Effect of the most common wound antiseptics on human skin fibroblasts.

BACKGROUND: Antiseptics are used for the cleansing of acute or chronic wounds to eliminate micro-organisms from the wound bed. However, they have effects on the skin cells. AIM: To determine the effects of hexetidine, povidone-iodine (PI), undecylenamidopropyl-betaine/polyhexanide (UBP), chlorhexidine, disodium eosin and hydrogen peroxide on human skin fibroblasts. METHODS: CCD-1064Sk cells were treated with hexetidine, PI, UBP, chlorhexidine, disodium eosin or hydrogen peroxide. Spectrophotometry was used to measure cell viability and flow cytometry was used to study apoptosis and necrosis after the treatment. In vitro wound scratch assays were performed to determine the gap closure. RESULTS: All antiseptics significantly reduced the viability of human skin fibroblasts compared with controls. The percentage wound closure was lower with hexetidine, PI and UBP. The scratch assay could not be measured after treatments with chlorhexidine, disodium eosin or hydrogen peroxide, owing to their cytotoxicity. The apoptosis/necrosis experiments evidenced a significant reduction in viable cells compared with controls. An increased percentage of apoptotic cells was observed after treatment with all antiseptics. Compared with controls, the percentage of necrotic cells was significantly increased with all antiseptics except for hexetidine. CONCLUSION: The proliferation, migration and viability of human skin fibroblasts are reduced by treatment with hexetidine, PI, UBP, chlorhexidine, disodium eosin and hydrogen peroxide.

Efficacy of Hexetidine, Thymol and Hydrogen Peroxide-Containing Oral Antiseptics in Reducing Sars-Cov-2 Virus in the Oral Cavity: A Pilot Study.

BACKGROUND: Studies have demonstrated the role of sputum as a site of severe acute respiratory syndrome-coronavirus-2 (SARSCoV-2) transmission. However, there is limited literature on the virucidal efficacy of oral antiseptics against SARS-CoV-2 virus. This study investigated the virucidal efficacy of three oral-antiseptics compared to a placebo-control in the sputum of SARS-CoV-2 infected individuals. METHODOLOGY: A pilot study of adults with SARS-CoV-2 positive results, as determined by reverse transcription-polymerase chain reaction (RT-PCR) of <7 days. The oral antiseptics investigated were: Hexetidine (0.1% w/v); Thymol (0.063% w/v) and H2O2(1.5%) compared to de-mineralized sterile water (Placebo-control). The primary outcome measure was the proportion of negative RT-PCR results at 15-mins, 30-mins, 1-hour, 2-hours and 4-hours After Oral antiseptics Interventions (AOI) compared to the placebo-control. Statistical analysis was done using STATA 15.0 software with p-values of <0.05 considered statistically significant. RESULTS: Data from a total of 66 participants that were RT-PCR SARS-CoV-2 positive at baseline (0-min) was analysed. At 15-mins AOI, the highest proportion of negativation from sputum samples was observed in the Hexedine group, with 69.2% of the baseline PCR positive cases converting to negative compared to 46.7% in the placebo-control group. In addition, H2O2 demonstrated efficacy at 2-hours AOI compared to placebo-control (62.5% vs 37.5% respectively) and other oral-antiseptics. Across all time-points, the oral-antiseptic groups compared to the placebo-control group, there was no statistically significant difference in the proportion of sputum samples which converted to a negative status (p>0.05). CONCLUSION: The findings in this study suggest there was no significant difference in the proportion of participants who converted to a negative sputum status across the treatment groups at various time points. Future studies could compare the cycle threshold (ct) viral titre values of sputum samples to determine quantitative differences.

CONTEXTE: Des études ont démontré le rôle des expectorations comme un site de transmission du syndrome respiratoire aigu sévère-coronavirus- 2 (SRAS-CoV-2). Cependant, il existe peu de documentation sur l'efficacité virucide des antiseptiques oraux contre le virus du SRASCoV-2. Cette étude a examiné l'efficacité virucide de trois antiseptiques oraux par rapport à un contrôle placebo dans les expectorations de personnes infectées par le SRAS-CoV-2. MÉTHODOLOGIE: Une étude pilote menée auprès d'adultes dont les résultats sont positifs pour le SRAS-CoV-2, tels que déterminés par la réaction en chaîne de la polymérase par transcription inverse (RT-PCR) pendant 7 jours. Les antiseptiques oraux étudiés étaient : Hexetidine (0,1% p/v) ; Thymol (0,063% p/v) et H2O2 (1,5%) par rapport à l'eau stérile déminéralisée (Placebo-contrôle). Le principal critère d'évaluation était la proportion de résultats RT-PCR négatifs 15 minutes, 30 minutes, 1 heure, 2 heures et 4 heures après les interventions antiseptiques orales (AOI) par rapport au contrôle placebo. L'analyse statistique a été réalisée à l'aide du logiciel STATA 15.0, les valeurs p de <0,05 étant considérées comme statistiquement significatives. RÉSULTATS: Les données d'un total de 66 participants qui étaient positifs à la RT-PCR SARS-CoV-2 au départ (0 minute) ont été analysées. Au bout de 15 minutes, la plus forte proportion de négativation des échantillons d'expectoration a été observée dans le groupe Hexedine, 69,2 % des cas positifs au départ par PCR devenant négatifs, contre 46,7 % dans le groupe témoin placebo. En outre, l'H2O2 a démontré son efficacité à 2 heures après l'apparition de la maladie par rapport au groupe placebo (62,5 % contre 37,5 % respectivement) et aux autres antiseptiques oraux. Pour tous les points temporels, les groupes d'antiseptiques oraux comparés au groupe placebo n'ont pas présenté de différence statistiquement significative dans la proportion d'échantillons d'expectoration qui sont devenus négatifs (p>0,05). CONCLUSION: Les résultats de cette étude suggèrent qu'il n'y a pas de différence significative dans la proportion de participants qui sont passés à un statut négatif d'expectoration dans les groupes de traitement à différents moments. Les études futures pourraient comparer les valeurs du titre viral au seuil de cycle (ct) des échantillons d'expectoration afin de déterminer les différences quantitatives. MOTS CLÉS: SRAS-CoV-2, antiseptiques oraux, hexétidine, peroxyde d'hydrogène.

Circulating Folate and Vitamin B12 and Risk of Prostate Cancer: A Collaborative Analysis of Individual Participant Data from Six Cohorts Including 6875 Cases and 8104 Controls.

BACKGROUND: Folate and vitamin B12 are essential for maintaining DNA integrity and may influence prostate cancer (PCa) risk, but the association with clinically relevant, advanced stage, and high-grade disease is unclear. OBJECTIVE: To investigate the associations between circulating folate and vitamin B12 concentrations and risk of PCa overall and by disease stage and grade. DESIGN, SETTING, AND PARTICIPANTS: A study was performed with a nested case-control design based on individual participant data from six cohort studies including 6875 cases and 8104 controls; blood collection from 1981 to 2008, and an average follow-up of 8.9 yr (standard deviation 7.3). Odds ratios (ORs) of incident PCa by study-specific fifths of circulating folate and vitamin B12 were calculated using multivariable adjusted conditional logistic regression. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Incident PCa and subtype by stage and grade. RESULTS AND LIMITATIONS: Higher folate and vitamin B12 concentrations were associated with a small increase in risk of PCa (ORs for the top vs bottom fifths were 1.13 [95% confidence interval (CI), 1.02-1.26], ptrend=0.018, for folate and 1.12 [95% CI, 1.01-1.25], ptrend=0.017, for vitamin B12), with no evidence of heterogeneity between studies. The association with folate varied by tumour grade (pheterogeneity<0.001); higher folate concentration was associated with an elevated risk of high-grade disease (OR for the top vs bottom fifth: 2.30 [95% CI, 1.28-4.12]; ptrend=0.001), with no association for low-grade disease. There was no evidence of heterogeneity in the association of folate with risk by stage or of vitamin B12 with risk by stage or grade of disease (pheterogeneity>0.05). Use of single blood-sample measurements of folate and B12 concentrations is a limitation. CONCLUSIONS: The association between higher folate concentration and risk of high-grade disease, not evident for low-grade disease, suggests a possible role for folate in the progression of clinically relevant PCa and warrants further investigation. PATIENT SUMMARY: Folate, a vitamin obtained from foods and supplements, is important for maintaining cell health. In this study, however, men with higher blood folate levels were at greater risk of high-grade (more aggressive) prostate cancer compared with men with lower folate levels. Further research is needed to investigate the possible role of folate in the progression of this disease.

Cumulative Effect of Racial Discrimination on the Mental Health of Ethnic Minorities in the United Kingdom.

OBJECTIVES: To examine the longitudinal association between cumulative exposure to racial discrimination and changes in the mental health of ethnic minority people. METHODS: We used data from 4 waves (2009-2013) of the UK Household Longitudinal Study, a longitudinal household panel survey of approximately 40 000 households, including an ethnic minority boost sample of approximately 4000 households. RESULTS: Ethnic minority people who reported exposure to racial discrimination at 1 time point had 12-Item Short Form Health Survey (SF-12) mental component scores 1.93 (95% confidence interval [CI] = -3.31, -0.56) points lower than did those who reported no exposure to racial discrimination, whereas those who had been exposed to 2 or more domains of racial discrimination, at 2 different time points, had SF-12 mental component scores 8.26 (95% CI = -13.33, -3.18) points lower than did those who reported no experiences of racial discrimination. Controlling for racial discrimination and other socioeconomic factors reduced ethnic inequalities in mental health. CONCLUSIONS: Cumulative exposure to racial discrimination has incremental negative long-term effects on the mental health of ethnic minority people in the United Kingdom. Studies that examine exposure to racial discrimination at 1 point in time may underestimate the contribution of racism to poor health.

Analysis of Antiviral Properties of Hexoral In Vitro against Some Viruses that Cause Acute Respiratory Infections and Herpes.

Antiviral properties of Hexoral (0.1% solution and 0.2% aerosol for local application) and its constituent hexetidine against viruses causing human respiratory tract infections and herpes virus were studied in vitro. It was found that non-cytotoxic concentrations of hexetidine (alone and as a component of Hexoral) attenuated infectious properties of highly virulent influenza virus A/H5N1, pandemic influenza virus A/H1N1pdm, respiratory syncytial virus, and herpes simplex virus type 1 after a short-term exposure (30 sec) by 100 or more times. It was found that hexidine mostly contributes to the virucidal effect of Hexoral.

Effect of oral antiseptic agents on phospholipase and proteinase enzymes of Candida albicans.

OBJECTIVE: Candida-associated denture stomatitis is the most prevalent form of oral candida infections among the denture wearers. Generally, antiseptic oral rinses used in the treatment of these infections are considered as an adjunct or alternative antifungal treatment. Studies have suggested that the intraoral concentrations of antiseptics decrease substantially to the sub-therapeutic levels on account of the dynamics of the oral cavity. This condition yields the question about the minimum antiseptic concentration that effect the character or pathogenesis of Candida during treatment. The extracellular phospholipase and proteinase enzymes of Candida albicans are regarded to have a crucial role in the pathogenesis of human fungal infections. Therefore, the aim of this study was to investigate the effect of different sub-therapeutic concentrations of chlorhexidine gluconate, hexetidine and triclosan on the production of these enzymes by C. albicans strains isolated from 20 patients with denture stomatitis. METHODS: Phospholipase test was done by using Sabouraud dextrose agar with egg yolk, proteinase test was done by using bovine serum albumin agar. METHODS: Phospholipase test was done by using Sabouraud dextrose agar with egg yolk, proteinase test was done by using bovine serum albumin agar. RESULTS: Exoenzyme production of 20 strains which were brief exposured to sub-therapeutic concentrations of three antiseptic agents decreased significantly compared with the strains that were not exposured with antiseptic values (p<0.05). There was significant difference between the sub-therapeutic concentrations of each of three antiseptics (p<0.05). When the same concentrations of each antiseptic was compared, there were no significant differences between enzymatic activities (p>0.05). CONCLUSIONS: The results of this study show that sub-therapeutic levels of each antiseptic may modulate candidal exoenzyme production, consequently suppressing pathogenicity of C. albicans.

Antiseptic mouthwashes could worsen xerostomia in patients taking polypharmacy.

OBJECTIVE: Polypharmacy is a common cause of xerostomia. This study aimed to investigate whether xerostomia could be an adverse drug event of mouthwashes, when they are used for longer than 2 weeks by patients taking polypharmacy. MATERIALS AND METHODS: This cross-sectional observational study included 120 hospitalized patients (60 middle-aged and 60 elderly patients), taking polypharmacy (≥4 drugs daily) and at risk of drug-induced xerostomia. Xerostomia was assessed by questioning participants. RESULTS: A total of 62.5% of patients complained of xerostomia. In the middle-aged group (mean age=44.0 (8.7) years; 35.0% women) xerostomia seemed independently associated to mouthwashes, at the limit of significance (OR=5.00, 95% CI=0.99-25.3, p=0.052). Active principles in mouthwashes were mainly quaternary ammonium compounds (91.9%). Mouthwashes may disturb the healthy balance of the biofilm moisturizing the oral mucosa. The biofilm contains mucins, salivary glycoproteins with oligosaccharides side chains able to sequester water and endogenous bacteria surrounded by a glycocalyx. Oral bacteria are fully susceptible to quaternary ammonium (chlorhexidine, hexetidine, cetylpyridinium chloride) and to other antiseptics used in mouthwashes, such as betain, resorcin, triclosan, essential oils and alcohol. However, caregivers currently recommend such dental plaque control products to patients suffering from xerostomia in order to reduce the risk of caries and periodontitis. CONCLUSION: This study is the first report that use of antiseptic mouthwashes for more than 2 weeks could worsen xerostomia in patients taking polypharmacy. Oral care protocols should avoid this iatrogenic practice, particularly when xerostomia alters the quality-of-life and worsens malnutrition.

Transvaginal access for NOTES: a cohort study of microbiological colonization and contamination.

BACKGROUND AND STUDY AIMS: Animal data and limited clinical evidence suggest a low incidence of infection following transvaginal natural orifice transluminal endoscopic surgery (NOTES). However, a systematic microbiological evaluation has not yet been carried out. The aim of this prospective cohort study was to evaluate the extent of microbiological contamination of the peritoneal cavity caused by the transvaginal access for NOTES and the impact of preoperative vaginal disinfection on vaginal colonization. PATIENTS AND METHODS: Consecutive female patients with symptomatic cholecystolithiasis were offered either transvaginal rigid-hybrid cholecystectomy (tvCCE) or conventional laparoscopic cholecystectomy. Patients who opted for tvCCE were prospectively evaluated between February and June 2010. Disinfection in patients undergoing tvCCE included hexetidine tablets and octenidine applied vaginally. All patients received a single dose of perioperative cefuroxime. Swabs were obtained from the posterior fornix and the peritoneal cavity at different intervals. RESULTS: Of 32 patients, 27 (84 %) opted to undergo tvCCE. One patient (4 %; 95 % confidence interval [CI] 0.7 % - 18.3 %) had a positive bacterial culture in the Douglas pouch prior to transvaginal access compared with two patients (7 %; 95 %CI 2.1 % - 23.4 %) following colpotomy closure (P = 1.000). Vaginal disinfection significantly decreased vaginal bacterial load (P = 0.001) and bacterial growth in routine cultures (P < 0.001); in 16 patients (59 %; 95 %CI 40.7 % - 75.5 %) vaginal swabs were sterile after disinfection. No postoperative surgical site infections occurred (95 %CI 0 % - 12.5 %). CONCLUSIONS: In selected patients and following vaginal antisepsis, transvaginal access for NOTES is associated with microbiological contamination of the peritoneal cavity in a minority of patients, indicating a low risk of peritoneal contamination caused by the transvaginal access.

[Assessment of in vitro activity and stability of antifungal suspensions for mouthrinses: to a reappraisal of empiric practices?]. / Étude d'activité in vitro et de stabilité de suspensions antifongiques pour bain de bouche : vers une remise en question de pratiques empiriques ?

Establishment of an effective prophylaxis against oral candidiasis by local treatment is essential for immunocompromised patients. The aim of the study is to assess effectiveness and stability of antifungal suspensions for mouthrinses. The assessed suspensions are compounded by one solvent among sterile water, spring water or sodium bicarbonate associated with amphotericin B (Fungizone®) or nystatine (Mycostatine®). Two others mixes are assessed: Mycostatine®-bicarbonate and Mycostatine®-Hextril®-bicarbonate as well as the two straight antifungal. In vitro activity is tested on five Candida species (C. albicans, C. glabrata, C. krusei, C. parapsilosis, C. tropicalis) after a five minutes contact between yeasts and the assessed suspension. A galenic study is realized during 3 days. Mixes associating a polyene with sodium bicarbonate have no effectiveness on Candida albicans, others mixes shows intermediate effectiveness (the percentage of yeast growth inhibition lies between 35% and 68%). Effectiveness results of Hextril®-based mixes are not explainable because of alcohol in its composition. Spring water-based mixes must be evicted due to microbiologic contaminations after 48hours. Mycostatine®-Hextril®-bicarbonate mix is not stable during 3 days. All those mouthrinses, poorly effective, excepted on C. glabrata, should be avoided. Straight Mycostatine® shows a good antifungal effectiveness excepted on C. krusei and its use should be recommended.

[Outbreak of Burkholderia cepacia complex caused by contaminated alcohol-free mouthwash]. / Ausbruch mit Burkholderia-cepacia-Komplex durch kontaminierte Mundspüllösung.

BACKGROUND: A total of three intensive care units (ICU) at a German university hospital were involved in an outbreak of Burkholderia cepacia complex (Bcc). METHODS: Patients with microbiological detection of Bcc were evaluated. Products used for mouth hygiene were microbiologically tested. The clonal identity of Bcc was proven by pulse-field gel electrophoresis (PFGE). RESULTS: On 3 ICUs 12 cases were identified whereby the first detection of Bcc was in respiratory specimens of 11 patients and 1 in a wound swab from the oral cavity. Of these patients six developed ventilator-associated pneumonia (VAP). Investigations revealed that five different batches of an alcohol-free mouthwash containing hexetidine were highly contaminated. Isolates of Bcc from patients and mouthwashes were genetically indistinguishable. A recall of the product was initiated. After elimination of the product from the ICUs no more cases were identified. CONCLUSIONS: The source of the outbreak was an intrinsically contaminated alcohol-free mouthwash. Detection of Bcc in specimens from ICU patients should lead to further investigations. Antiseptic oral care products are recommended for reducing the risk of VAP but they may be microbiologically contaminated and, in consequence, increase the risk. The safety of patient care products should be increased by stricter regulations.

The effect of hexetidine mouthwash on the prevention of plaque and gingival inflammation: a systematic review.

OBJECTIVE: To review the literature concerning hexetidine-containing mouthwash as a monotherapy or as an adjunct to oral hygiene in the prevention of plaque accumulation and gingival inflammation. MATERIALS AND METHODS: PubMed-MEDLINE and the Cochrane-CENTRAL were searched through January 2010 to identify appropriate studies. The primary outcome measurements were plaque accumulation and gingivitis parameters. RESULTS: Independent screening of titles and abstracts of 168 papers resulted in six publications that met the eligibility criteria. Mean values and standard deviations were obtained by data extraction. Descriptive comparisons are presented for hexetidine mouthwash and control mouthwashes (chlorhexidine and placebo). CONCLUSIONS: Considering the potential benefits in the light of the observed side effects, hexetidine appears to be a poor alternative to chlorhexidine.

Antimicrobial topical agents used in the vagina.

Vaginally applied antimicrobial agents are widely used in the vagina in women with lower genital tract infections. An 'antimicrobial' is a general term that refers to a group of drugs that are effective against bacteria, fungi, viruses and protozoa. Topical treatments can be prescribed for a wide variety of vaginal infections. Many bacterial infections, such as bacterial vaginosis, desquamative inflammatory vaginitis or, as some European authors call it, aerobic vaginitis as well as infection with Staphylococcus aureus or group A streptococci, may be treated in this way. Candida vulvovaginitis is a fungal infection that is very amenable to topical treatment. The most common viral infections which can be treated with topical medications are condylomata acuminata and herpes simplex. The most often encountered protozoal vaginitis, which is caused by Trichomonas vaginalis, may be susceptible to topical medications, although this infection is treated systemically. This chapter covers the wide variety of commonly used topical antimicrobial agents for these diseases and focuses on the individual therapeutic agents and their clinical efficacy. In addition, potential difficulties that can occur in practice, as well as the usage of these medications in the special setting of pregnancy, are described in this chapter.

[Prevention of respiratory infection in patients following surgical intervention].

The objective of the present study was to estimate the efficacy of therapy with hexetedine for the prevention of the respiratory infection in the patients undergoing surgical intervention. The study included 64 patients (28 adults and 36 children) ranging in the age from 3 to 55 years who were examined before and after surgery (radiosurgical tonsillectomy and radiosurgical uvulopalatoplasty). Complete clinical examination was supplemented by a microbiological study of cultivated mucosal swab samples obtained from the pharynx before and after the treatment. 41 patients of the study group received hexetedine (hexoral) for the 4 days preceding the operation and during 3 days of the postoperative period. It was shown that the patients treated with hexetedine both in the pre- and postoperative periods experienced a substantial decrease in microbial infestation of pharyngeal mucosa and accelerated elimination of the inflammatory process. Moreover, the general therapeutic effect on day 5 after surgery was more pronounced in the hexetedine-treated patients compared with controls.

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

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

Parotid gland swelling following mouthrinse use.

BACKGROUND: Unilateral or bilateral swelling of the parotid gland is a reported side effect of rinsing the mouth with chlorhexidine. Although the incidence rate is extremely low, there have been several case reports on this topic and the authors of these reports have suggested several explanations for the mechanism of this complication. METHODS: In this report, two cases of parotid gland swelling are discussed. Both patients developed unilateral parotid swelling following the use of a mouthwash, case 1 after using a chlorhexidine mouthwash following flap surgery and case 2 after using a hexetidine mouthwash in an approved clinical trial that was testing different mouthwashes. RESULTS: In both of the cases, differential diagnoses were made to explain the cause of the parotid swelling. However, discontinuing use of the product resulted in an eventual complete resolution of symptoms in both patients. CONCLUSIONS: Swelling of the parotid gland following use of a mouthwash has previously been reported, although previous reports found this side effect only in patients who used chlorhexidine mouthwashes. This complication has therefore been informally linked to chlorhexidine. The present case report questions this hypothesis and suggests that parotid gland swelling may not be related to the type of mouthwash used, but may instead be a consequence of the rinsing action itself.

[Combined local therapy in oropharyngeal diseases].

A pilot trial of efficacy of the drugs lisobact and stomatidin in local treatment of acute pharyngitis and combined therapy of tonsillitis and paratonsillar abscess included 82 patients with tonsillitis (n=30), paratonsillar abscess (n=30) and acute pharyngitis (n=22) aged 15-72 years. Effectiveness of the treatment was assessed by changes in clinical symptoms, pharyngoscopic picture and results of bacteriological studies. It was found that treatment with lisobact and stomatidin diminished considerably bacterial contamination of the paratonsillar abscess and pharyngeal mucosa. Local treatment with lisobact and stomatidin for paratonsillar abscess in combination with systemic antibacterial drug reduces the time of hospital stay, in tonsillitis patients - of disability. High compliance to lisobact and stomatidin treatment was observed.

[Efficacy of an antiseptic dialysis of purulent wounds in the dentofacial region with hyvalix].

The article presents data proving the possibility of using the solutions of "Hyvalix" medication for an antiseptic preparation of septic cavities after lancing of abscesses and phlegmons of dentofacial region. It was shown the efficacy of "Hyvalix" medication in comparison with traditional solutions of antiseptic means.

Clinical study on the effectiveness and side effects of hexetidine and chlorhexidine mouthrinses versus a negative control.

OBJECTIVES: The aim of this clinical, controlled double-blind trial was to evaluate the effectiveness and side effects of two different mouthrinses. METHOD AND MATERIALS: Ninety subjects with gingivitis (or slight periodontitis) were randomly allocated to three groups: group 1, Chlorhexamed (0.1% chlorhexidine); group 2, Hexoral (0.1% hexetidine); and group 3, a placebo-control compound. The subjects were instructed on how to use the mouthrinse. At baseline, as well as after 2 and 4 weeks, the Approximal Plaque Index (API), the Bleeding Index (BI), the Community Periodontal Index of Treatment Needs, the Gingival Index (GI), and the Discoloration Index (DI), were measured. Statistical analysis was carried out with the Kruskal-Wallis test, Fisher's exact test, and Wilcoxon test. RESULTS: In group 1, the mean API improved significantly (P < or = .001) after 4 weeks. The mean BI was reduced significantly, as was the GI. In group 2, the mean API and the mean BI both decreased significantly, and a statistically significant reduction of the GI was also seen. In group 3, significant improvements of the mean values of all parameters were documented after 4 weeks. When comparing group 3 with groups 1 and 2, the difference in the reduction of the API was statistically significant (P < .002). No statistical difference could be shown when comparing groups 1 and 2. Regarding the improved results of the BI and the GI, no statistically significant difference was found in the effectiveness of all 3 compounds. All 3 groups showed some increase in the mean DI after 4 weeks. Comparing groups 1 and 2 directly, the difference in the increase in the discoloration of the teeth was statistically significant (P = .0035). There was no statistical difference in the mean discoloration scores comparing groups 2 and 3. CONCLUSION: This double-blind clinical trial demonstrated Hexoral to be a useful alternative to Chlorhexamed mouthrinse, as well as one causing less discoloration.