluoride mouth rinse use in these adult subjects.

Uncontrolled Randomized Clinical Trial Demonstrates Similar Long-Term (6 months) Antigingivitis and Antiplaque Efficacy for 2 Mouth Rinses: One that Uses Cetylpyridinium Chloride (CPC) as an Active Agent and the Other that Uses Essential Oils (EO) as an Active Agent

Article Title and Bibliographic Information Comparison of the effects of cetylpyridinium chloride with an essential oil mouth rinse on dental plaque and gingivitis—a six-month randomized controlled clinical trial Albert-Kiszely A, Pjetursson BE, Salvi GE, Witt J, Hamilton A, Persson GR, et al. J Clin Periodontol 2007;34(8):658-67 Level of Evidence 2 Purpose/Question The purpose of this study was to compare the long-term (6 months) clinical and microbiological effects of an experimental CPC mouth rinse with that of a commercially available and widely used EO mouth rinse in an unsupervised, uncontrolled 6-month randomized clinical trial. Source of Funding This study was supported by a grant from the manufacture of the experimental CPC mouth rinse, Procter & Gamble Company (Mason, OH), and by the Clinical Research Foundation (CRF) for the Promotion of Oral Health, University of Berne, Switzerland. Type of Study/Design This is a parallel randomized 2-group study that had no negative control.