Chlorhexidine Mouthwash Research Articles

Comparison of Two Routinely Used Mouthwashes for Plaque Control Among Young Adults: An Observational Study

ABSTRACT Background: The most common and convenient technique to provide antiplaque medicines is through mouth rinses, which have the advantage of accessing places that are difficult for a toothbrush to clean. Chlorhexidine and Listerine mouthwashes were tested for their effectiveness when used in addition to routine teeth cleaning techniques. However, the studies assessing the antibacterial effects of these among young adults are diversified and limited. Materials and Methods: This comparative study was conducted among 240 schoolchildren. The participants were separated into three groups: A, B, and C. The research was conducted at two intervals of time, before therapy and during treatment period. The plaque was assessed through the plaque index (Turesky modification of Quigley-Hein plaque index (1970)). After a month, individuals had oral examination and were assessed. Results: Following the first week, a comparison of plaque scores was made between the three groups. Plaque score is lower in group C and group B than in group A in the succeeding second, third, and fourth weeks, but Tukey’s test results suggest that group C has a larger decrease in plaque than group B. Conclusion: According to this study, as compared to a placebo mouthwash, both a mouthwash containing 0.2% chlorhexidine and one containing phenol dramatically reduced plaque development and gingival irritation.

Comparative efficacy of Moringa oleifera and coconut oil-based mouthwashes versus chlorhexidine in reducing human oral microbial populations in healthy adults: a single blind clinical trial

IntroductionDentists have considered chlorhexidine as the gold standard antimicrobial solution against oral microbes for decades. The side effects of chlorhexidine and our historical reliance on natural remedies create the need for herbal alternative. This study evaluated the effectiveness of chlorhexidine, coconut oil, and moringa on the prevalence of human oral bacteria using a single-blind, randomised, clinical trial method. MethodsA total of 90 oral swabs were collected from consenting human participants on day 0 of the clinical trial. The participants were given either chlorhexidine (group A), coconut oil (group B), or Moringa oleifera (group C) mouthwashes and instructed to rinse for 14 days, twice daily. The participants were sampled again on day 14. Total plate count (TPC) and differential plate count (DPC) were done on both samples of each participant collected on day 0 and day 14. Bacteria were identified by standard biochemical tests. ResultsStreptococcus mitis, Veillonella parvula, Klebsiella aerogenes, Streptococcus mutans, Bacteroides fragilis, Aggregatibacter actinomycetecomitans, Streptococcus pneumoniae, and Staphylococcus aureus were isolated from the plaque. All 3 types of mouthwash exhibited statistically significant differences in TPC and DPC of day 0 and day 14 when compared using a paired t-test (P value = 0.03, 0.01, and <0.01 respectively). No statistically significant difference was noted in the antimicrobial activity of the three mouthwashes when compared using one-way ANOVA, post-hoc Tukey’s test. ConclusionOur results show that M. oleifera and coconut oil have a bactericidal effect on oral microbial populations associated with caries and periodontal disease, comparable to chlorhexidine.

Antibacterial Activity of Robusta Coffee (Coffea Canephora) Husk Extract Against Enterococcus Faecalis and Phorphyromonas Gingivalis: In Vitro Study

Enterococcus faecalis is one of the bacteria that is commonly found in infected root canals, necrotic pulp and failure of root canal treatment, while Phorphyromonas gingivalis play a role in inducing periodontitis. Both bacteria can enter the blood circulation and lead to risk factors for systemic disease such as atherosclerosis. ChKM is the most widely used root canal sterilization, and also 0.2 % chlorhexidine mouthwash for long-term usage. It can destroy a potent cell and is allergenic. Developing an alternative material for root canal sterilization and mouthwash for plaque control is necessary. One of the alternative natural products that is predicted to have antibacterial effect is robusta coffee husk peels. This research aimed to investigate the antibacterial activity of robusta coffee (Coffea canephora) husk extract on E. faecalis and P. gingivalis. The robusta coffee husk was extracted using the maceration process with 96 % ethanol as the solvent. This research is an experimental laboratory, was tested by disk diffusion methods (Kirby-Baurer) using Gram-positive E. faecalis ATCC 29212 and Gram-negative P. gingivalis ATCC 33277 consisted of 6 groups: Aquadest as a negative control group, ChKM (for E.facecalis) and 0.2 % chlorhexidine (for P. gingivalis) as positive control, 4 treatment groups of coffee robusta husk extract with different concentrations there were 250, 250, 500, 750 and 1,000 mg/mL. The antibacterial effect was examined by measuring the clear zone around the disk paper. The results of this study proved the presence of antibacterial activity of coffee robusta husk extract against E. faecalis and P. gingivalis. The higher concentrations followed with a greater antibacterial effect. HIGHLIGHTS Robusta coffee husk extract (Coffea canephora) has an antibacterial property against Gram-positive and Gram-negative bacteria Robusta coffee husk was extracted using the maceration process, and disk diffusion methods (Kirby-Baurer) for antibacterial test Robusta coffee husk extract with a concentration of 1,000 mg/mL showed the greatest inhibition zone. The higher the concentration, the bigger inhibition zone appeared GRAPHICAL ABSTRACT

Comparative evaluation of propolis mouthwash with 0.2% chlorhexidine mouthwash as an adjunct to mechanical therapy in improving the periodontitis among perimenopausal women: a randomized controlled trial

ObjectiveTo evaluate the efficacy of Propolis mouthwash compared to chlorhexidine mouthwash as an adjunct to mechanical therapy in improving clinical parameters in perimenopausal women with chronic periodontitis.MethodologyA double-blind, randomized, controlled clinical trial was conducted by recruiting 144 subjects with mild to moderate chronic periodontitis. After scaling and root planning, subjects were allocated to two treatment groups: 0.2% chlorhexidine mouthwash and 20% propolis mouthwash twice daily for six weeks. Clinical parameters such as pocket probing depth (PPD), clinical attachment loss (CAL) and bleeding on probing (BOP) were analysed at baseline, six weeks, and 12 weeks.ResultThe mean value of PPD in the propolis group was 4.67 at baseline, reduced to 4.01 at six weeks and 3.59 at 12 weeks. While in the chlorhexidine group, the baseline value of 4.65 reduced to 4.44 and 4.25 at six weeks and 12 weeks, respectively. The baseline value of the mean CAL in the propolis group was 4.45. This value was reduced to 4.15 at six weeks and 3.77 at 12 weeks. For the chlorhexidine group, the baseline value of CAL was 4.80, which was reduced to 4.50 and 4.19 at six weeks and 12 weeks. The mean value of bleeding on probing in the propolis group was 77.20, which decreased to 46.30 at six weeks and 14.60 at the final visit. In the chlorhexidine group, the mean value of 77.30 was reduced to 49.60 and 22.80 at subsequent visits.ConclusionThis study concludes that both propolis and chlorhexidine mouthwash positively improve clinical parameters; however, propolis is significantly more effective in improving BOP.Trial registrationID: NCT05870059, Date of Registration: 02/02/2022. (https://beta.clinicaltrials.gov/study/NCT05870059).

Evaluation of the effect of ozonated water in treatment of denture stomatitis associated with removable prosthetics

BackgroundOzone therapy is highly demarcated in the dental field owing to its efficient antimicrobial action in its gaseous and aqueous forms. One of the most common difficulties accompanied by utilizing dentures is denture stomatitis (DS) which is principally triggered by Candida albicans (C. albicans).ObjectivesAssessing and comparing the impact of ozonated water versus chlorhexidine mouthwash on healing of intra-oral inflammations associated with complete dentures.Subjects and methodsFifty middle-aged male completely edentulous patients wearing complete dentures were screened for the possibility of having any accompanied DS and/or C. albicans. Patients were randomly distributed into two groups. Group I patients were treated with chlorhexidine mouthwash and oral hygiene measures (OHM); while, Group II patients received ozonated water as a mouthwash and OHM. Evaluation of inflammation, pain grade, and oral Candidiasis count took place for all patients in all visits; from the initial day of treatment and after 7, 14, and 30 days.ResultsThe inflammation’s area and severity together with pain grade showed a significant decrease with time when using both chlorhexidine mouthwash and ozonated water. Comparing the use of chlorhexidine mouthwash and ozonated water together showed insignificant differences. Regarding the Candida forming units (CFU) there was a significant decrease in the colonies number over time, but with insignificant difference between the two groups.ConclusionsOzonated water showed favorable results in reducing the area and severity of inflammation and pain grade. Ozonated water has an antifungal effect and can be used as an alternative mouth rinse in treating denture stomatitis.

Comparative evaluation of different oil pulling agents and 0.2% chlorhexidine mouthwash as an adjunct to full-mouth scaling and root planing in plaque-induced gingivitis: A single-blind randomized control trial

Abstract Introduction: Oil pulling is old Indian natural daily practice which has been written in Ayurveda texts such as Charak and Sushruta Samhita. The act of swishing oil around the mouth removes microbes. Therefore, oil pulling reduces plaque-induced gingivitis. Naturally occurring products like coconut oil and sesame oil are enriched with antimicrobial activity. These oils are cheaper and easily available. Therefore, the aim of this article is to compare the efficacy of coconut, sesame oil, and chlorhexidine mouthwash as an adjunct to full-mouth scaling and root planing (SRP) in patients with plaque-induced gingivitis. Aim and Objectives: This study aimed to compare the efficacy of coconut oil sesame oil and chlorhexidine mouthwash as an adjunct to SRP in patients with plaque-induced gingivitis. Materials and Methods: Sixty patients of plaque-induced gingivitis were randomly divided into four groups: SRP, coconut oil, sesame oil, and chlorhexidine mouthwash. Clinical measurements included plaque index, gingival index (GI), and simplified oral hygiene index at baseline, 7 days, 15 days, 1 month, and 3 months. Microbial analysis was carried out. Results: There was a significant reduction in plaque and gingival scores from baseline to 3 months for the chlorhexidine group. Intragroup comparison shows a statistically significant reduction in plaque and GI. Conclusion: Oil pulling considers to affect microbes to treat plaque-induced gingivitis.

Drug-induced Stevens-Johnson syndrome in Post traumatic facial injury.

Stevens-Johnson syndrome is a severe adverse drug reaction affecting the skin and mucous membrane. The causes include Sulfonamides, Anticonvulsants, etc. A patient developed ulcerations in the lips and oral cavity with difficulty in swallowing and rashes over the back, abdomen, and genitalia following administration of injection ceftriaxone 1 g intravenous (IV) b.i.d, injection pantoprazole 40 mg IV b.i.d, tablet aceclofenac + paracetamol 325 mg b.i.d, tablet cetirizine 10 mg b.i.d, chlorhexidine mouth wash, and injection metronidazole 500 mg IV t.i.d for the treatment of traumatic facial injury after 4 days of treatment. Injection ceftriaxone and tablet aceclofenac + paracetamol were suspected as the cause of this reaction. The two drugs were stopped. The patient was treated with corticosteroids, other antimicrobials, and oral topical anesthetics. Health-care providers should be careful about the possible adverse drug reactions even to commonly used drugs.

Comparative evaluation of efficacy of a botanical oral rinse containing Punica granatum, grapefruit seed extract, thymol with chlorhexidine mouthwash on plaque and gingivitis

Comparative evaluation of efficacy of a botanical oral rinse containing Punica granatum, grapefruit seed extract, thymol with chlorhexidine mouthwash on plaque and gingivitis

Antibacterial, Antibiofilm, and Tooth Color Preservation Capacity of Magnesium Oxide Nanoparticles Varnish (in vitro Study).

Antibacterial and antibiofilm properties of magnesium oxide nanoparticles (MgONPs) mixture assessed against Streptococcus mutans (S. mutans), in addition to examining MgONPs varnish impact on the preservation of the tooth color and inhibition of methylene blue diffusion to the enamel. MgONPs mixture was prepared in deionized water (DW), absolute ethanol (E), and rosin with ethanol (RE), named varnish. The antibacterial and antibiofilm capacities of MgONPs mixtures were tested by agar well diffusion, colony-forming unit (CFU), and biofilm inhibition microtiter methods in triplicate and compared to sodium fluoride varnish (NaF) and chlorhexidine mouthwash (ChX). A spectrophotometer was used to record basic tooth color. The artificial demineralization was initiated for 96 h. Then, experimental materials were applied to the corresponding group, and 10-day pH cycles proceeded. Then, the color was recorded in the same ambient environment. The methylene blue diffusion was evaluated by staining the samples for 24 h. After that, the diffusion test was calculated by a digital camera attached to the stereomicroscope. The agar well diffusion test expressed a significant inhibition zone with all MgONPs mixtures (p = 0.000), and maximum inhibition zone diameter associated with MgONPs-RE. The same finding was observed in the CFU test. Additionally, 2.5%, 5%, and 10% MgONPs-RE varnish showed strong biofilm inhibition capacity (p = 0.039) compared to NaF and ChX groups that inhibit biofilm formation moderately (p = 0.003). The study shows that the 5% MgONPs-RE varnish maintains basic tooth color with minimal methylene blue diffusion compared to NaF varnish (p = 0.00). Evaluating MgONPs as a mixture revealed antibacterial and antibiofilm capacity against S. mutans with a higher effect of MgONPs-RE varnish. Also, examining the topical effect of MgONPs-RE varnish on the preservation of the tooth color after pH cycle challenges and methylene blue diffusion to enamel confirmed the high performance of MgONPs-RE varnish at 5%.

Efeitos de um enxaguatório liberador de oxigênio para manutenção da saúde peri-implantar. Estudo piloto clinico, randomizado e controlado

Abstract Introduction The control of peri-implant biofilm plays a crucial role in the long-term success of dental implants. Topical treatment alternatives aimed at reducing or preventing biofilm accumulation around the implant's prosthetic components are critical for the success of the treatment. Objective The present study has clinically evaluated the effects of an oxygen-releasing mouthwash (BlueM®) over a 90-day period, following implant placement surgery. Material and method Inclusion and exclusion criteria allowed for the selection of participants who, after implant placement, were randomized into two groups: the control group, which used a 0.12% chlorhexidine mouthwash, and the BlueM group, which received the oxygen-releasing BlueM mouthwash. All participants were instructed to rinse twice daily for the first 10 days and once a day up to 30 days post-surgery. Clinical parameters were evaluated, including the visible plaque index (VP), marginal bleeding (MB), presence of calculus (PC), suppuration (SUP), mucositis (MU), and the extent of keratinized gingiva (KG). These data were collected at the time of suture removal (baseline). At 90 days postoperative, in addition to the aforementioned parameters, probing depth (PD), bleeding on probing (BOP), and the presence of peri-implantitis (PI) were evaluated. Result Nine patients were included in this study, with a total of 38 implants. The BlueM group demonstrated a reduction in MB and an even greater reduction in VP. The other assessed parameters showed similar results to those in the control group. Conclusion BlueM mouthwash has clinical benefits for biofilm control and gingival inflammation reduction.

MODERN SCIENTIFIC TRENDS IN THE TREATMENT AND PREVENTION OF DENTAL CARIES

Background. Dental caries remains the most common disease of humanity today. The results of scientific research and clinical observations show that dental caries is most often treated surgically. The most effective way to reduce caries incidence is through primary prevention. Objective. The purpose of the study is to determine the current state of the problem of treatment and prevention of dental caries, to outline promising directions for solving this problem. Methods. In order to find out the main world trends in the treatment and prevention of dental caries, we studied the English-language papers of authors from Portugal, the USA, Saudi Arabia, Korea, Brazil, China, Argentina, the United Kingdom, Cote d'Ivoire, Italy, Ireland, Germany, France, Norway, Sweden, Denmark, Switzerland, Turkey, Belgium, Poland and Croatia published in 2019–2023, including literature reviews that tracked the fundamental data of previous years. The analysis of literary sources made it possible to determine that world scientists have made significant achievements with methodological and methodical conclusions, conducted a comparative assessment and proposed new ways to solve the problem in modern conditions. Results. The issue of modern scientific trends in the treatment and prevention of dental caries are presented in this paper. It was established that the main methods of primary prevention in dentistry were the use of sealants for pits and fissures, local professional use of fluoride preparations, use of fluorine-containing toothpaste, chlorhexidine mouthwash at home, use of xylitol, recommendations for regular visits to the dentist, adherence to a non-cariogenic diet and oral hygiene habits. An analysis of various treatment approaches for dental caries is presented. An evaluation of the proposed treatment methods was carried out in the aspect of a critical approach to preventive removal of hard tooth tissues. The main prospective directions for improvement of treatment and preventive measures are outlined. Conclusions. Dentistry should begin with the identification and elimination of cariesogenic factors, preventive measures should be dominant. With the elimination of carious disease, the need for related specialties will significantly decrease

Comparative Evaluation of Efficacy of Chlorhexidine with Centella asiatica in the Management of Stage 2 Grade B Periodontitis in Type 2 Diabetes Mellitus Patients − A Randomised Controlled Clinical Trial

Introduction: Chemical plaque control agents are used as an adjunct to non-surgical periodontal therapy. Adjunctives can assist in proper oral hygiene maintenance. Type 2 diabetes mellitus is a metabolic disease that can reflect in the periodontium. Periodontal disease prevention and management in Type 2 diabetes patients need routine dental care. Over counter mouthwashes used by patients can result in side effects; this has popularised the use of herbal mouthrinses that have minimal side effects. Aim: The present study aimed at evaluating the efficacy of chlorhexidine (CHX) with Centella asiatica in the management of Stage 2 Grade B periodontitis in type 2 diabetes mellitus patients. Materials and method: Seventy Type 2 diabetes mellitus patients with periodontitis were recruited for this study. In Group A, 35 subjects received scaling and root planing (SRP) and 10% C. asiatica mouthwash. In Group B, 35 subjects received SRP and 0.2% CHX mouthwash (Colgate-plax, Colgate-Palmolive). Clinical periodontal outcomes measured were plaque index (PI), gingival index (GI), bleeding on probing (BOP) and probing depth (PD) at baseline, 1 month and 3 months post therapy. Salivary total antioxidant capacity (TAOC) and Interleukin 1β levels were also measured at baseline and 3 months. Results: Clinical parameters PI, GI, BOP and PD were reduced significantly in groups A and B, post-treatment, 3-month follow-up. However, the intergroup comparison didnot show any significant difference. Salivary TAOC levels were significantly increased in both groups after 3 months therapy. The intergroup comparison of salivary TAOC levels between groups didnot show any significant difference. Salivary interleukin 1β levels were significantly reduced in both groups post-treatment. Conclusion: This study suggests the anti-inflammatory and antioxidant potential of C. asiatica mouthwash and a safe alternative to CHX mouthwash as an adjunct in the management of Stage 2 Grade B periodontitis in type 2 diabetes mellitus patients.

Evaluación comparativa de enjuague bucal con peróxido de hidrógeno y clorhexidina sobre los niveles de interleucina-1ß salival en pacientes con diabetes mellitus tipo 2 y periodontitis crónica: ensayo clínico controlado aleatorio

Introduction: Periodontal inflammation causes dysbiosis and change in the microbiota. Nonsurgical periodontal therapy (NSPT) helps in removal of plaque and restoring periodontal health. Various adjunctive therapy like use of mouthwash helps in maintenance of periodontal health and reducing inflammatory load. Materials and Methods: A total of 108 subjects diagnosed with type 2 diabetes mellitus and periodontitis were divided into three groups: Group 1 received NSPT and rinsing with 0.2% chlorhexidine mouthwash for 3 months, Group 2 received NSPT and rinsing with 1.5% hydrogen peroxide mouthwash for 3 months, Group 3- received NSPT only (control group). The clinical parameters measured included Plaque Index (PI), Gingival Index (GI), Bleeding on probing (BOP) and probing (PD) at baseline, 1, 2, 3 months follow up. Salivary interleukin 1βlevels were measured at baseline and 3 months interval. Results: Group 1, 2 and 3 showed significant reduction in PI, GI, BOP and PD at 1 and 3 months follow up (p&lt;0.05). However, Intergroup comparison of clinical parameters showed significant reduction in group 1 and 2 when compared with group 3 (p&lt;0.05). Salivary interleukin 1-β levels showed significant reduction from baseline to 3 months in all the three groups and intergroup comparison didn’t show any significant changes, (p&gt;0.05). Conclusions: Hydrogen peroxide mouthwash as an adjunct to NSPT can be considered as a safe and effective measure to reduce periodontal inflammation in type 2 diabetes mellitus patients with chronic periodontitis.

Antibacterial effect of resveratrol extract compared to chlorhexidine mouthwash against primary cariogenic pathogen, Streptococcus mutans.

Modern dental caries prevention methods have focused on using herbal products that ideally inhibit the critical cariogenic bacteria (Streptococcus mutans). The present study compared antibacterial efficacy of the resveratrol herbal extract and 0.12% chlorhexidine (CHX) against Streptococcus mutans (S. mutans). In this in vitro study the pure powder of resveratrol (Bulksupplement) was dissolved in dimethyl sulfoxide as its solvent to produce a 1000-µg/mL concentration of resveratrol solution, which was later used at different dilutions. The antibacterial effects of resveratrol solution and 0.12% CHX mouthrinse on the standard strain of S. mutans were determined using a minimum inhibitory concentration (MIC) test in a tube, minimum bactericidal concentration (MBC) test in a solid medium, and a well diffusion test to measure the zone of inhibition. The data were analyzed using Kruskal-Wallis, Bonferroni, and Man-Whitney tests (α=0.05). The MIC and MBC of resveratrol was 250 µg/mL. In addition, this extract exhibited a diameter of 6.67 mm for the inhibition zone at only the 1000-µg/mL concentration. The MIC of CHX was 15.6 µg/mL, and its MBC was 31.25 µg/mL. The highest growth inhibition zone of CHX was 16.67 mm. Resveratrol extract exhibited a dose-dependent antibacterial (bacteriostatic and bactericidal) activity against S. mutans. Although it was not as effective as CHX, it might be a suitable alternative to prevent dental caries. Key words:Antibacterial agents, Chlorhexidine digluconate, mouthwashe, resveratrol, streptococcus mutans.

Influence of Chairside Simulated Adjustment (Finishing and Polishing) Protocol andChlorhexidine Mouthwash Immersion onColor Stability and Translucency of 2 and 3 Preshaded Multilayered Monolithic Zirconia.

BACKGROUND Preshaded monolithic zirconia (MLZ) is reported to have high translucency. This study aimed to assess the effect of chlorhexidine gluconate (ChG) mouthwash on color and translucency parameter (TP) of 2 different preshaded MLZ dental ceramics after clinical adjustment. MATERIAL AND METHODS Two MLZ disk-shaped specimens [NPM (Nacera Pearl Multi-Shade) (n=72) and CZM (Ceramill Zolid FX Multilayer)] (n=72) were simulated for clinical adjustment, finished, and polished using 2 adjustment kits [recommended kit, third-party kit: Diasynt Plus and SUN (n=12 each)] and later immersed in ChG mouthwash (Avohex) for 2 weeks. Difference in color (ΔE) and TP (Y) were calculated using the CIELab formula after measuring the coordinates (Lab) with a colorimeter. Individual changes in color and TP were assessed on the Clinical acceptance (perceptible) threshold (CAT/CPT) and Translucency perception threshold (TPT), respectively. Differences between the 2 ceramics were assessed using one-way ANOVA and post hoc tests, with all differences considered significant at P<0.05. RESULTS NPM and CZM differed in color at baseline despite having the same Vita shade combination. Between the 2 preshaded MLZ ceramics, NPM showed significant changes in color when adjusted with a third-party kit. Chlorhexidine produced changes in color and TP that were designated as clinically perceptible (ΔE=1.0 to 3.3) on the CAT/CPT and TPT scales, irrespective of the adjustment kit used. ChG produced the least or no changes in glazed MLZ specimens. CONCLUSIONS ChG mouthwash, whenever prescribed for preshaded MLZ restoration, should be adjusted prior to final glazing to avoid clinical adjustments that adversely affects color and translucency of the restoration.

Effect of preoperative chlorhexidine, essential oil, and cetylpyridinium chloride mouthwashes on bacterial contamination during dental implant surgery: A randomized controlled clinical trial

BackgroundAlthough the role of chlorhexidine and other mouthwashes in periodontal therapy has been elucidated, little information is available on their use as routine preoperative mouth rinses before surgery, especially in periodontal procedures such as dental implant surgery. ObjectiveThis study aimed to compare the efficacy of preoperative chlorhexidine, essential oil, and cetylpyridinium chloride mouthwashes in reducing bacterial contamination at the time of implant placement. Materials and MethodsEligible patients who underwent dental implant surgery were randomly divided into four groups based on the mouthwash used: (1) 0.12 % chlorhexidine, (2) essential oil, (3) cetylpyridinium chloride, and (4) saline (served as the control group). All the patients of each group rinsed preoperatively with 15 mL of the respective mouthwash for 60 s. Saliva samples before (pre) and immediately after rinsing with the mouthwash (post) and after suturing the flap (end) were collected on the day of the implant placement. Real-time quantitative polymerase chain reaction (qPCR) was performed to analyze the samples and quantify the targeted periodontal pathogens using a propidium monoazide (PMA) dye. ResultsForty patients were included in the study. Real-time qPCR demonstrated a significant reduction in the number of pathogens in the saliva samples of the mouthwash groups compared to that of the control group. A statistically significant difference was observed between the groups for the pre–post and pre–end samples (p < 0.001) but not for the post–end samples (p = 0.203). A statistically significant difference was observed between the chlorhexidine, essential oil, and cetylpyridinium chloride mouthwash groups and the saline group (P < 0.001). The bacterial counts significantly differed with and without the use of the PMA dye. ConclusionsPreoperative chlorhexidine, essential oil, and cetylpyridinium chloride mouthwashes can reduce the bacterial load at the time of implant placement, thereby reducing the incidence of implant-related complications.

Mucormycosis of the Mandible and Tongue: A Systematic Scoping Review

Mucormycosis is a rare human infection associated with Mucorales, a group of filamentous moulds found in different environmental niches. Its oral manifestations may occur in the mandible and tongue despite being rare. We aimed to systematically review the data on clinical manifestations, risk factors, diagnostic approaches, treatment options, and outcomes of mandibular and tongue mucormycosis. An electronic search of articles published between January 1975 and November 2022 in PubMed, Web of Science, and EMBASE databases was performed. A total of 22 articles met the inclusion criteria and reported 27 cases of oral mucormycosis in total. Fourteen patients had mandibular mucormycosis signs unrelated to COVID-19 infection, 6 had SARS-CoV-2-related mandibular mucormycosis, and 6 had manifestations in the tongue. All published case reports during the COVID-19 pandemic were from India. Patient ages ranged from 4 months old to 82 years, and most patients had important comorbidities, such as blood dyscrasias related to immune deficiency and uncontrolled type 2 diabetes mellitus. The signs and symptoms of mandibular and tongue mucormycosis varied from dental pain, loose teeth, and nonhealing sockets to dysphagia and paraesthesia of the lip. Some patients also reported trismus, draining sinus tract, and facial pain. The diagnosis of oral mucormycosis was based on a combination of clinical, radiographic, and histopathologic findings by demonstrating fungal hyphae in tissue specimens. In most cases, mucormycosis was managed with systemic amphotericin B, strict glycaemic control, and aggressive surgical debridement of infected tissue, minimising the progression of the fungal infection and thus improving the survival rate. In some cases, combined antifungal therapy, antibiotic therapy, and chlorhexidine mouthwashes were used successfully. Recognition of the signs and symptoms by oral care providers is pertinent for the early diagnosis and treatment of tongue and mandibular mucormycosis, and providers should be aware of the possibility of this opportunistic fungal infection in patients with COVID-19. A multidisciplinary approach is recommended for the management of this lethal infection.

Effect of prepared herbal mouthwash in maintaining the oral health of school children: A single-blind randomised control trial

Background and aimOral health is a vital indicator of overall well-being, quality of life, and general health, with historical roots in Unani medicine (i.e. preventive measures, oral hygiene, and treatment). This study aims to assess the efficacy and safety of prepared herbal mouthwash in maintaining oral health among school children. Experimental procedure110 schoolchildren were randomly assigned to the test group (treated with herbal mouthwash -Anacyclus pyrenthrum DC, Punica granutum (pericarp), Capparis spinosa (root bark), and Quercus infectoria Oliv (galls)) and the control group (treated with 0.2 % Chlorhexidine Mouthwash) for 30-days. The response was assessed by DMFT, Salivary pH, Oral hygiene index-simplified (OHI-S), Plaque index (Loe & Silness) (PI), Plaque index simplified (O'Leary et al., 1972) (PI-S), Gingival Index (Löe-Silness) (GI), and Bleeding on probing (BOP) on baseline and 30th day GI and PI were further assessed on 60th, 90th and 120th days to determine the sustainable effect of the intervention. ResultsAfter treatment, Mean OHI-S, PI, PI-S, GI and BOP significantly reduced on the 30th day from baseline (p ≤ 0.001) in both groups. After discontinuing intervention, both groups showed significantly lower PI and GI scores on the 120th day from baseline. (p < 0.001). ConclusionThis study revealed that prepared mouthwash is safe and significantly effective in maintaining oral health, and it could be used as an adjunct to mechanical oral hygiene measures.

Comparative Assessment of Octenidine and Chlorhexidine Mouthwash in Gingivitis and Periodontitis Patient: A Clinical Trial

Background: A common and tried-and-true ingredient in mouthwashes that works well against the development of plaque, gingivitis, and oral microbial growth is chlorhexidine gluconate (CHX). However, when it must be taken for an extended period of time, its benefits are limited by the accompanying side effects, which include taste modification, cytotoxicity, supragingival calculus formation, mucosal irritation, and tooth discoloration. In the 1980s, octenidine dihydrochloride (OCT), a new antibacterial cationic surfactant molecule, was produced at the Sterling-Winthrop Research Institute in Rensselaer, NY. OCT binds to negatively charged microbial surfaces and has a strong adherence to lipid components, which causes disruption of the cell membrane of bacteria, yeast, and fungus. Aim: The purpose of the study was to evaluate the efficacy of mouthwashes with 0.1% octenidine and 0.2% chlorhexidine in patients with gingivitis and periodontitis. Material and Method: Participants in this clinical experiment were split into two groups, each consisting of forty patients with periodontitis and gingivitis. Next, as an addition to scaling and root planning (SRP), 20 patients from each group were provided chlorhexidine mouthwash and 20 patients were recommended to use octenidine mouthwash. At baseline and three months later, clinical measures such as the O’Leary plaque index (PI), bleeding index, probing pocket depth (POD), and clinical attachment loss (CAL) were assessed. Result: All clinical measurements showed that the Octenidine group performed much better than the chlorhexidine group in both the gingivitis and periodontitis groups. Conclusion: When compared to chlorhexidine, Octenidine performed better across all of the previously listed clinical parameters. As a result, it can be regarded as a promising mouthwash for upcoming medical and scientific investigations.

Comparison between mastic gum resin extract and chlorhexidine mouthwash in the prevention of biofilm formation on titanium dental implants.

The biofilm formation around dental implant abutment is considered the main cause of peri-implant infection. The use of antimicrobial mouthwash might potentially reduce biofilm formation and subsequent infection. This study aimed to evaluate the antibiofilm properties of mastic gum resin extract (MGRE) against S. Mutans biofilm on the surface of titanium dental implant discs. This study used grade five (medical grade) titanium dental implant discs measuring 15 mm in diameter. The substances in the MGRE were analyzed by gas chromatography mass spectrometry (GC-MS) which found 12 detectable chemicals in MGRE. In this study, S. mutans was collected around the healing abutment of a recently placed dental implant and then cultured on titanium discs (in vitro). After bacterial growth on the titanium specimens for 24 hours, they were subjected to either chlorhexidine gluconate (CHX), (n = 6) or MGRE (n = 6). The antibacterial activity tests showed that both CHX and MGRE significantly inhibited bacterial growth compared to the negative control, the lactate production and turbidity measurements were significantly lower in MGRE and CHX compared to the control (p ≤ 0.05). Regarding the antibiofilm activity, both treatments showed significantly less turbidity in their biofilm compared to the control. Moreover, scanning electron microscopy (SEM) images showed that there were very limited adherence cells on the titanium implant discs in treatment groups, while there were confluent and attached bacterial cells in the control. The MGRE showed an antimicrobial property against S. mutans indicating that it has a potential for clinical use as a mouthwash.