Octenidine Research Articles

The efficacy of combination of sodium hypochlorite (NaOCL)/hypochlorous acid (HOCL) in wound management: A systematic review and network meta-analysis

Introduction Antiseptic and antibacterial solutions are increasingly used in the treatment of various types of wounds. The successful stabilization of wounds using a combination Sodium Hypochlorite/Hypochlorous acid (NaOCl/HOCl) or superoxidized solution (SOS) has been reported, serving as an effective solution without irritating mammal cells and without posing a carcinogenic hazard. Presently, no systematic review or meta-analysis is available that compares the effectiveness of these antiseptic solutions. The present study aims to investigate the role of NaOCl/HOCl in the treatment of wounds. Methods The systematic review with extended to network meta-analysis (NMA) was conducted using NaOCl/HOCl, povidone-iodine, octenidine dihydrochloride, polyhexamethylene biguanide, alcohol, and silver compared with normal saline. The primary outcome was wound healing. Using surface under the cumulative ranking curve (SUCRA), the direct and indirect comparisons were conducted with the probability of selecting the best treatment. Results A total of 507 studies were identified from PUBMED and SCOPUS databases, and 64 articles were duplicates. Among 29 studies included, 22 randomized controlled trials (RCTs) and 7 cohort studies met our inclusion criteria. NaOCl/HOCl had a higher chance of wound healing 1.07-1.30 times compared with all the regimens. NaOCl/HOCl has the probability of providing the best treatment, followed by silver and octenidine with SUCRAs of 36.9, 23.1, and 21.8, respectively. Conclusions NaOCl/HOCl ranks first and proves to have the highest efficacy, followed by silver, octenidine, and PHMB for treatment.

Comparative evaluation of antimicrobial efficacy of 0.1% octenidine dihydrochloride, superoxidized solution, ozonated water, 0.1% silver nanoparticle solution, and Q mix™ 2 in 1 in root canals infected with Enterococcus faecalis

Abstract Introduction: The objective of this study was to compare and evaluate the antimicrobial efficacy of 0.1% octenidine dihydrochloride, superoxidized solution, ozonated water, 0.1% silver nanoparticles (AgNp) solution, and Q mix™ 2 in 1 in root canals infected with Enterococcus faecalis. Methodology: One hundred and fifty permanent mandibular premolars were inoculated with E. faecalis (0.5 McFarland standards) were incubated at 37°C for 7 days after which preoperative microbial sampling was done and the number of viable E. faecalis cells was obtained as CFU/mL. The specimens were irrigated with 0.1% octenidine dihydrochloride (group 1), Q mix™ 2 in 1 (group 2), super oxidized solution (group 3), 0.1% AgNp solution (group 4), ozonated water (group 5), and normal saline (group 6) during mechanical instrumentation. The final irrigation was followed by microbial sampling and the number of viable E. faecalis cells was obtained as CFU/mL. Statistical Analysis: Data were analyzed by paired t-test and ANOVA with Tukey’s post hoc test. Results: Paired t-test showed a statistically significant difference between mean CFU before and after irrigation in groups I, II, III, IV, and V respectively (P < 0.05). Group VI showed no statistically significant difference between CFU before and after irrigation (P = 0.131). Conclusion: The mean bacterial reduction was statistically significant for all the study groups, proving their good antibacterial activity against E. faecalis in root canals whereas 0.1% octenidine dihydrochloride and ozonated water demonstrated relatively higher antimicrobial potential.

Evaluating the Expression of Efflux Pumps in Pseudomonas aeruginosa in Exposure to Sodium Dodecyl Sulfate, Didecyldimethylammonium Chloride, and Octenidine Dihydrochloride.

Emerging resistance of Gram-negative bacteria, including Pseudomonas aeruginosa, to commonly used detergents and disinfectant is encountering us with hazard. Inappropriate use of disinfectants has forced bacteria to gain resistance. The ability of bacteria to extrude substrates from the cellular interior to the external environment has enabled them to persist in exposure to toxic compounds, which is due to existence of transport proteins. Efflux pumps, in Gram-negative bacteria, are proteins responsible for exporting molecules outside of the cell, by crossing the two membranes. In this study, 40 P. aeruginosa strains from hospitals, clinics, and burn center laundries and 40 P. aeruginosa strains from urban laundries were collected. This study evaluated the minimum inhibitory concentration (MIC) level of sodium dodecyl sulfate (SDS), didecyldimethylammonium chloride (DDAC), and octenidine dihydrochloride (Od) in P. aeruginosa strains. The real-time PCR was carried out to evaluate the expression of MexAB-OprM, MexCD-OprJ, and MexXY-OprM efflux system. The obtained results indicated a higher MIC level for SDS, DDAC, and Od in medical laundries. The sub-MIC level of DDAC and Od increased the expression level of MexAB-OprM, MexCD-OprJ, and MexXY-OprM in P. aeruginosa strains, suggesting that efflux pumps contribute to disinfectant resistance in P. aeruginosa.

Comparison of the antibacterial effect of experimental primary tooth canal pastes containing octenidine dihydrochloride and calcium hydroxide: An in vitro study

Comparison of the antibacterial effect of experimental primary tooth canal pastes containing octenidine dihydrochloride and calcium hydroxide: An in vitro study

Synthesis and broad-spectrum biocidal effect of novel gemini quaternary ammonium compounds

Since the discovery of antimicrobial agents, the misuse of antibiotics has led to the emergence of bacterial strains resistant to both antibiotics and common disinfectants like quaternary ammonium compounds (QACs). A new class, ’gemini’ QACs, which contain two polar heads, has shown promise. Octenidine (OCT), a representative of this group, is effective against resistant microorganisms but has limitations such as low solubility and high cytotoxicity. In this study, we developed 16 novel OCT derivatives. These compounds were subjected to in silico screening to predict their membrane permeation. Testing against nosocomial bacterial strains (G+ and G-) and their biofilms revealed that most compounds were highly effective against G+ bacteria, while compounds 7, 8, and 10–12 were effective against G- bacteria. Notably, compounds 6–8 were significantly more effective than OCT and BAC standards across the bacterial panel. Compound 12 stood out due to its low cytotoxicity and broad-spectrum antimicrobial activity, comparable to OCT. It also demonstrated impressive antifungal activity. Compound 1 was highly selective to fungi and four times more effective than OCT without its cytotoxicity. Several compounds, including 4, 6, 8, 9, 10, and 12, showed strong virucidal activity against murine cytomegalovirus and herpes simplex virus 1. In conclusion, these gemini QACs, especially compound 12, offer a promising alternative to current disinfectants, addressing emerging resistances with their enhanced antimicrobial, antifungal, and virucidal properties.

The influence of the pectin structure on the properties of hydrogel dressings doped with octenidine-containing antiseptic

This article presents a method for producing hydrogel dressings using high methylated pectin from apples or citrus, doped with the antiseptic agent, octenidine dihydrochloride. Octenidine was incorporated in-situ during the polymer crosslinking. The pectins were characterized by their varying molecular weight characteristics, monosaccharide composition, and degree of esterification (DE). The study assessed the feasibility of producing biologically active hydrogels with pectin and delved into how the polymer's characteristics affect the properties of the resulting dressings. The structure evaluation of hydrogel materials showed interactions between individual components of the system and their dependence on the type of used pectin. Both the antimicrobial properties and cytotoxicity of the dressings were evaluated. The results suggest that the primary determinants of the functional attributes of the hydrogels are the molecular weight characteristics and the DE of the pectin. As these values rise, there is an increase in polymer-polymer interactions, overshadowing polymer-additive interactions. This intensification strengthens the mechanical and thermal stability of the hydrogels and enhances the release of active components into the surrounding environment. Biological evaluations demonstrated the ability of octenidine to be released from the dressings and effectively inhibit the growth of microbial pathogens.

Identification of mechanisms modulating chlorhexidine and octenidine susceptibility in Proteus mirabilis.

We aimed to identify mechanisms underlying the tolerance of Proteus mirabilis-a common cause of catheter associated urinary tract infection-to the clinically used biocides chlorhexidine (CHD) and octenidine (OCT). We adapted three clinical isolates to grow at concentrations of 512µg ml-1 CHD and 128µg ml-1 OCT. Genetic characterization and complementation studies revealed mutations inactivating the smvR repressor and increasing smvA efflux expression were associated with adaptation to both biocides. Mutations in mipA (encoding the MltA interacting protein) were less prevalent than smvR mutations and only identified in CHD adapted populations. Mutations in the rppA response regulator were exclusive to one adapted isolate and were linked with reduced polymyxin B susceptibility and a predicted gain of function after biocide adaptation. Biocide adaptation had no impact on crystalline biofilm formation. SmvR inactivation is a key mechanism in both CHD and OCT tolerance. MipA inactivation alone confers moderate protection against CHD, and rppA showed no direct role in either CHD or OCT susceptibility.

Bio-based modification of polyhydroxyalkanoates (PHA) towards increased antimicrobial activities and reduced cytotoxicity

With the increased occurrence of bacteria resistance to conventional antibiotics, the development of novel antimicrobials is urgently needed. Traditional biomaterials used for delivering these agents often struggle to achieve sustained release while maintaining non-cytotoxic properties. In this study, we present an innovative approach using bacterial polyhydroxyalkanoates (PHA) as a carrier for antimicrobial delivery, specifically designed for wound healing applications. Octenidine dihydrochloride (OCT), a widely used antimicrobial agent, served as our model drug. To achieve the desired balance of OCT release and low cytotoxicity, we introduced a novel bio-derived additive, 3-hydroxy-pentadecanoic acid (3OHC15), extracted from bacteria. This additive significantly improved the hydrophilicity of PHA films, resulting in enhanced and sustained release of OCT. Importantly, the additive did not adversely affect the material's tensile strength or thermal properties. The increased OCT release led to improved antibacterial activity against both Gram-negative and -positive strains. Most notably, the incorporation of 3OHC15 in PHA mitigated the cytotoxic effects of the released drug on human fibroblasts, ensuring biocompatibility. This work represents a novel strategy in the design of biomaterials for the delivery of bioactive compounds, achieving a critical balance between efficacy and cytocompatibility, and marks a significant advancement in the field of antimicrobial delivery systems.

Evaluation of postoperative pain in endodontic retreatment with apical periodontitis using ozonated 2% chlorhexidine and 0.1% octenidine application: A randomized clinical trial.

This study aimed to evaluate and compare postoperative pain (PP) in single-visit nonsurgical endodontic retreatment (SV NSER) with 2% chlorhexidine (CHX), 0.1% octenidine (OCT) with or without ozone, and 5.25% sodium hypochlorite (NaOCl). In this randomized, parallel, prospective, double-blind, clinical trial, 132 single-rooted, root-filled teeth with symptomatic apical periodontitis (AP) requiring NSER were allocated into six groups randomly (n = 22/group): 2% CHX with NaOCl (CHXH), 2% Ozonated CHX without NaOCl (OCHX), 2% Ozonated CHX with NaOCl (OCHXH), 0.1% OCT with NaOCl (OCTH), 0.1% Ozonated OCT without NaOCl (OOCT), and 0.1% Ozonated OCT with NaOCl (OOCTH). Standard NSER protocol was followed groups were irrigated with 15 ml of ozonated or nonozonated irrigant (CHX/OCT) for 3-5 min with ultrasonic agitation. PP at baseline, after 6, 12, 24, 48 h, and 7 days was recorded using the Visual Analog Scale (VAS). Logistic regression of predictor variables was compared using the Chi-square test. For group-wise and time-wise comparisons, a two-way analysis of variance followed by the post hoc Bonferroni test was carried out. None of the patient-related variables in logistic regression obtained a statistically significant (P > 0.05) role in PP. The VAS score after 6 h was OCHX (4.72) > OOCT (4.42) > CHXH (4.23) > OCTH (3.95) > OCHXH (3.42) > OOCTH (3.21). OOCTH and OCHXH groups demonstrated statistically significant reductions in VAS scores at various time intervals (P < 0.05). SV NSER with ozonated OCT, CHX irrigation, and NaOCl resulted in lesser PP at all time intervals, i.e., 6, 12, 24, 48 h, and 7 days in patients with symptomatic AP.

Self-Assembled Hydrogel Membranes with Structurally Tunable Mechanical and Biological Properties.

Using supramolecular self-assembled nanocomposite materials made from protein and polysaccharide components is becoming more popular because of their unique properties, such as biodegradability, hierarchical structures, and tunable multifunctionality. However, the fabrication of these materials in a reproducible way remains a challenge. This study presents a new evaporation-induced self-assembly method producing layered hydrogel membranes (LHMs) using tropocollagen grafted by partially deacetylated chitin nanocrystals (CO-g-ChNCs). ChNCs help stabilize tropocollagen's helical conformation and fibrillar structure by forming a hierarchical microstructure through chemical and physical interactions. The LHMs show improved mechanical properties, cytocompatibility, and the ability to control drug release using octenidine dihydrochloride (OCT) as a drug model. Because of the high synergetic performance between CO and ChNCs, the modulus, strength, and toughness increased significantly compared to native CO. The biocompatibility of LHM was tested using the normal human dermal fibroblast (NHDF) and the human osteosarcoma cell line (Saos-2). Cytocompatibility and cell adhesion improved with the introduction of ChNCs. The extracted ChNCs are used as a reinforcing nanofiller to enhance the performance properties of tropocollagen hydrogel membranes and provide new insights into the design of novel LHMs that could be used for various medical applications, such as control of drug release in the skin and bone tissue regeneration.

The effect of octenidine dihydrochloride on the antibacterial activity of a formulated resin composite: an in vitro study

BackgroundIt has been noticed that failure of composite resin restorations can be attributed to either of the two following causes: fracture or secondary caries. For that reason, it is mandatory to formulate a restorative material with antibacterial effect. An octenidine dihydrochloride (OCT) has been assessed as an alternative to antimicrobial material, such as chlorhexidine due to their higher microbicidal effect and less cytotoxicity.ObjectiveCurrent study aimed to add different concentrations of octenidine dihydrochloride into experimental flowable resin composite and evaluate its antibacterial activity over different periods of time to provide the manufacturers with more precise information.MethodsA flowable resin composite material mix was formulated. Octenidine dihydrochloride antibacterial material was then added separately to the formulated mix at 1% wt. and 1.5% wt. concentration, respectively. Antibacterial activity was assessed against Streptococcus mutans using agar diffusion test and compared to a commercial resin composite.ResultsIt showed that by increasing the percentage of incorporated octenidine dihydrochloride (1% and 1.5%), respectively, the antibacterial efficacy against the Streptococcus mutans increased. Results of this study also showed the time had a significant decrease in the antibacterial effect.ConclusionsIt can be concluded that by the incorporation of octenidine dihydrochloride (1% and 1.5%), respectively, the antibacterial efficacy against the Streptococcus mutans increased. Time had a significant decrease in the antibacterial effect of OCT.

Comprehensive Assessment of the Efficacy of Chitosan-Based Wound Dressings in Combination With Various Antiseptics

Comprehensive Assessment of the Efficacy of Chitosan-Based Wound Dressings in Combination With Various Antiseptics

Octenidine exposure was not associated with reduced octenidine susceptibility of meticillin-resistant Staphylococcus aureus in an extended-care facility in Singapore

Antiseptics such as chlorhexidine gluconate (CHG) and octenidine dihydrochloride (OCT) are frequently used in hospitals to prevent and control the transmission of meticillin-resistant Staphylococcus aureus (MRSA). Given the increasing prevalence of reduced CHG susceptibility of MRSA, there are concerns about the possibility of reduced OCT susceptibility. This study evaluated the prevalence of reduced CHG and OCT susceptibility over 3 years, and assessed the association between OCT exposure and reduced OCT susceptibility in MRSA. MRSA isolates from inpatients who acquired MRSA in an extended-care facility between 2019 and 2021 were included in antiseptic susceptibility testing. Inpatients were exposed to universal daily CHG bathing from January to September 2019, and universal daily OCT bathing after October 2019. The minimum inhibitory concentrations (MICs) of CHG and OCT were determined using the broth microdilution method. Multi-variable logistic regression was used to assess if OCT exposure was independently associated with reduced OCT susceptibility. Of 186 isolates, 179 (96%) had reduced CHG susceptibility (MIC ≥4mg/L) and 46 (25%) had reduced OCT susceptibility (MIC ≥2mg/L). Reduced OCT susceptibility rates were 26.9%, 13.8% and 14.3% in 2019, 2020 and 2021, respectively. Reduced CHG susceptibility rates were 95.4%, 100% and 95.9% in 2019, 2020 and 2021, respectively. OCT exposure was not associated with reduced OCT susceptibility (adjusted odds ratio 0.23, 95% confidence interval 0.08-0.75; P=0.014), after adjusting for age, gender, race, year of sample collection, days at risk in facility, hospitalization in preceding year, and MRSA colonization/infection in preceding year. The prevalence of reduced OCT susceptibility has remained low, despite universal OCT bathing for extended inpatient care. However, the rate of reduced CHG susceptibility was high. OCT exposure was not associated with reduced OCT susceptibility in MRSA.

Comparing the Effectiveness of Octenidine Hydrochloride and Chlorhexidine Gluconate Mouthrinses in Reducing Plaque and Oxidative Stress in Institutionalized Children with Down Syndrome.

Due to decreased manual dexterity, a lack of motivation, and difficulty on the part of the caregiver conducting efficient oral hygiene measures at home, patients with Down syndrome (DS) are badly affected. The objective of this study is to compare the efficacy of 0.1% octenidine (OCT) hydrochloride and 0.12% chlorhexidine (CHX) gluconate on plaque control and oxidative stress in institutionalized children with DS. In 20 children, salivary samples were collected for analysis of the inflammatory marker high-sensitive C-reactive protein (hsCRP) and oxidative stress markers, specifically malondialdehyde (MDA). Plaque index (PlI) and gingival index (GI) were scored. After oral prophylaxis, the participants were randomly assigned to two groups, each consisting of 10 individuals (octenidol and CHX). Salivary oxidative stress marker assays were carried out using a modified version of Yagi's (1984) method, and absorbance was measured at 540 nm using an ultraviolet-visible spectrophotometer at 535 nm. hsCRP assays were conducted via latex turbidimetric immunoassay. On comparison between the two groups, the OCT group showed a statistically significant reduction in GI, PlI, and MDA values (p < 0.05). It was seen that the use of 0.1% OCT hydrochloride could facilitate the maintenance of good oral hygiene and periodontal status, especially in patients with motor difficulties. PMS/IEC/2016/02. Raj AS, George S, S A, et al. Comparing the Effectiveness of Octenidine Hydrochloride and Chlorhexidine Gluconate Mouthrinses in Reducing Plaque and Oxidative Stress in Institutionalized Children with Down Syndrome. Int J Clin Pediatr Dent 2024;17(4):437-441.

Impact of Interfering Substances on the Bactericidal Efficacy of Different Commercially Available Hypochlorous Acid-Based Wound Irrigation Solutions Commonly Found in South-East Asia.

The high prevalence of chronic wounds is a growing concern. Recently, hypochlorous acid (HOCl)-based solutions were introduced as an alternative antimicrobial for wound cleansing. In this study, we assessed the in vitro bactericidal activities of seven commercially available wound irrigation products commonly found in South-East Asia. The evaluation was conducted using quantitative suspension method, EN 13727 in either low or high protein conditions. Under low protein conditions, four out of the five HOCl products achieved bactericidal activity (≥5 log10 reduction factor; RF) within 2-5 min, and only one product achieved 5 log10 RF at 15 s. None of the HOCl achieved 5 log10 RF under high protein, even after 30 min of exposure time. In contrast, protein interference on the antimicrobial activities of polyhexamethylene biguanide-based product is less pronounced (low protein: 60 s vs. high protein: 2 min to attain ≥5 log10 RF). Octenidine dihydrochloride is the only active not affected by protein interference achieving ≥5 log10 RF within 15 s in both low and high protein conditions. These findings warrant the need to screen antimicrobial wound care products, especially HOCl-based products, in high protein condition to better reflect the antimicrobial activities in wound care.

Comparative evaluation of antimicrobial efficacy of QMix 2in1, Octenidine Dihydrochloride irrigants, 940nm diode laser with and without NaOCl, against mature E. faecalis biofilm: An in vitro study

To compare the antimicrobial efficacy of NaOCl, QMix 2in1, Octenidine dihydrochloride, 940nm diode laser with and without NaOCl against matured E. faecalis biofilm.Ninety extracted single-rooted teeth were instrumented and autoclaved. The specimens were exposed to E. faecalis contamination over a period of 21 days and subsequently divided into six distinct groups through a random assignment process. Group I-Control, Group II-NaOCl, Group III-940nm Diode laser, Group IV-940nm Diode laser + NaOCl, Group V-QMix 2in1, Group VI-Octenidine Dihydrochloride. Microbial specimens were gathered, cultured, and the quantification of colony-forming units was conducted.ANOVA, Post hoc test, And Tuckey test were applied to find significance.940nm Diode laser +NaOCl group showed a greater antimicrobial effect compared to other groups. No significant difference was observed between 940nm Diode laser and 940nm diode laser +NaOCl (p=.550), NaOCl and QMix 2 in 1 (p=.121), NaOCl and 940nm Diode laser groups (p =.680)The concurrent use of both sodium hypochlorite and 940nm Diode laser light manifests a synergistic influence, enhancing the bactericidal efficacy. The antibacterial effect of QMix 2in1 is comparable to that of NaOCl, 940nm Diode laser, more effective than OCT and less effective than the combination of sodium hypochlorite and 940nm Diode laser.A combination of 940nm laser and NaOCl is effective in reducing the bacterial count because of their capacity to penetrate effectively deep into dentinal tubules, resulting in intensified bactericidal action compared to newer irrigants used alone.

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.

Deep Eutectic Solvent Eutectogels for Delivery of Broad-Spectrum Antimicrobials.

Gel-based wound dressings have gained popularity within the healthcare industry for the prevention and treatment of bacterial and fungal infections. Gels based on deep eutectic solvents (DESs), known as eutectogels, provide a promising alternative to hydrogels as they are non-volatile and highly tunable and can solubilize therapeutic agents, including those insoluble in hydrogels. A choline chloride:glycerol-cellulose eutectogel was loaded with numerous antimicrobial agents including silver nanoparticles, black phosphorus nanoflakes, and commercially available pharmaceuticals (octenidine dihydrochloride, tetracycline hydrochloride, and fluconazole). The eutectogels caused >97% growth reduction in Gram-positive methicillin-resistant Staphylococcus aureus and Gram-negative Pseudomonas aeruginosa bacteria and the fungal species Candida albicans.

Comparative Evaluation of Octenidine with Chlorhexidine Mouthwash in Gingivitis and Periodontitis Patients: A Randomized Clinical Trial

ABSTRACT Introduction: Chlorhexidine gluconate (CHX) has been still regarded as the most efficient mouthwash. Due to its recognized negative effects, it can only be used for a short duration. Octenidine dihydrochloride (OCT), an antiseptic substance found by Sterling Winthrop in the 1980s, has proven helpful in preventing the co-aggregation of dental plaque microbial invaders without disrupting the typical, healthy oral flora. However, there is very little research on octenidine’s effectiveness as a mouthwash for preventing plaque. Therefore, this study is being conducted to examine the effectiveness of mouthwashes containing 0.1% Octenidine and 0.2% chlorhexidine. Methodology: In this clinical trial, subjects were divided into two groups, 60 patients each with gingivitis and periodontitis. Then, from each group, 30 patients were advised to use octenidine mouthwash, and 30 patients were prescribed chlorhexidine mouthwash as an adjunct to scaling and root planning. Clinical parameters like O’Leary plaque index, Bleeding index, Probing pocket depth, and clinical attachment loss were evaluated at baseline and after 3 months. Result: In both the gingivitis and periodontitis groups, the octenidine group significantly outperformed the chlorhexidine group in all clinical metrics Conclusion: Octenidine showed better results in comparison to chlorhexidine with respect to all the above-mentioned clinical parameters. Hence, it can be considered a promising mouthwash for future therapeutic and research studies.

In Vitro Assessment of Antifungal and Antibiofilm Efficacy of Commercial Mouthwashes against Candida albicans.

Candida albicans is the most critical fungus causing oral mycosis. Many mouthwashes contain antimicrobial substances, including antifungal agents. This study aimed to investigate the in vitro activity of 15 commercial mouthwashes against 12 strains of C. albicans. The minimal inhibitory concentrations (MICs), minimal fungicidal concentrations (MFCs), and anti-biofilm activity were studied. MICs were determined by the micro-dilution method using 96-well plates, and MFCs were determined by culturing MIC suspensions on Sabouraud dextrose agar. Anti-biofilm activity was evaluated using the crystal violet method. The mouthwashes containing octenidine dihydrochloride (OCT; mean MICs 0.09-0.1%), chlorhexidine digluconate (CHX; MIC 0.12%), and CHX with cetylpyridinium chloride (CPC; MIC 0.13%) exhibited the best activity against C. albicans. The active compound antifungal concentrations were 0.5-0.9 µg/mL for OCT products and 1.1-2.4 µg/mL for CHX rinses. For mouthwashes with CHX + CPC, concentrations were 1.56 µg/mL and 0.65 µg/mL, respectively. Products with polyaminopropyl biguanide (polyhexanide, PHMB; MIC 1.89%) or benzalkonium chloride (BAC; MIC 6.38%) also showed good anti-Candida action. In biofilm reduction studies, mouthwashes with OCT demonstrated the most substantial effect (47-51.1%). Products with CHX (32.1-41.7%), PHMB (38.6%), BAC (35.7%), Scutellaria extract (35.6%), and fluorides + essential oils (33.2%) exhibited moderate antibiofilm activity. The paper also provides an overview of the side effects of CHX, CPC, and OCT. Considering the in vitro activity against Candida albicans, it can be inferred that, clinically, mouthwashes containing OCT are likely to offer the highest effectiveness. Meanwhile, products containing CHX, PHMB, or BAC can be considered as promising alternatives.