Chlorhexidine Mouthwash Research Articles

Comparing the efficacy of Chlorhexidine Mouthwash and Natural Honey in Reducing Plaque and Improving Gingival Health. A Randomized Controlled Trial

Comparing the efficacy of Chlorhexidine Mouthwash and Natural Honey in Reducing Plaque and Improving Gingival Health. A Randomized Controlled Trial

Corrosion of copper nickel titanium archwire in chlorhexidine, sodium fluoride, and chitosan mouthwashes

Background Copper (Cu), nickel (Ni), chromium (Cr) ion release, and surface topography change from the orthodontic wire are the initial processes of corrosion that may affect the mechanical properties of the archwire. In this study, we aim to evaluate the effect of CHX, NaF, and chitosan on the corrosion of CuNiTi wire nickel and copper ions released, surface roughness change, and archwire deflection. Methods Ninety samples of CuNiTi Tanzo™ archwires were divided into five groups according to their immersion solution: Artificial Saliva, CHX, NaF, CHX-NaF, and chitosan group. Each group was further divided into three subgroups (n=6) corresponding immersion time, i.e., two, four, and six weeks. The corrosion of the samples was analyzed with an atomic absorption spectrophotometer (AAS), scanning electron microscope (SEM), and universal testing machine (UTM). Results The amount of nickel ion releases was increasing, but the copper ion releases were reduced by the time of observations. The highest nickel ion was released in the CHX-NaF group and the lowest in the chitosan group for six-week immersion. It also corresponded to the surface topography by SEM analysis which showed the most extended cracks and deep pits in the CHX-NaF group and a smoother surface in the chitosan group. Copper ion release showed the highest ion release in the NaF group and the lowest release in the chitosan group. The unloading force of CuNiTi archwire deflection remains the same at week two and week four for all mouthwashes. Conclusion The use of mouthwashes that contained CHX, NaF, and chitosan could further alter the passive layer and cause higher nickel and copper ion release and increased CuNiTi archwire surface structure porosity. But there is no distinction between mouthwashes to release the unloading force within two until four weeks.

Effect of propolis mouthwash on the incidence of ventilator-associated pneumonia in intensive care unit patients: a comparative randomized triple-blind clinical trial

ObjectivesVentilator-associated pneumonia (VAP) increases the length of hospitalization and mortality rate. This study aimed to determine the effect of propolis mouthwash on the incidence of VAP in intensive care unit (ICU) patients.Materials and methodsTriple-blind, comparative randomized, controlled clinical trial was conducted over one year, with 110 ICU patients at Imam-Hossein and Bahar hospitals (Shahroud) and Kowsar Hospital (Semnan) in Iran. The intervention group used 15 cc of 0.06% propolis mouthwash solution twice daily at 8 AM and 4 PM for seven days. The control group used 15 cc of 0.2% chlorhexidine mouthwash at the same times and duration. Data were collected using a demographic questionnaire, APACHE II, Beck Oral Assessment Scale, and Modified Clinical Pulmonary Infection Score (MCPIS).ResultsThere was no significant difference in demographic information, disease severity, and oral health between the two groups before and after intervention (P > 0.05). The incidence of VAP in the intervention group compared to the control group was 10.9% vs. 30.9% on the third day (P = 0.0166, 95% CI: 0.53–0.83 and RR = 0.35), 23.6% vs. 43.6% on the fifth day (P = 0.0325 and 95% CI: 0.31–0.95 and RR = 0.54), and 25.5% vs. 47.3% on the seventh day (P = 0.0224, 95% CI: 0.32–0.92, and RR = 0.54). The Mann–Whitney indicated the incidence of VAP was significantly lower in the intervention group on the third, fifth, and seventh days.ConclusionPropolis mouthwash can be considered as an alternative to chlorhexidine mouthwash for ICU patients.Clinical relevancePropolis mouthwash serves as a simple, economical intervention to potentially reduce incidence of VAP.Trial registration(IRCT20110427006318N12, date 02.04.2019).

Comparative evaluation of the efficacy of Triphala mouthwash and Curcumin mouthwash in the treatment of gingivitis – A randomized controlled study

BackgroundNumerous studies on Triphala and Curcumin mouthwashes were analyzed individually and no study has compared the efficacy of Triphala mouthwash to Curcumin mouthwash in the management of gingivitis. Although various mouthwashes have shown reduction of plaque and gingivitis the search is still on for an ideal mouthwash with minimum side effects and better patient acceptance. ObjectivesTo access the efficacy of all the mouthwashes in the management of gingivitis. MethodsBy purposive sampling, 81 patients of both sexes with gingivitis were randomized by lottery method into 3 groups - A, B and C. Group A received scaling and Triphala mouthwash, Group B received scaling and Curcumin mouthwash and Group C underwent scaling and received Chlorhexidine mouthwash. Oral hygiene was assessed using Plaque, Gingival and Bleeding indices at baseline,7th day and 14th day. The inter-group comparisons were analysed using One-way analysis of variance (ANOVA) and multiple comparisons using Tukey's Honest significant difference test (α = 0.05) and the intra-group comparisons for the indices across various time periods within each group were analysed using Repeated-measures ANOVA and Bonferroni-adjusted pairwise comparisons post hoc test (α = 0.05). The statistical significance was set at p ≤ 0.05. ResultsThe study has shown that herbal mouthwashes are as effective as chlorhexidine in treating gingivitis although curcumin mouthwash showed a greater potential in reducing gingival inflammation. ConclusionBoth Triphala and Curcumin mouthwashes were proven to be equally effective in reducing plaque, gingival and bleeding scores, although curcumin was better in reducing gingival inflammation. Hence herbal mouthwashes such as Triphala and Curcumin with no side effects can be considered as an alternative mouthwash to chlorhexidine.

Hyperpure chlorine dioxide versus chlorhexidine in intra-oral halitosis (ODOR trial) – protocol of a double-blinded, double-arm, parallel non-inferiority pilot randomized controlled trial

IntroductionIntra-oral halitosis (IOH) is the most common type of bad breath; its consequences impair quality of life. However, evidence-based treatment protocols and guidelines are lacking. Our aim is to investigate the effectiveness of chlorine dioxide as an applicable complementary treatment modality in IOH after tongue cleaning.Methods and analysisThe ODOR trial will be a single-center, double-blinded, parallel-group, double-armed pilot randomized controlled trial with a non-inferiority design. The efficacy of hyperpure chlorine dioxide will be compared to chlorhexidine mouthwash. We plan to investigate the short-term effects of the intervention over a 3-h period. The primary endpoint will be changes in organoleptic test scores. At the end of the pilot investigation of the first 30 patients each, sample size calculation will be performed. If feasible, the investigators will continue the study by enrolling more patients.Trial registrationThe trial has been registered at ClinicalTrials.gov (NCT06219226).

Biological Evaluation of Oral Care Products Using 3D Tissue-Engineered In Vitro Models of Plaque-Induced Gingivitis.

The aim of this study was to investigate and visualize the anti-inflammatory and anti-bacterial effects of different oral care products using an infected and inflamed 3D tissue-engineered gingival mucosal model. A 3D full-thickness oral mucosal model was engineered inside tissue culture inserts using collagen hydrogels populated with human gingival fibroblasts and THP-1 monocytes and layered with oral epithelial cell lines. Oral saliva bacteria were cultured and added to the surface of the models and inflammation was further simulated with lipopolysaccharide (LPS) of Escherichia coli. The 3D models were exposed to three different types of toothpastes, a chlorhexidine antiseptic mouthwash, different antibiotics, and a mechanical rinse with phosphate-buffered saline (PBS) prior to biological evaluation using the PrestoBlue tissue viability assay, histology, optical coherence tomography (OCT), confocal microscopy, and measurement of the release of the inflammatory markers IL-1β, IL-6, and IL-8 with ELISA. Multiple-endpoint analyses of the infected oral mucosal models treated with different anti-bacterial agents showed consistent outcomes in terms of tissue viability, histology, OCT, and confocal microscopy findings. In terms of anti-inflammatory testings, the positive control group showed the highest level of inflammation compared with all other groups. Depending on the anti-bacterial and anti-inflammatory potential of the test groups, different levels of inflammation were observed in the test groups. The inflamed 3D oral mucosal model developed in this study has the potential to be used as a suitable in vitro model for testing the biocompatibility, anti-inflammatory, and anti-bacterial properties of oral care products including mouthwashes and toothpastes. The results of this study indicate that the chlorhexidine mouthwash has both anti-bacterial and cytotoxic effects on the 3D oral mucosal model. Hyaluronic-acid-containing toothpaste has significant anti-bacterial and anti-inflammatory effects on the 3D oral mucosal model.

Comparative evaluation of microhardness of three restorative materials after immersion in chlorhexidine mouthwash: An in vitro study

Aim: To evaluate and compare the microhardness of Filtek Z250XT, Beautifil II, and Neo Spectra ST HV after immersion in chlorhexidine mouthwash. Materials and Methods: Thirty disc specimens (10 for each group) made of three different restorative materials, Group 1 – Filtek (3M ESPE), Group 2 – Beautifil II (Shofu), and Group 3 – Neo Spectra ST HV (Dentsply). To simulate 1 year of daily mouthwash use, 10 specimens from each group were immersed in chlorhexidine, kept in an incubator at 37°C for 12 h, and later subjected to microhardness measurement using Vicker’s hardness test. Finally, analysis of variance and post hoc tests were used to analyze the results statistically. Results: A significant reduction in microhardness was observed after immersion in chlorhexidine in Groups 1 and 3 compared to Group 2. Conclusions: Filtek Z250XT exhibits the highest microhardness compared to the other two materials. However, Beautifil II is more resistant to chlorhexidine mouthwash and does not show a significant reduction compared to the other two restorative materials.

Comparative evaluation of the efficacy of probiotic, Aloe vera, povidine-iodine, and chlorhexidine mouthwashes in the treatment of gingival inflammation: A randomized controlled trial.

Chemical plaque control with mouthwashes as an adjunct to mechanical plaque control with a toothbrush and dental floss has been considered an effective method for controlling gingivitis. The anti-inflammatory effects of chemical plaque control benefit the oral tissues by reducing inflammation and bleeding. The aim of the present study was to evaluate and compare the clinical efficacy of probiotic, Aloe vera, povidine-iodine, and chlorhexidine (CHX) mouthwashes in treating gingivitis patients by assessing changes in their clinical parameters. This prospective study was conducted on 40 patients from our outpatient department, divided into 4 groups of 10 patients each: probiotic mouthwash group (group 1); herbal (Aloe vera) mouthwash group (group 2); povidone-iodine mouthwash group (group 3); and CHX mouthwash group (group 4). All participants were provided with the same type of manual toothbrush, the Pepsodent® toothpaste and a respective mouthwash for twice-daily use until the end of a 28-day observation period. Clinical parameters, such as the marginal plaque index (MPI) and bleeding on interdental brushing (BOIB), were recorded at baseline, and on the 14th and 28th day of the study period. All groups showed a significant decrease in the MPI and BOIB scores. The results were similar in patients who used a probiotic mouthwash and those who used a CHX mouthwash. A comparable change in the mean scores was observed among the herbal and povidone-iodine groups from baseline to day 28. In the treatment of chronic gingivitis patients,a probiotic mouthwash was nearly as effective as CHX in reducing the plaque and bleeding scores. It showed better results in all clinical parameters than herbal and povidone-iodine mouthwashes. Using a mouthwash along with routine tooth brushing can help in treating gingivitis and slow the progression of the periodontal disease.

Essential Oils from the Perspective of Dentistry

Introduction: With a significant increase in interest in recent years regarding essential oils, the purpose of this work was to identify how Dentistry has researched and utilized these substances through an integrative review of articles available in indexed databases. The bibliographic survey was conducted in November and December 2022, through electronic research, consulting the Pubmed and LILACS databases. The descriptors and boolean operators used were: "volatile oils" OR "essential oils" AND "dentistry". The material published between 2018 and 2022 indexed in the mentioned databases and with a free version was included. Studies that did not address the proposed study theme were excluded. Material and Method: Out of 104 scientific articles found, 29 studies were reviewed and analyzed. Result and Discussion: A variety of plant derivatives have been studied for their inhibitory effect on C. albicans biofilms and for cytotoxicity, several are considered promising for the development of future research and bioproducts applicable to human health. Clinical studies indicated that the EOs from Pelargonium graveolens and Zataria multiflora are potentially effective in treating oral candidiasis, and the most promising EOs were obtained from Allium tubeorosum, Cinnamomum cassia, Cinnamomum zeylanicum, and Coriandrum sativum L. Further non-clinical and clinical studies with these EOs are necessary to determine their potential use and safety for the treatment of oral candidiasis. Listerine mouthwash was often compared with other chemical agents, mainly chlorhexidine, which in terms of plaque control is considered the gold standard in efficacy and substantivity. However, the use of chlorhexidine has disadvantages like altered taste sensations, teeth discoloration. With all this, the World Health Organization (WHO) recommended that researchers analyze the use of natural products, such as extracts of herbs and plants, to combat these negative effects. In another randomized study, they concluded that the mouthwash containing aqueous extracts of essential oils was as effective antibacterial agents as chlorhexidine mouthwashes, corroborating with other descriptive and experimental studies. Conclusion: The articles demonstrated extensive study regarding essential oils in Dentistry, presenting various applications that are still being explored: they have potential in the development of preventive or therapeutic agents for various oral diseases, use in dental materials, and popular applications. There is still a need for more clinical trials to establish safety and efficacy in oral health due to the wide variety of existing essential oils.

Comparative effectiveness of Propolis with chlorhexidine mouthwash on gingivitis – a randomized controlled clinical study

BackgroundTo assess and compare the effectiveness of propolis mouthwash with chlorhexidine mouthwash in the reduction of plaque and gingivitis.MethodsA single centre, latin-square cross-over, double masked, randomized controlled clinical trial was conducted on 45 chronic generalized gingivitis subjects who were chosen from the dental clinic of MAHSA University, Malaysia. A total of 45 subjects were randomly assigned into one of the three different groups (n = 15 each) using a computer-generated random allocation sequence: Group A Propolis mouthwash; Group B Chlorhexidine mouthwash; and Group C Placebo mouthwash. Supragingival plaque and gingival inflammation were assessed by full mouth Plaque index (PI) and gingival index (GI) at baseline and after 21 days. The study was divided into three phases, each phase lasted for 21 days separated by a washout period of 15 days in between them. Groups A, B and C were treated with 0.2% Propolis, Chlorhexidine, and Placebo mouthwash, respectively, in phase I. The study subjects were instructed to use the assigned mouthwash twice daily for 1 min for 21 days. On day 22nd, the subjects were recalled for measurement of PI and GI. After phase I, mouthwash was crossed over as dictated by the Latin square design in phase II and III.ResultsAt baseline, intergroup comparison revealed no statistically significant difference between Groups A, B and C (p > 0.05). On day 21, one-way ANOVA revealed statistically significant difference between the three groups for PI (p < 0.001) and GI (p < 0.001). Bonferroni post-hoc test showed statistically significant difference between Propolis and Chlorhexidine mouthwash (P < 0.001), with higher reduction in the mean plaque and gingival scores in propolis group compared to chlorhexidine and placebo groups.ConclusionsPropolis mouthwash demonstrated significant improvement in gingival health and plaque reduction. Thus, it could be used as an effective herbal mouthwash alternative to chlorhexidine mouthwash.Trial registrationThe trial was retrospectively registered on 25/07/2019 at clinicaltrials.gov and its identifier is NCT04032548.

Evaluation of different mouthwashes through their effect on their influence on the force loss of orthodontic elastic ligatures

Background: In several orthodontic treatments, elastomeric chains are utilised to produce force, however, this force degrades over time, which may impact tooth mobility. This study aims to investigate how different mouthwashes (Chlorhexidine 0.2%, Sensodyne, and Listerine) may affect the force degradation of two different types of elastic ligatures (Ortho Matrix and 3M Unitek) through the amount of force remaining. Materials and methods: Two control groups and six experimental groups each included 600 pieces of the elastomeric chains Ortho matrix (OM) and 3M Unitek (3M). Pieces were stretched to a 25mm thickness, placed on pins set into an acrylic block, and kept at 37°C in artificial saliva. For the duration of the study, each of the test groups spent one minute immersed in one of three distinct kinds of mouthwash. Ten continuous thermocyclers with temperatures ranging from 5 to 55 degrees Celsius were performed each day, alternating between cold and hot water baths. While calculating the forces, we considered six different time intervals: the beginning, 24 hours, 1, 2, 4, and 6 weeks. The one-way analysis of variance (ANOVA) test and the t-test were used to compare the mean force of a number of different mouthwashes, elastomeric chains, and times. A value of 0.05 was chosen as the cutoff for statistical significance. Results: Over time, both types of elastomeric chains significantly lost force at 6 weeks (p&lt;0.05). At all times, the 3M Unitek (3M) created more force than the Ortho matrix (OM) elastomeric chain. Compared to other mouthwashes, chlorhexidine mouthwash had a substantially less impact on force degradation, with discernible very simple change when compared to control groups (Artificial saliva). Conclusion: According to findings, the 3M Unitek offered a higher force level than the other sort of elastomeric chains, and there is a difference that is clinically significant between the two types of elastomeric chains. It is possible that the pH of the mouthwashes, as opposed to other substances, contributes to the gradual loss of power over time. Mouthwashes containing chlorhexidine had the third-smallest influence on the force degradation of elastomeric chains, after Sensodyne and Listerine..

Antibacterial Effect of Mouth Rinsing with a Solution Containing 1.6% Syzygium aromaticum Extract against Streptococcus mutans: An In vivo Randomized Controlled Trial

Background and Objective: Clove (Syzygium aromaticum) extract has antimicrobial and antioxidant potential. The objective was to assess and compare the salivary Streptococcus mutans counts on Mitis Salivarius Bacterium agar plates after 1 h of mouth rinsing with 30 mL solutions containing S. aromaticum and 0.2% chlorhexidine among 18–30-year-old adults in a clinical setting. Methodology: Sixteen participants fulfilling the eligibility criteria were randomized into two groups. Group A: rinsed with 0.16% S. aromaticum extract mouth rinse and Group B: rinsed with 0.2% chlorhexidine mouthwash. Saliva samples of the participants were collected before and 1 h after mouth rinsing with 30 mL of interventional mouth rinse, for S. mutans count analysis. IBM SPSS Statistics for Windows version 20 (IBM Corp., Armonk, N.Y., USA) was used for statistical analysis. The significance level was fixed at P &lt; 0.05. Intra and Intergroup comparison of microbial counts was done using the Wilcoxon signed–rank test and Mann–Whitney U-test, respectively. Results: The results of the study showed that there was a significant reduction in salivary S. mutans counts in both the groups postmouth rinsing with interventional solutions (P &lt; 0.05). However, the intergroup comparison revealed that, in the chlorhexidine group, there was significantly more reduction in salivary S. mutans counts compared to S. aromaticum mouth rinsing group (P = 0.02). Conclusion: There was a reduction in salivary S. mutans counts after mouth rinsing with a solution containing S. aromaticum. Hence, clove mouth rinse could be an effective aid for the prevention and control of dental caries since it is safe and culturally acceptable.

Effectiveness of Moringa oleifera Mouthwash in Young Adults as an Anti Plaque Agent – An Interventional Study

Background: Periodontitis is a chronic inflammatory disease affecting the oral cavity’s supportive structures, including gums and surrounding bone. Herbal mouthwashes have phytopharmacological agents such as Moringa oleifera (MO), and the use of herbal mouthwash has increased. Moringa mouthwash has potential for oral health due to its biocompatibility and anti-inflammatory effect. This study compares the effect of chlorhexidine gluconate (CHX) and moringa mouthwash on plaque and its reduction. Methodology: The in vitro tests included the determination of minimum inhibitory concentration using broth dilution and agar diffusion. This interventional study included 25 individuals with more than 1 plaque score. The study was conducted for 2 months with a washout period of 2 weeks between the use of both mouthwashes. The Quigley–Hein Plaque Index of the study subjects was recorded at the designated baseline and after 28 days of use throughout the study period. The statistical test used was the Wilcoxon signed-rank test, and the level of significance was considered to be &lt;0.05. Results: The results showed that the reduction in the mean plaque scores from baseline to day 28 was statistically significant in the moringa-based mouthwash. Similarly, the index scores showed a statistically significant reduction following the use of the moringa-based mouthwash when compared with the gold-standard chlorhexidine mouthwash with P = 0.00. The comparison showed that MO offered the same improvement as CHX. Conclusion: The current study aimed to provide an insight role of MO mouthwash as a possible adjunctive oral hygiene aid and its inhibitory effect on plaque reduction when compared to CHX.

A Clinico - Microbial Study to Assess the Benefits of Medicinal Plant Extracts in Chronic Periodontitis

Background: There has been an increasing trend for the development of natural formulations for plaque control using medicinal plants as an adjunct, which can be a feasible alternative as these are widely available, cost-effective, and have fewer side effects. Aim: The evaluation of the effects of medicinal plant extracts in chronic periodontitis (CP). Materials and Methods: This study was carried out in two phases; first the antibacterial activity of two medicinal plant extracts was tested on periodontal pathogens, thereafter, a clinical assessment was carried out on subjects with CP. Forty-five individuals suffering from CP were randomized into three different groups; Group A: Scaling and root planing (SRP) along with Piper longum rinse, Group B: SRP along with mixture of Tinospora cordifolia and P. longum rinse, Group C: SRP along with chlorhexidine (CHX) (control group). The clinical parameters (gingival index [GI], plaque index, gingival bleeding index [BI], probing pocket depth [PPD], and clinical attachment level [CAL]) were recorded at baseline and months 1 and 3. The intra- and intergroup comparison of clinical parameters for all groups at different time intervals was performed. Results: At the end of the trial, all the three groups showed a statistically significant reduction when compared to baseline for all the clinical parameters. In intergroup comparison, statistically significant reduction in GI, PPD, and CAL for both Group A and Group C was seen at 3 months as compared to Group B. Comparable reduction was seen between Group A and C for all the clinical parameters. Reduction in plaque and gingival BI was seen to be highest in Group A. Conclusion: P. longum can be effectively utilized as an additive to mechanical periodontal treatment in comparison to CHX mouthwash for CP patients.

Surgical Site Infection Prevention Strategies in Cardiac Surgery: A Systematic Review

Background: Cardiac surgery becomes one of surgical procedure that has potential for develop several complications including surgical site infection (SSI). Despite the case is still very common, SSI can be regarded as the most preventable, especially when the treatment approach used, because there are many risk factors associated with the target. This systematic review aims to assess the effectiveness of interventions strategies used to reduce the incident of SSI in cardiac surgery. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines provide a standardized framework for conducting and reporting systematic reviews. A comprehensive search was conducted across major electronic databases, The following database were PubMed, Scopus and ProQuest. The inclusion criteria were clinical and a randomized control trial published between 2018 to 2023. The primary outcome measure was SSI rates. Results: The studies encompassed diverse perioperative intervention strategies, such as pre operative nasal ointment, pre operative showering and shaving, chlorhexidine mouthwash, and negative pressure therapy. In total, 436.762 articles regarding SSI prevention strategies in cardiac surgery were found in this study. However, around 7 articles that were met with the criteria of this study. Conclusion: Actions to reduce the incidence of SSI are carried out at all perioperative stages. The action taken was modifying the intervention and also using additional therapy carried out by health workers.

Efficacy of adjunctive octenidine hydrochloride as compared to chlorhexidine and placebo as adjuncts to instrumentation in stage I-II periodontitis: A double-blinded randomized controlled trial.

This randomized, controlled, double-blinded clinical trial aimed to evaluate the efficacy of octenidine hydrochloride and chlorhexidine mouthwashes as adjuncts to instrumentation in stage I-II periodontitis patients. Forty-five patients with mild-to-moderate periodontitis were randomly allocated to three groups: 0.1% octenidine dihydrochloride (OCT), placebo, and 0.12% chlorhexidine (CHX) mouthwashes. Patients were instructed to use the mouthwash after instrumentation for twice a day up to 3 weeks. Periodontal parameters such as probing pocket depth (PPD), clinical attachment loss (CAL), O'Leary plaque index (PI), Loe and Silness gingival index (GI), Lobene stain index (SI), and oral soft tissue changes were recorded at baseline and once every week for 3 weeks. The visual analogue scale (VAS) was also recorded as a self-administered questionnaire at the end of the study. The one-way ANOVA was used to compare VAS scores between the groups. The repeated measures ANOVA and post hoc Newman-Keuls tests were used to assess the differences in the periodontal parameters between groups at different time intervals. The Kruskal-Wallis test was used to compare the mean SI. There was a significant reduction in the mean GI of the OCT and CHX groups compared to placebo (p < 0.05). OCT usage resulted in significantly less staining, according to mean SI, when compared to CHX. Furthermore, VAS scores revealed that OCT was significantly the preferred mouthwash (p < 0.01). Adjunctive octenidine hydrochloride may be an alternative to chlorhexidine in its ability to control the periodontal parameters in patients with stage I-II periodontitis. Further larger studies are necessary to confirm these findings.

MANAGEMENT OF COATED TONGUE RESEMBLES PSEUDOMEMBRANOUS CANDIDIASIS IN A MULTIDRUG-THERAPY PATIENT

Introduction: Coated tongue or tongue coating is characterized by white deposit covering dorsum of the tongue. The thick-coated tongue almost resembles oral candidiasis. It is challenging to make the diagnosis and provide the proper treatment especially when supporting examination tools are unavailable. Objective: To discuss the diagnosis making and management of coated tongue with suspicion of pseudomembranous candidiasis with a lack of supporting examination tools. Case(s): A 61-year-old man was referred to the Oral Medicine Clinic for oral examination. No complaints of pain in the oral cavity. He had a history of type-2 diabetes mellitus, coronary heart disease (CHD), and pleuritis and was taking medication. During hospitalization, never cleaned his oral cavity. Case Management: Intraorally, white plaque covering almost the entire dorsum of the tongue, which could be scraped off on the anterior 1/3 but not on the posterior 2/3. The diagnosis was suspected coated tongue with oral candidiasis as the differential diagnosis. The treatments were compressing the tongue using gauze soaked in 3% hydrogen peroxide (H2O2) solution, scrapping off using a tongue scraper, then rinsing with water. The thick-coated tongue can be easily removed. He was also given 0,2% chlorhexidine gluconate (CHX) mouthwash as an antiseptic and petroleum jelly for dry lips. The tongue condition improved on 2nd day therapy after rinsing regularly using 0,2% CHX. Conclusion: Recognizing the signs, symptoms, and associated factors of Candida infection is important. Coated tongue which resembles pseudomembranous candidiasis was successfully treated using 3% H2O2 compresses, tongue scraping, and 0.2% CHX mouthwash. Keywords: Chlorhexidine gluconate, Coated tongue, Hydrogen peroxide, Infection, Oral candidiasis

In Vitro Effects of Chlorhexidine and Listerine Mouthwashes on Color Stability of Glazed Bilayer Zirconia and IPS E.Max Ceramics

In Vitro Effects of Chlorhexidine and Listerine Mouthwashes on Color Stability of Glazed Bilayer Zirconia and IPS E.Max Ceramics

Subgingival microbial changes in Down Syndrome adults with periodontitis after chlorhexidine adjunct non-surgical therapy and monthly recalls–A 12-month case series study

ObjectivesDown Syndrome (DS) adults are at risk for periodontitis. Previous reports indicated difficulties in periodontopathogen reduction or eradication in DS individuals after periodontal treatment. This case series follows the subgingival microbial changes in adult DS individuals with periodontitis who received chlorhexidine adjunct non-surgical therapy plus 12-month recalls. MethodsTwenty periodontitis DS participants (7 females; 25.5 ± 5.6 years of age; 3 with generalized periodontitis) partook in a study involving non-surgical mechanical periodontal therapy, twice daily chlorhexidine gel toothbrushing, chlorhexidine mouthwash, and monthly recalls. The subgingival microbiota profile was followed at baseline, 6-, and 12-months post-operation. ResultsDesulfobulbus, Saccharibacteria (TM7), Tannerella, and Porphyromonas were the major subgingival genera in this DS cohort. Favorable chlorhexidine adjunct non-surgical treatment outcomes were observed, with the relative abundance of Desulfobulbus sp. HMT 041, Saccharibacteria (TM7) [G-1] bacterium HMT 346 or 349, and Tannerella forsythia significantly reduced at the end of the study, but no significant reduction of Porphyromonas gingivalis or Aggregatibacter actinomycetemcomitans could be observed. Relative abundance of Desulfobulbus sp. HMT 041 and T. forsythia were also found to be significantly associated with plaque, bleeding on probing, and probing pocket depth (PPD, in mm) at a site level, while the relative abundance of Halomonas pacifica was negatively associated with PPD. ConclusionsSuccessful chlorhexidine adjunct non-surgical treatment with hygiene care was accompanied by a subgingival microbial shift involving certain periodontopathogenic species, except P. gingivalis and A. actinomycetemcomitans. Further investigations are required to clarify the mechanism underpinning the unchanged relative abundance of the above two pathogens despite favorable clinical responses. Clinical SignificanceDS adults face challenges achieving optimal home care or hygiene for periodontal healing and disease prevention. Chemical adjunct mechanical periodontal therapy plus regular recalls appeared promising clinically and microbiologically, with subgingival periodontopathogenic species reduction. The persistence of A. actinomycetemcomitans and P. gingivalis in subgingival niches post-treatment warrants further investigation.

In vitro Study of the Synergistic Effect of Different Concentrations of Chlorhexidine Mouthwash and Ethanolic Extract of Pinus Gerardiana on Oral Pathogens (Streptococcus Mutans and Candida Albicans)

Introduction: Tooth decay is the most common chronic disease in the world. Streptococcus mutans is the most important bacteria that cause tooth decay. The most common chemical method to prevent tooth decay is using mouthwash. Chlorhexidine is used as a standard mouthwash. The use of herbal compounds with antibacterial effect is preferable to chlorhexidine due to less side effects. The purpose of this study was to investigate the combination of different concentrations of chlorhexidine mouthwash and ethanol extract of Pinus gerardiana medicinal plant on oral pathogens (Streptococcus mutans and Candida albicans). Method: A combination of different concentrations of chlorhexidine mouthwash and ethanol extract of Pinus gerardiana medicinal plant was prepared and its effect in different dilution against Streptococcus mutans and Candida albicans was investigated by disc diffusion, well diffusion, and prevention of biofilm formation methods. Results: The results of disc diffusion, well diffusion, and biofilm method showed that the ethanolic extract of Pinus gerardiana medicinal plant alone had no significant antimicrobial effect on Streptococcus mutans and Candida albicans and it was not comparable to chlorhexidine. Conclusion: According to the findings of this study, the antibacterial and antifungal effects of chlorhexidine gradually increased with the increase in concentration, and 0.2% chlorhexidine had the highest inhibitory effect on bacteria and fungi under the present study.