Clinical and microbiological effects of the use of a cetylpyridinium chloride dentifrice and mouth rinse in orthodontic patients: a 3-month randomized clinical trial.

Objective: To assess the clinical, microbiological, and patient-based effects of using a cetylpyridinium chloride (CPC) toothpaste and mouth rinse in orthodontic patients. Design: Parallel randomized controlled, triple-blinded trial (participants, examiners, outcomes' assessors). A computer-generated list was used to allocate treatments. Central allocation was used for concealment. Participants: Thirty-one placebo (10 males, 21 females; mean age 15.2 ± 2.1) and 32 test patients (15 males, 17 females; mean age 15.0 ± 1.8) with fixed orthodontic appliance were included in the study. Interventions: Patients were randomly assigned to both brush and rinse with placebo or with CPC-based products. Products were purposely prepared in white opaque bottles. After screening and professional prophylaxis, patients received a baseline examination, and started to use the assigned products. Patients were monthly assessed during a 3-month period. Main outcome measures: Plaque (PlI) and gingival (GI) indexes. Secondary outcome variables: Calculus index, tooth staining, subgingival microbiological samples, patient-based variables (questionnaire, compliance, and remaining mouth rinse), side-effects (debonded braces or mucosal injuries). Results: Sixty-three patients were randomized, 13 patients were excluded from analysis because of early dropout, leaving 50 patients for intention to treat analysis. PlI in the upper jaw diminished (0.18; SD = 0.82) after 1 month in the test group, while it increased (0.26; SD = 0.62) in the placebo group (P = 0.024). Statistically significant higher GI values were observed in the placebo group at 1 month (mean increase = 0.05; SD = 0.33 versus mean decrease = 0.03; SD = 0.38) and 3 months (mean = 0.05; SD = 0.43 versus mean = 0.02; SD = 0.34). The taste of the test product was rated higher than the placebo at 2- and 3-month visits (P < 0.05). Non-significant changes were observed in microbiological parameters, overgrowth of opportunistic species or remaining secondary outcome variables, including side-effects. Conclusion: The use of CPC-based toothpaste and mouth rinse in orthodontic patients had limited effect in reducing plaque accumulation and gingival inflammation. Effects were little and highly variable. The use of the test products was not associated with relevant adverse effects. Trial registration: Trial registration: Local internal reference: P07/133.

Implant decontamination with 2% chlorhexidine during surgical peri-implantitis treatment: a randomized, double-blind, controlled trial.

OBJECTIVE: The objective of this randomized, double-blind, controlled trial was to evaluate the clinical, radiographic, and microbiological effects of implant surface decontamination with a 2% chlorhexidine (CHX) solution in comparison with a 0.12% chlorhexidine + 0.05% cetylpyridinium chloride (CPC) solution during resective surgical peri-implantitis treatment. MATERIAL AND METHODS: Forty-four patients (108 implants) with peri-implantitis were treated with resective surgical treatment consisting of bone re-contouring, surface debridement and chemical decontamination, and apically repositioned flap. Patients were randomly allocated to decontamination with a 2% CHX solution (test group) or 0.12% CHX + 0.05% CPC (control group). Clinical and radiographic parameters were recorded before treatment (baseline), and at 3, 6, and 12 months after treatment. Microbiological parameters were recorded during surgery. RESULTS: Multilevel analysis showed no significant differences in bleeding, suppuration, probing pocket depth, and radiographic bone loss between control and test group over three follow-up measurements (3, 6, and 12 months) from baseline. Both decontamination procedures resulted in significant reductions in anaerobic bacterial counts on the implant surface, but no significant difference was noted between control and test group (mean log 3.37 ± 2.34 vs. 3.65 ± 2.87, P = 0.99). CONCLUSIONS: The use of a 2% CHX solution for implant surface decontamination during resective peri-implantitis therapy does not lead to improved clinical, radiographic, or microbiological results compared with a 0.12% CHX + 0.05% CPC solution. Overall, the additional use of CHX reduces anaerobic bacterial load on the implant surface better than mechanical debridement alone, but does not seem to enhance clinical treatment outcomes (ClinicalTrials.gov number NCT01852253).

Effectiveness of Oral Antiseptics on Tooth Biofilm: A Study in vivo.

AIM: To evaluate the effectiveness of five different mouthwashes through measurement of the plaque index. MATERIALS AND METHODS: Fifty subjects took part in this blind study, randomized into blocks of five groups according to the active ingredient of the mouthwash: CHX group (0.12% chlorhexidine gluconate), essential oils (EO) group, cetylpyridinium chloride (CPC) group, Tri group (triclosan) and Hamamelis virginiana (HV) group. All subjects were evaluated for a reduction in the bacterial plaque index at 7, 14 and 21 days. RESULTS: There was a significant reduction in the mean plaque index during the period of evaluation (p < 0.01), and the reduction during the period of evaluation was different between mouthwashes (p < 0.01). The reduction in the plaque index at the end of 21 days was, in decreasing order, CHX > EO > CPC > Tri > HV. CONCLUSION: The reduction in the plaque index during the period of evaluation was different between the types of mouth-wash. The mouthwash containing the active ingredient chlorhexidine was the most effective, followed by the essential oil, cetylpyridinium chloride, triclosan and H. virginiana.

Effectiveness of a Chlorhexidine Digluconate 0.12% and Cetylpyridinium Chloride 0.05% Solution in eliminating Candida albicans Colonizing Dentures: A Randomized Clinical in vivo Study.

BACKGROUND: Effective denture hygiene is important for patients suffering from denture stomatitis (DS). This study aimed to evaluate the efficacy of a solution containing 0.12% chlorhexidine (CHX) digluconate and 0.05% cetylpyridinium chloride (CPC) in eliminating Candida albicans colonizing dentures. MATERIALS AND METHODS: Forty denture wearers (11 men, 29 women; age range 40 to 80 years) with clinical evidence of DS were randomly divided into two groups, one test and one control. The dentures of the test group were treated by immersion in a solution of 0.12% CHX and 0.05% CPC while those of the control group were immersed in distilled water. Swabs were collected from the fitting surfaces of the upper dentures prior and post cleaner use and examined mycologically. RESULTS: Reduction in the number of colony-forming units (CFU) of Candida albicans after immersion of the dentures in a solution of 0.12% CHX and 0.05% CPC was significantly greater than that of the control group. CONCLUSION: A solution of 0.12% CHX and 0.05% CPC tested as a product of disinfection of the acrylic dentures showed significant results after immersion of 8 night hours for 4 days.

The effect of a mouthrinse containing chlorine dioxide in the clinical reduction of volatile sulfur compounds.

This study sought to evaluate the clinical effect of a mouthrinse containing 0.3% chlorine dioxide (ClO2) in reducing oral volatile sulfur compounds (VSC). Halitosis was induced by L-cysteine in 11 volunteers, and 4 solutions were compared: a test solution containing 0.3% ClO2, 0.07% cetylpyridinium chloride (CPC), and 0.05% sodium fluoride; a placebo; a solution containing 0.05% CPC; and a control solution of 0.2% chlorhexidine gluconate (CHX). VSC levels were assessed using a Halimeter, and 6 measurements were made from baseline to 3 hours postrinse. The VSC reduction rate of the test mouthrinse was superior to the placebo and the CPC solution. There was no difference between the test solution and the CHX solution in VSC reduction rates immediately postrinse, or at 2 and 3 hours postrinse; both solutions were statistically superior to the placebo and the CPC solution.

Evaluation of oral antiseptic rinsing before sputum collection to reduce contamination of mycobacterial cultures.

To assess whether rinsing with oral antiseptics before sputum collection would reduce contamination of mycobacterial cultures, 120 patients with suspected tuberculosis were randomly assigned to rinse with chlorhexidine or cetylpyridinium mouthwash before collection. The culture contamination rate was significantly lower after rinsing with chlorhexidine before collection, especially for cultures grown in MGIT medium.

In vitro oral biofilm formation on triclosan-coated sutures in the absence and presence of additional antiplaque treatment.

PURPOSE: This study evaluated the in vitro plaque inhibitory effect of triclosan-coated polyglactin 910 sutures in the absence and presence of an additional antiplaque agent commonly used after oral surgery. MATERIALS AND METHODS: Triclosan-coated sutures were incubated for 4 hours in freshly collected human saliva and, when appropriate, subsequently treated with an antiplaque rinse containing chlorhexidine-cetyl pyridinium as active components. Sutures without a triclosan-coating served as a control. RESULTS: Triclosan-coated sutures harbored similar amounts of plaque as did uncoated sutures. Exposure to the antiplaque rinse caused significant decreases in viable organisms for uncoated and triclosan-coated sutures. However, after application of the antiplaque rinse, more micro-organisms were found on triclosan-coated than on uncoated sutures. CONCLUSION: Sutures coated with triclosan do not provide a sufficient antimicrobial effect to prevent in vitro colonization by oral bacteria, whereas use in combination with a chlorhexidine-cetyl pyridinium-containing antiplaque rinse appears to be counterproductive.

Efficacy of antiplaque mouthwashes: a five-day clinical trial.

The aim of this study was to evaluate and compare the efficacy of antiplaque mouthwashes. Plaque levels were determined by applying a plaque-disclosing solution using the Turesky et al modification of the Quigley Hein plaque index. The control group (n = 6) brushed twice per day with fluoride toothpaste for one minute and rinsed with water, while the study groups (n = 6) brushed once per day with fluoride toothpaste for one minute, followed by rinsing with 5.0 mL of mouthwash diluted with 10.0 mL of water for 30 seconds. The control group brushed and rinsed with water twice per day. The results indicated that cetylpyridinium chloride in combination with sodium fluoride offered maximum plaque inhibition, followed by chlorhexidine gluconate and sodium monofluorophosphate, while plaque levels increased in the control group and with the combination of chlorhexidine gluconate and sodium fluoride. The only antiplaque agents to demonstrate a statistically significant difference from the control were cetylpyridinium chloride in combination with sodium fluoride, and chlorhexidine gluconate. Increasing the fluoride concentration had no impact on antiplaque activity.

Efficacy of an alcohol-free CPC-containing mouthwash against oral multispecies biofilms.

OBJECTIVE: The aim of this work was to develop two static-model multispecies oral biofilm systems to compare the efficacy of a placebo mouthwash to an alcohol-free mouthwash containing 0.075% CPC. METHODS: Two model biofilm systems were used: a 24-well glass-bottom microplate (GM) system and a chamber slide (CS) system. These were inoculated with Schaedler media containing pooled, unfiltered saliva. During incubation at 37 degrees C in 5% CO2, Schaedler media was replaced every 24 hours. Five-day and 10-day multispecies biofilms in the GM and CS systems were then exposed to phosphate buffered saline, the placebo mouthwash, or the alcohol-free 0.075% CPC-containing mouthwash. Biofilms were visualized in three-dimensions by Confocal Laser Scanning Microscopy (CLSM), and fluorometric analyses were performed on biofilms in the GM system. RESULTS: CLSM demonstrated that regardless of the model system used, the alcohol-free 0.075% CPC-containing mouthwash solution increased the number of damaged biofilm cells. The efficacy of CPC was inversely related to the age of the biofilm. A contrariety between the two biofilm systems was that the CS system indicated that alcohol-free 0.075% CPC-containing mouthwash partially disrupted biofilms. Fluorometric analysis ofGM biofilms also demonstrated that the alcohol-free 0.075% CPC-containing mouthwash damaged biofilm cells. CONCLUSION: Two static oral multispecies model biofilms systems demonstrated that an alcohol-free 0.075% CPC-containing mouthwash had greater antimicrobial efficacy than a placebo mouthwash. The alcohol-free 0.075% CPC-containing formulation is effective against multispecies oral biofilms.

In vitro antibacterial efficacy of cetylpyridinium chloride-containing mouthwashes.

OBJECTIVE: The objective of this study was to examine the ability of three CPC-containing mouthwashes to kill planktonic bacteria in an in vitro short-exposure assay. METHODS: This blind study was conducted on two common oral bacterial species: Aggregatibacter (Actinobacillus) actinomycetemcomitans and Streptococcus mutans. The following mouthwashes were tested: two containing 0.075% CPC and 0.05% NaF in an alcohol-free base, and one containing 0.075% CPC and 0.05% NaF plus 6% alcohol. Additionally, a 0.05% NaF-only mouthwash was included as a negative control. Bacteria were exposed to one of the test mouthwashes for 30 seconds and then washed thoroughly, serially diluted, and plated on appropriate media to determine viable bacterial counts. Viable counts were converted to a log reduction in colony forming units (CFUs) relative to the negative control. RESULTS: All three test mouthwashes included in this study gave a statistically significant reduction of > 3 log CFUs relative to samples treated with the negative control. CONCLUSION: All three experimental 0.075% CPC mouthwash formulas gave a > 99.9% reduction in viable bacteria of both species following 30 seconds of treatment.

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

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

Pseudomembranous oral candidiasis resolved with a mouthwash containing 0.05% chlorhexidine + 0.05% cetylpyridinium chloride.

A 50-year-old woman was referred to the clinic reporting oral discomfort during the previous month and plaques of a white removable slough. Diagnosis of pseudomembranous oral candidiasis was clinically confirmed. When the tongue and palatal mucosa were wiped with gauze, the soft yellowish-white slough detached revealing the erythematous surface beneath. The patient also presented paranoid schizophrenia and severe depression, pulmonary emphysema, and two vertebral hernias. She was a smoker (10 cigarettes per day) with xerostomia that was being treated with: bupropion, reboxetine, quetiapine, trazadone clotiapine, pregabalin, fentanyl (patches), and alprazolam. To minimize the risk of potential drug interactions, a mouthwash containing 0.05% chlorhexidine + 0.05% cetylpyridinium chloride was prescribed three times a day for two weeks. At the end of the two weeks, the candidiasis had abated.

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

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

Polyelectrolyte-surfactant-complex nanoparticles as a delivery platform for poorly soluble drugs: A case study of ibuprofen loaded cetylpyridinium-alginate system.

Previously, we reported on the surfactant cetylpyridinium chloride (CPC) as a crosslinker of alginate for the formation of stable polyelectrolyte-surfactant-complex nanoparticles. Here, we evaluate this system for increased solubility of a poorly soluble drug. The aim was to use CPC for solubilisation of ibuprofen and to use the micellar associates formed for alginate complexation and nanoparticle formation. We acquired deeper insights into the entropy led interactions between alginate, CPC and ibuprofen. Stable nanoparticles were formed across limited surfactant-to-polyelectrolyte molar ratios, with ~150 nm hydrodynamic diameter, monodispersed distribution, and negative zeta potential (-40 mV), with 34% ibuprofen loading. Their structure was obtained using small-angle X-ray scattering, which indicated disordered micellar associates when ibuprofen was incorporated. This resulted in nanoparticles with a complex nanostructured composition, as shown by transmission electron microscopy. Drug release from ibuprofen-cetylpyridinium-alginate nanoparticles was not hindered by alginate, and was similar to the release kinetics from ibuprofen-CPC solubilisates. These innovative carriers developed as polyelectrolyte-surfactant complexes can be used for solubilisation of poorly soluble drugs, where the surfactant simultaneously increases the solubility of the drug at concentrations below its critical micellar concentration and crosslinks the polyelectrolyte to form nanoparticles.

Surfactive and antibacterial activity of cetylpyridinium chloride formulations in vitro and in vivo.

AIM: To compare effects of three cetylpyridinium chloride (CPC) formulations with and without alcohol and Tween80 on physico-chemical properties of salivary pellicles, bacterial detachment in vitro and bacterial killing in vivo. MATERIAL AND METHODS: Adsorption of CPC to salivary pellicles in vitro was studied using X-ray photoelectron spectroscopy and water contact angle measurements. Adhesion and detachment of a co-adhering bacterial pair was determined in vitro using a flow chamber. Killing was evaluated after live/dead staining after acute single use in vivo on 24- and 72-h-old plaques after 2-week continuous use. RESULTS: The most pronounced effects on pellicle surface chemistry and hydrophobicity were observed after treatment with the alcohol-free formulation, while the pellicle thickness was not affected by any of the formulations. All CPC formulations detached up to 33% of the co-adhering pair from pellicle surfaces. Bacterial aggregate sizes during de novo deposition were enhanced after treatment with the alcohol-free formulation. Immediate and sustained killing in 24 and 72 h plaques after in vivo, acute single use as well as after 2-week continuous use were highest for the alcohol-free formulation. CONCLUSIONS: CPC bioavailability in a formulation without alcohol and Tween80 could be demonstrated through measures of pellicle surface properties and bacterial interactions in vitro as well as bacteriocidal actions on oral biofilms in vivo.

In vivo antiplaque efficacy of combined antimicrobial dentifrice and rinse hygiene regimens.

PURPOSE: To evaluate using digital plaque image analysis the antiplaque efficacy of oral care regimens including use of antimicrobial toothpaste in combination with antimicrobial mouthrinse. METHODS: 16 subjects completed the study protocol including: (1) initial treatment phase, all subjects used a standard sodium fluoride dentifrice with 2x/day brushing, (2) second treatment phase, subjects were randomized to two treatment groups: stannous fluoride/sodium hexametaphosphate dentifrice or sodium fluoride triclosan/copolymer dentifrice; (3) third treatment phase, the group using stannous fluoride dentifrice rinsed with alcohol-free cetylpyridinium chloride mouthrinse and the group using triclosan dentifrice rinsed with essential oil mouthrinse. During each phase, plaque levels were assessed in the morning before toothbrushing (AM), post-brushing in the morning (PB) and in the afternoon (PM). RESULTS: Stannous fluoride dentifrice was superior to triclosan dentifrice in plaque growth inhibition between toothbrushing. Both mouthrinses provided additional plaque prevention benefits when used with antimicrobial dentifrices. The cetylpyridinium chloride mouthrinse and stannous fluoride dentifrice regimen was particularly effective, building accretive efficacy over time. Average plaque reductions exceeded 50% vs. sodium fluoride dentifrice alone. Chemotherapeutic dentifrices and rinses increase plaque control used alone and particularly in combination. The stannous fluoride-cetylpyridinium chloride regimen showed the greatest benefits.

Antiplaque/antigingivitis efficacy and safety of a cetylpyridinium chloride/zinc gluconate mucoadhesive gel. Results of a 6-month clinical trial.

This article presents the results of a controlled clinical trial evaluating a new at-home treatment to improve gingival health. Designed for overnight application at the gingival margins and in the interproximal spaces, the product is a mucoadhesive gel containing 0.10% cetylpyridinium chloride (CPC) and 0.592% zinc gluconate (ZG). The authors assessed the efficacy and safety of the CPC/ZG gel in adults with low-to-moderate gingival and plaque index scores by comparing clinical and laboratory findings for subjects using the CPC/ZG gel with those for subjects using the control gel (0% CPC and 0.592% ZG). Clinical findings at 3 and 6 months showed statistically significant improvements in two of the three major indices of gingival health in the CPC/ZG group compared with the control group. The performance of the treatment gel was supported by results of microbial analyses of plaque samples.

Efficacy of 8 mg lidocaine and 2 mg cetylpyridinium chloride (CPC) fixed-combination lozenges on sore throat pain intensity compared with 1 mg lidocaine and 2 mg CPC fixed-combination lozenges in subjects with sore throat due to upper respiratory tract infection: a randomized double-blind parallel-group single-dose study.

BACKGROUND: Lozenges containing lidocaine and cetylpyridinium chloride (CPC) are commonly used for the treatment of sore throat. The lidocaine acts locally to provide pain relief and the CPC has an antiseptic effect. Mebucaine CL, a well-established fixed-combination sore throat lozenge, contains 1 mg lidocaine and 2 mg CPC. Single-agent lozenges containing 8 mg lidocaine have also been demonstrated to be significantly superior to placebo in confirmatory pain intensity assessments. This study compared a new lozenge formulation, containing 8 mg lidocaine and 2 mg CPC, with the currently marketed lozenge for the treatment and relief of sore throat symptoms in subjects diagnosed with a sore throat due to an upper respiratory tract infection (URTI). METHODS: In this double-blind parallel-group study, 250 adults with a sore throat due to an URTI were randomized to receive a single lozenge containing either 8 mg lidocaine + 2 mg CPC (n = 125) or 1 mg lidocaine + 2 mg CPC (n = 125). The primary efficacy endpoint of the study was the change in sore throat pain intensity (STPI) between baseline (immediately pre-treatment) and the 2-h post-dose assessment, measured on a 100 mm visual analog scale. STPI was measured at baseline and regular intervals up to 240 min after the lozenge was administered (evaluated in clinic). Any difficulty in swallowing and time to onset and duration of the analgesic effect were also assessed. RESULTS: No increase in efficacy was demonstrated with the higher dose of lidocaine. The difference in the 2-h post-dose change in STPI was not statistically significant between the treatments. There was only one statistically significant difference between the treatments in all of the efficacy outcomes assessed: pain relief scores at 4 h post-dose were higher with 1 mg lidocaine + 2 mg CPC than with 8 mg lidocaine + 2 mg CPC (P = 0.0461). The most commonly reported adverse event (AE) was a headache; the only other AE experienced by more than one subject was throat irritation. No severe adverse events were reported during the assessment period. CONCLUSIONS: The modest difference in the pattern of effectiveness between the two treatments observed in this study does not support use of the 8 mg lidocaine + 2 mg CPC lozenge. TRIAL REGISTRATION: ClinicalTrials.gov, NCT01265446 . Registered on 20 December 2010.

The effects of antimicrobial sprays and mouthrinses on supragingival plaque regrowth: a comparative study.

BACKGROUND: Due to the side effects of chlorhexidine digluconate (CHX) mouthrinsing, a spray has been proposed as an alternative method of CHX delivery to the oral cavity. The aim of this study was to investigate the plaque inhibitory effects of CHX, cetylpyridinium chloride (CPC), and triclosan (TRN) delivered by sprays and mouthrinses. METHODS: The study was an observer-masked, randomized cross-over design balanced for carryover effects, involving 15 healthy volunteers in a 4-day plaque regrowth model. Products being tested (0.2% CHX, 0.12% CHX, 0.05% CPC, and 0.03% TRN) were used both as sprays and mouthrinses. A saline solution served as a negative control. On day 1, subjects received professional prophylaxis, suspended oral hygiene measures, and commenced using their allocated products. On day 5, subjects were scored for disclosed plaque. RESULTS: CHX sprays (P<0.01) were the most effective sprays in preventing plaque regrowth, without significant differences between the two concentrations tested (P>0.05). TRN spray showed a significant inhibition of plaque regrowth in comparison to the negative control (P<0.05). CPC spray did not differ from saline spray (P>0.05). A similar trend of efficacy was detected for rinses. Although the effect on plaque regrowth observed with CHX rinses was superior to that of CHX sprays (P<0.0003), the latter did not cause side effects (P>0.2). CONCLUSIONS: These findings, together with those from clinical trials, suggest that the CHX-containing sprays may represent an effective alternative to CHX rinses when mechanical oral hygiene has to be avoided in restricted areas. On the contrary, the TRN and CPC sprays showed little or no plaque inhibitory effects.

Antimicrobial efficacy of gutta-percha supplemented with cetylpyridinium chloride.

To develop a root canal filling material with high antimicrobial activity, we prepared gutta-percha supplemented with the cationic surfactant cetylpyridinium chloride (CPC). Thermoplastic gutta-percha was supplemented with 0.05%, 0.2%, or 0.8% CPC. The gutta-percha containing CPC was tightly packed at the bottom of a 24-well plate. Its antimicrobial activity against eight representative endodontic pathogens-including gram-positive and gram-negative bacteria and fungi-was evaluated by adding 0.5 mL of liquid samples containing pathogens to the wells. After 24 h of cultivation under appropriate conditions, microbial growth was analyzed by counting colony-forming units (CFU). Gutta-percha alone (without CPC) partially inhibited microbial growth, probably through the antimicrobial effect of some of its components, such as zinc oxide. Addition of CPC dose-dependently increased the antimicrobial efficacy of gutta-percha. Addition of 0.05%, 0.2%, and 0.8% CPC reduced the viable microbial number to below the lower limit of detection (20 CFU/mL) for all tested pathogens except Pseudomonas aeruginosa, which was detected in 0.8% CPC-containing gutta-percha, although the viable number significantly decreased. Gutta-percha with CPC might be useful for preventing microbial infections during root canal therapy. (J Oral Sci 58, 277-282, 2016).