Color stability and solubility of Biodentine and NeoPutty in contact with different irrigation solutions.

Objectives: This study aimed to evaluate the color stability and solubility of Biodentine and NeoPutty in contact with different irrigation solutions. Materials and Methods: Biodentine and NeoPutty were set in cylindrical molds with 7 mm diameter and 1.5 mm high and immersed in distilled water, 17% ethylenediaminetetraacetic acid (EDTA), 2% chlorhexidine (CHX), 9% 1-hydroxyethylidene 1,1-diphosphonate (HEDP), and 5% sodium hypochlorite (NaOCl) solutions for 24 hours. The color change was measured with a spectrophotometer. The solubility values were calculated as the mass loss was expressed as a percentage of the original mass using an analytical balance with 10-4 g accuracy. Data were analyzed with Kruskal-Wallis followed by Mann-Whitney U tests, and 2-way analysis of variance test followed by Bonferroni corrections for pairwise comparisons for solubility and color stability with a 5% significance threshold, respectively. Results: Biodentine exhibited higher color changes compared to the NeoPutty contact with all solutions except distilled water (p < 0.05). Both hydraulic cements (HCs) showed higher discoloration values immersion in CHX followed by NaOCl. No statistically significant difference was found between Biodentine and NeoPutty regardless of irrigation solution in terms of solubility (p > 0.05). Solubility values were lower in the distilled water group compared to EDTA and CHX (p < 0.05). Conclusions: Tested HCs showed solubility and color changes at various rates. NeoPutty could be an appropriate material in aesthetic areas. The usage of HEDP as an irrigant solution can be considered suitable for various endodontic treatments due to its relatively lower solubility and discoloration values.

A Comparative Analysis of the Antimicrobial Efficacy of Nisin in Different Vehicles Against Enterococcus faecalis: An In Vitro Study.

Aim To evaluate and compare the antimicrobial efficacy of nisin in different carriers against Enterococcus faecalis. Materials and methods Test materials were divided into four groups of five samples each as follows: group 1 = nisin + 17% ethylenediaminetetraacetic acid (EDTA); group 2 = nisin + 2% chitosan; group 3 = nisin + 2% chlorhexidine; group 4 = nisin + distilled water (control). The antimicrobial effectiveness was assessed using the direct contact method, where a standardized E. faecalis suspension was applied to the test materials. Optical density (OD) was assessed using enzyme-linked immunosorbent assay (ELISA) at the end of days one and seven. Data were analyzed using ANOVA and Tukey's post hoc analysis. The level of significance was set at p < 0.05. Results On day one, there was a significant difference in the mean OD values (p < 0.001) with group 3 showing the highest, followed by groups 1, 2, and 4. On day seven, all groups demonstrated antibacterial activity (group 1 > group 3 > group 4 > group 2) but the differences were not statistically significant (p = 0.393). Intragroup analysis showed a decrease in the OD values from day one to day seven, the difference of which was not significant in all groups except group 1, which showed a significant difference (p = 0.035). Conclusion The antibacterial efficacy of nisin was synergistically enhanced with the addition of 17% EDTA and 2% chlorhexidine over seven days against E. faecalis.

Effectiveness of Chlorhexidine and Aloe Vera Mouthwash in Patients With Periodontal Disease: A Randomized Controlled Trial.

BACKGROUND: Aloe vera has gained significant attention in clinical research, and promoting natural substances is a prevailing trend in dentistry. AIM: This study compares the effectiveness of aloe vera mouthwash and 0.2% chlorhexidine gluconate mouthwash in reducing plaque accumulation and gingivitis. MATERIALS AND METHODS: A single-masked trial included 270 volunteers who were systemically healthy and aged between 18 and 45 years. The participants were randomly assigned to three groups: Group A (the test group) received aloe vera mouth rinse, Group B (the positive control group) received a placebo (distilled water), and Group C (the negative control group) received 0.2% chlorhexidine. Clinical indicators, which include the plaque index (PI) by Sillness and Loe in 1964 and the gingival index (GI) by Loe and Sillness in 1963, were evaluated at baseline, day 15, and day 30 for all three groups. Participants were directed to rinse their mouths with the specified mouthwash twice daily for 30 days. RESULTS: Significant reductions in the GI and PI were observed in both aloe vera and chlorhexidine mouthwashes, with a statistical significance of p<0.001. The placebo mouthwash also showed reductions in both the GI and PI, with a significance level of p<0.001. Post hoc analysis revealed no significant differences between the aloe vera and chlorhexidine groups for the GI and PI, with p-values of 0.6 and 0.8, respectively. CONCLUSION: Aloe vera has proven equally effective as chlorhexidine in reducing plaque and gingivitis. This makes it a viable alternative for treating and preventing gingivitis, appealing to those preferring natural, holistic oral care. Incorporating aloe vera mouthwash into daily routines offers an effective, natural solution for maintaining gum health.

A Comparative Evaluation of Nanosilver Fluoride, Chlorhexidine, and Sodium Fluoride When Used as a Varnish on Streptococcus mutans Levels in Children with Caries.

Aim: The purpose of the present study is to evaluate the effect of nanosilver fluoride (NSF), chlorhexidine (CHX), and sodium fluoride (NaF) when used as a varnish on Streptococcus mutans levels in children with dental caries. Study design: A total of 120 children (age range 8-12 years) with incipient caries were randomly assigned to four groups (n = 30): group I-NSF varnish, group II-CHX varnish, group III-NaF varnish, and group IV-control. Varnish application at baseline was performed once. To assess the levels of S. mutans using the culture method [colony-forming units (CFUs)] and optical density (OD), plaque and samples were taken at baseline (T0), 1 month (T1), and 3 months (T3). Additionally, the oral hygiene index-simplified (OHI-S) was noted for clinical assessment. Results: By the end of 3 months, a statistically significant reduction in plaque CFU and salivary CFU was found in group II. At the conclusion of the 3 months, group I had the greatest decrease in OHI-S. After 3 months, the plaque CFU score did not differ significantly across groups I, II, and III. However, a statistically significant difference in OD values (p-value of 0.00) was discovered between group I and all other groups. Conclusion: Children with early caries can effectively lower their S. mutans count by using NSF varnish. How to cite this article: Raja T, Agarwal N, Jabin Z, et al. A Comparative Evaluation of Nanosilver Fluoride, Chlorhexidine, and Sodium Fluoride When Used as a Varnish on Streptococcus mutans Levels in Children with Caries. Int J Clin Pediatr Dent 2024;17(4):410-416.

Comparative Evaluation of the Antimicrobial Efficacy of Elettaria cardamomum (0.5%) Mouthwash, Camellia sinensis (0.5%) Mouthwash, and 0.12% Chlorhexidine Gluconate Mouthwash against Streptococcus mutans: An In Vitro Study.

Aim: The in vitro study aimed to evaluate and compare the antimicrobial efficacy of Elettaria cardamomum (0.5%) mouthwash, Camellia sinensis (0.5%) mouthwash, and 0.12% chlorhexidine gluconate mouthwash against Streptococcus mutans. Materials and methods: A total of 60 samples of the five mouthwash preparations were prepared to check for their antimicrobial efficacy. The zone of inhibition (ZOI) against S. mutans was measured as a diameter in mm, and the minimum inhibitory concentration (MIC) of mouthwash preparations was measured as µg/mL. All the groups were compared statistically using the Mann-Whitney U test and the Kruskal-Wallis test. Results: The highest ZOI was observed in group V chlorhexidine gluconate [mean: 20.8, standard deviation (SD): 0.58], followed by group III C. sinensis (alcohol-free) (mean: 15.5, SD: 0.67), group IV C. sinensis (alcohol-based) (mean: 14.08, SD: 0.66), and group II E. cardamomum (alcohol-based) (mean: 13.2, SD: 0.45). The least ZOI was observed in group I E. cardamomum (alcohol-free) (mean: 10.7, SD: 0.45). This difference was statistically significant (p < 0.01). The MIC was similar in all the groups (p = 0.13). Conclusion: Chlorhexidine gluconate 0.12% mouthwash showed the best antimicrobial action; however, C. sinensis mouthwash showed potential against S. mutans. E. cardamomum mouthwash exhibited limited antimicrobial activity. How to cite this article: Deolikar S, Jawdekar A, Saraf T, et al. Comparative Evaluation of the Antimicrobial Efficacy of Elettaria cardamomum (0.5%) Mouthwash, Camellia sinensis (0.5%) Mouthwash, and 0.12% Chlorhexidine Gluconate Mouthwash against Streptococcus mutans: An In Vitro Study. Int J Clin Pediatr Dent 2024;17(4):461-466.

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

Background and objectives: 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. Materials and methods: 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. Results: On comparison between the two groups, the OCT group showed a statistically significant reduction in GI, PlI, and MDA values (p < 0.05). Conclusion: 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. Clinical trial registration: PMS/IEC/2016/02. How to cite this article: 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.

Antimicrobial efficacy of chitosan versus sodium hypochlorite: A systematic review and meta-analysis.

AIM: This meta-analysis aimed to compare the antibacterial efficacy of chitosan/chitosan nanoparticles (Ch/Ch-NPs) versus sodium hypochlorite/chlorhexidine (NaOCl/CHX). MATERIALS AND METHODS: A search was performed in four electronic databases until December 08, 2023. Studies with missing, unclear, and insufficient data sets were excluded. The included studies were assessed by two independent reviewers using the Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies. The meta-analysis of standardized mean difference was performed using a random effects model. Additionally, funnel plots as well as Egger's regression intercept test were used to evaluate potential publication bias. RESULTS: A total of 426 samples were used in nine included studies. There was no difference in antibacterial efficacy between Ch/Ch-NPs-NaOCl (SMD: 0.005; 95% CI: -0.844-0.854; p = 0.990). However, the antibacterial efficacy of NaOCl was statistically more effective than Ch/Ch-NPs (SMD: 0.807; 95% CI: 0.015-1.599; p = 0.046) using the bacterial culture method, and Ch/Ch-NPs was statistically higher than NaOCl (SMD: -1.827; 95% CI: -2.720, -0.934; p < 0.000) using confocal laser scanning microscopy. CONCLUSIONS: Ch/Ch-NPs may be an alternative to NaOCl against Enterococcus faecalis. The methods used in the in vitro studies evaluating the antibacterial efficacy of irrigation solutions against E. faecalis may have had an impact on the results.

Evaluation of Folic Acid-Containing Mouthrinse and Chlorhexidine Mouthrinse as an Adjunct to Scaling and Root Planing in Patients With Periodontal Disease.

BACKGROUND: Periodontal disease is a host-mediated inflammation caused due to microbial challenge. Hence, mechanisms involving the control of host-associated mediators can be a potential target. The conventional nonsurgical periodontal treatment modality includes scaling and root planing (SRP), which is often combined with adjunctive chemical plaque control agents for effective disease control. Chlorhexidine (CHX) is the most common chemical plaque control agent used. Recent research is now being focused on exploring other medicinal substitutes that may benefit control of inflammation and tissue healing. Folic acid is an important nutrient that increases the ability of oral epithelial cells to resist local irritants and inflammation if supplemented either systemically or locally. AIM: The current study aimed to evaluate the effect of folic acid and CHX mouthwash as an adjunct to scaling and root planing for treating patients with chronic periodontitis. METHODOLOGY: In this study, 30 patients with chronic periodontitis were included and assigned to either of the two groups: Group A (receiving folic acid-containing mouthrinse) and Group B (receiving CHX mouthrinse). Periodontal measurements, including plaque index, probing pocket depth, gingival index, and healing index, were evaluated at baseline and again four weeks after scaling and root planing. RESULTS: Significant reduction was detected in all clinical parameters (plaque index, gingival index, probing pocket depth, healing index) for both groups (p<0.05) when evaluated from baseline to four weeks. CONCLUSION: Both mouthrinses were effective when used as an adjunct to scaling and root planing in the treatment of periodontitis. Hence, folic acid-containing mouthrinse can be used in patients with chronic periodontitis.

Real-time flow cytometry to assess qualitative and quantitative responses of oral pathobionts during exposure to antiseptics.

Antiseptics are widely used in oral healthcare to prevent or treat oral diseases, such as gingivitis and periodontitis. However, the incidence of bacteria being tolerant to standard antiseptics has sharply increased over the last few years. This stresses the urgency for surveillance against tolerant organisms, as well as the discovery of novel antimicrobials. Traditionally, susceptibility to antimicrobials is assessed by broth micro-dilution or disk diffusion assays, both of which are time-consuming, labor-intensive, and provide limited information on the mode of action of the antimicrobials. The abovementioned limitations highlight the need for the development of new methods to monitor and further understand antimicrobial susceptibility. In this study, we used real-time flow cytometry, combined with membrane permeability staining, as a quick and sensitive technology to study the quantitative and qualitative responses of two oral pathobionts to different concentrations of chlorhexidine (CHX), cetylpyridinium chloride (CPC), or triclosan. Apart from the real-time monitoring of cell damage, we further applied a phenotypic fingerprinting method to differentiate between the bacterial subpopulations that arose due to treatment. We quantified the pathobiont damage rate of different antiseptics at different concentrations within 15 minutes of exposure and identified the conditions under which the bacteria were most susceptible. Moreover, we detected species-specific and treatment-specific phenotypic subpopulations. This proves that real-time flow cytometry can provide information on the susceptibility of different microorganisms in a short time frame while differentiating between antiseptics and thus could be a valuable tool in the discovery of novel antimicrobial compound, while at the same time deciphering their mode of action. IMPORTANCE: With increasing evidence that microorganisms are becoming more tolerant to standard antimicrobials, faster and more accessible antimicrobial susceptibility testing methods are needed. However, traditional susceptibility assays are laborious and time-consuming. To overcome the abovementioned limitations, we introduce a novel approach to define antimicrobial susceptibility in a much shorter time frame with the use of real-time flow cytometry. Furthermore, phenotypic fingerprinting analysis can be applied on the data to study the way antiseptics affect the bacterial cell morphology over time and, thus, gain information on the mode of action of a certain compound.

Plumbagin enhances antimicrobial and anti-biofilm capacities of chlorhexidine against clinical Klebsiella pneumoniae while reducing resistance mutations.

With the widespread misuse of disinfectants, the clinical susceptibility of Klebsiella pneumoniae (K. pneumoniae) to chlorhexidine (CHX) has gradually diminished, posing significant challenges to clinical disinfection and infection control. K. pneumoniae employs overexpression of efflux pumps and the formation of thick biofilms to evade the lethal effects of CHX. Plumbagin (PLU) is a natural plant extract that enhances membrane permeability and reduces proton motive force. In this study, we elucidated the synergistic antimicrobial activity of PLU in combination with CHX, effectively reducing the MIC of CHX against K. pneumoniae to 1 µg/mL and below. Crucially, through crystal violet staining and confocal laser scanning microscopy live/dead staining, we discovered that PLU significantly enhances the anti-biofilm capability of CHX. Mechanistically, experiments involving membrane permeability, alkaline phosphatase leakage, reactive oxygen species, and RT-qPCR suggest that the combination of PLU and CHX improves the permeability of bacterial inner and outer membranes, promotes bacterial oxidative stress, and inhibits oqxA/B efflux pump expression. Furthermore, we conducted surface disinfection experiments on medical instruments to simulate clinical environments, demonstrating that the combination effectively reduces bacterial loads by more than 3 log10 CFU/mL. Additionally, results from resistance mutation frequency experiments indicate that combined treatment reduces the generation of resistant mutants within the bacterial population. In summary, PLU can serve as an adjuvant, enhancing the anti-biofilm capability of CHX and reducing the occurrence of resistance mutations, thereby extending the lifespan of CHX.IMPORTANCEAs disinfectants are extensively and excessively utilized worldwide, clinical pathogens are progressively acquiring resistance against these substances. However, high concentrations of disinfectants can lead to cross-resistance to antibiotics, and concurrent use of different disinfectants can promote bacterial resistance mutations and facilitate the horizontal transfer of resistance genes, which poses significant challenges for clinical treatment. Compared with the lengthy process of developing new disinfectants, enhancing the effectiveness of existing disinfectants with natural plant extracts is important and meaningful. CHX is particularly common and widely used compared with other disinfectants. Meanwhile, Klebsiella pneumoniae, as a clinically significant pathogen, exhibits high rates of resistance and pathogenicity. Previous studies and our data indicate a significant decrease in the sensitivity of clinical K. pneumoniae to CHX, highlighting the urgent need for novel strategies to address this issue. In light of this, our research is meaningful.

The effects of chlorhexidine gel and tranexamic acid application after tooth extraction on the risk of alveolar osteitis formation: a double blind clinical study.

BACKGROUND: Alveolar osteitis(AO), one of the most common complications occurring in 1-10% of cases following tooth extraction, occurs due to the disruption of clot formation in the extraction socket. This study aims to evaluate the effect of using absorbable gelatin sponge, chlorhexidine gel, and tranexamic acid agents on the development of AO following extraction. METHODS: Between March and October 2023, the teeth of 98 healthy patients (average age: 38, range: 19-62) with extraction indications were extracted at Recep Tayyip Erdogan University, Faculty of Dentistry, Department of Oral and Maxillofacial Surgery. 113 extraction sockets(85 molars and 28 premolars) were randomly treated with absorbable gelatin sponge(AGS), chlorhexidine gel with AGS, and tranexamic acid with AGS. Pain and edema levels were recorded using visual analog scale(VAS) ranging from 0 to 10 by the patients. Additionally, presence of halitosis, trismus and exposed bone was noted on forms on 3rd and 7th days (recorded as present or absent). The study prospectively aimed to prevent AO using 3 different dental agents in the extraction sockets. Statistical analyses of the study were conducted using the SPSS software package. RESULTS: Alveolitis was observed in 12 out of 113 tooth extractions(%10.6). Pain and edema scores significantly decreased in absorbable gelatin sponge group on the 7th day (p < 0.05). Pain score on the 7th day in chlorhexidine group and age, edema score on the 7th day in tranexamic acid group, were found to be significantly higher (p < 0.05). CONCLUSION: Incidence of AO, can be reduced by placing agents in the extraction socket, preventing post-extraction pain experienced by patients. CLINICAL TRIALS ID: NCT06435832.

Comparison of the anti-plaque and anti-gingivitis efficacy of Chlorhexidine and Malva mouthwashes: randomized crossover clinical trial.

OBJECTIVES: Although mechanical oral hygiene is widely practiced, it faces several challenges. Mouthwashes, such as chlorhexidine (CHX), are being explored as adjuncts to biofilm control, but their prolonged use has several side effects. Consequently, there is ongoing research into natural alternatives. This randomized crossover clinical study aimed to compare the antiplaque and antigingivitis efficacy of 0.12% CHX and a 5% Malva sylvestris METHODS: Forty-four participants were involved in two phases, each comprising three stages with variations in the mouthwash solution used only. During the study, participants refrained from mechanical plaque removal for seven days. At first day, they received whole-mouth prophylaxis and oral health assessment. After three days, gingival inflammation assessment and prophylaxis in were performed in contralateral quadrants. Participants then used a randomly assigned mouthwash solution for four days. On the 7th day, they completed a questionnaire about their perception and appreciation of the mouthwash. Additionally, gingival inflammation and plaque index were also performed by a calibrated examiner. After a minimum 21-day washout period, participants entered the second phase, repeating the three stages RESULTS: Results showed no statistically significant differences between the Malva sylvestris and CHX groups regarding inflammation and plaque formation. However, CHX demonstrated a significantly greater mean reduction (7th - 4th day) in gingival inflammation compared to Malva (p=0.02) (0.01±0.19 and 0.00±0.19, respectively). Additionally, participants using CHX reported a more pleasant taste and considered higher plaque control perception (p<0.05) CONCLUSIONS: In conclusion, both products exhibited similar antiplaque effects, but CHX outperformed Malva in controlling gingival inflammation. CLINICAL SIGNIFICANCE: Mouthwashes with Malva sylvestris may be a good alternative, in a short-term period, to control biofilm. However, lower antigingivitis efficacy may be expected when compared to chlorhexidine.

Topical Oxygen Therapy for Promoting Healing After Implant Placement Using Blue® M Gel: A Report of Two Cases.

Peri-implant diseases, such as peri-implant mucositis and peri-implantitis, are distinguished by a gradual onset of inflammation within the peri-implant mucosa, resulting in bone resorption and, ultimately, implant failure. Topical oxygen therapy is recognized for its ability to decrease inflammation, enhance blood flow, and provide a bacteriostatic effect. Utilizing oxygen-based therapy products as a local treatment for peri-implant mucositis and peri-implantitis may lead to comparable clinical results as traditional local adjuncts such as chlorhexidine, antibiotics, and antibacterial agents. This article discusses two case reports in which the Blue® M gel was utilized. In the first case, a 50-year-old female patient with a decade-long history of betel quid chewing and missing upper right first and second molars was treated with Blue® M gel to reduce the chances of peri-implantitis and promote healing following a first-stage surgical procedure for implant placement. In the second case, Blue® M gel was applied to a 56-year-old female patient who experienced pain and inflammation one week after the initial surgical procedure for implant placement to restore the missing posterior teeth on the lower right side. The use of the Blue® M gel led to accelerated healing in both instances.

Comparative Evaluation of Antifungal Efficacy of 3% Sodium Hypochlorite, 2% Chlorhexidine Gluconate, Ozonated Water, Alum Water, and Normal Saline Solutions against Endodontopathogenic Microorganism, Candida Albicans: A Microbiological In Vitro Study.

Aims and objective: To compare and evaluate the antifungal efficacy of 3% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX) gluconate, 4 mg/mL ozonated water, and 2M alum water against Candida albicans (C. albicans). Materials and methods: A total of 35 patients were selected from those attending the outpatient department of Pedodontics and Preventive Dentistry at Santosh Dental College and Hospitals, Ghaziabad. Their salivary samples were taken and cultured on a Sabouraud's dextrose agar (SDA) plate. The antifungal efficacy of 3% NaOCl, 2% CHX gluconate, 4 mg/mL concentration of ozonated water, and 2M alum water was assessed against clinical strains of C. albicans with the help of agar well diffusion method. The microbial isolates were inoculated into 10 mL of sterile peptone water and incubated at 37°C for 8 hours. The cultures were swabbed on the surface of sterile Mueller-Hinton agar plates using a sterile cotton swab. Five wells of 6 mm diameter were punched in each Petri dish. Around 100 µL of each test solution was poured into the designated wells. Further, the plates were incubated in an upright position at 37°C for 24 hours. The antifungal activity of the test solutions was determined by measuring the diameter of the inhibition zone in mm produced against the Candida isolates, and means were calculated. Results: It was observed that all test solutions used in this study were inhibitory against C. albicans but with a variation in the size of inhibitory zones. According to the means of the diameter of inhibitory zones for all test solutions, the 3% NaOCl represented the statistically significant largest average zones of inhibition against C. albicans, followed by 2% CHX when compared with the other two test solutions alum water and ozonated water. Ozonated water produced the smallest mean inhibitory zone. How to cite this article: Sharma A, Naorem N, Srivastava B, et al. Comparative Evaluation of Antifungal Efficacy of 3% Sodium Hypochlorite, 2% Chlorhexidine Gluconate, Ozonated Water, Alum Water, and Normal Saline Solutions against Endodontopathogenic Microorganism, Candida Albicans: A Microbiological In Vitro Study. Int J Clin Pediatr Dent 2024;17(S-1):S17-S24.

Antimicrobial Efficacy of Mangifera indica, Mentha arvensis, and Chlorhexidine Mouthwashes on Streptococcus mutans and Candida albicans in Children: A Comparative In Vivo Study.

Background: Herbal medicines are both promotive and preventive in inhibiting dental caries. Most commonly used natural plant extracts like mango (Mangifera indica) and pudina (Mentha arvensis) as an entire or together are scientifically well proven to be safe and effective against various oral health problems, especially in preventing dental caries and periodontal diseases. Aim: The present study aims to comparatively evaluate the effect of Mangifera indica, Mentha arvensis, and Chlorhexidine (CHX) (0.2%) mouthwashes on Streptococcus mutans (S. mutans) and Candida albicans (C. albicans) in children. Materials and methods: By random allocation, 45 healthy children were selected between the age-group of 7 and 10 years of both genders from a residential school. They were divided into three study groups of 15 in each; group I-CHX (control group), group II-Mangifera indica mouthwash, and group III-Mentha arvensis mouthwash. Stimulated whole saliva sample collected for the amount of colony forming units and cultured for S. mutans and C. albicans. The data was tabulated, and statistical analysis was done with one-way variance analysis of the variance (ANOVA), Tukey's post hoc honestly significant difference (HSD) test, and Bonferroni and Kruskal-Wallis test. Results: Mangifera indica (group II) and Mentha arvensis (group III) showed a significant reduction of salivary counts at baseline, 14th day, and 21st day period and minimal effect on C. albicans for Mangifera indica. Among the three types of mouthwash, the CHX was the most superior; it showed a statistically significant reduction overall. When compared to Mangifera indica with Mentha arvensis, Mentha arvensis showed a statistically significant reduction in S. mutans and C. albicans and had an almost equivocal effect like CHX. Conclusion: Both herbal mouthwashes had a significant reduction in the S. mutans and C. albicans in children. So, it can be considered an active ingredient in mouthwashes. It may serve as a natural antimicrobial mouthwash with no adverse effects. How to cite this article: Kajjari S, K VB, Janardhanan S, et al. Antimicrobial Efficacy of Mangifera indica, Mentha arvensis, and Chlorhexidine Mouthwashes on Streptococcus mutans and Candida albicans in Children: A Comparative In Vivo Study. Int J Clin Pediatr Dent 2024;17(S-1):S78-S83.

Effect of glycerol on properties of chitosan/chlorhexidine membranes and antibacterial activity against Streptococcus mutans.

Introduction: Chitosan membranes with glycerol can function as an effective dispersing agent for different antibiotics or active ingredients that can be used in the treatment of diseases present in the oral cavity. Methods: The effects of the addition of glycerol on the mechanical, water absorption, swelling, pH, thickness, disintegration, rugosity, and antibacterial properties of chitosan-chlorhexidine- glycerol membranes were investigated in this study. Results and discussion: Mechanical results indicated that chitosan membranes' rugosity, strength, flexion, and thickness differed at loading 1, 3, 5, 10, 15, and 20% of glycerol (p < 0.05). The chitosan membranes' rugosity, dissolution, strength, and pH results were significantly enhanced by the presence of glycerol at 3, 5, and 10% concentrations. In this investigation, the antimicrobial activity model used was the inhibition of Streptococcus mutans CDBB-B-1455 by chitosan-chlorhexidine membranes. It was observed that there was no change in inhibition with different concentrations of glycerol. The results suggest that chitosan-glycerol-chlorhexidine membranes may be a potential candidate for topical antiseptic application in buccal-dental disorders caused by S. mutans, such as caries, periodontal diseases, and oral squamous cell carcinoma, helping to prevent the development of serious conditions that can compromise human health.

An in-depth study on survival mechanism of bacterial isolates in disinfectants within the hospital environment.

Introduction: The emergence of disinfectant resistance has become a severe threat due to reduced effectiveness. This study was undertaken to determine how bacteria adapt to survive exposure to disinfectants in the busiest section of a tertiary care hospital in Varanasi, India. Methods: Four isolates (two Klebsiella pneumoniae, Kp1 and Kp2; two Pseudomonas aeruginosa, Pa1 and Pa2) were obtained from chlorhexidine (CHX)-based handwash during microbiological surveillance of "in-use disinfectants" in hospital. Six disinfectants [4% CHX, 2% glutaraldehyde, 7.5% hydrogen peroxide, 1% sodium hypochlorite and 0.1% benzalkonium chloride (BAC), and 70% ethyl alcohol] were tested against these four isolates to determine minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Antibiotic profile, change in MIC on exposure to disinfectants and biofilm formation in the presence and absence of disinfectants was studied. Whole genome sequencing (WGS) was done to identify the resistance mechanisms. Result: The isolates showed the highest MBC/MIC ratio (4) against glutaraldehyde. Exposure to supra-inhibitory concentration of BAC for 21 days resulted in doubling of MIC/MBC. The majority (75%) of the isolates were multidrug resistant. All the isolates were strong biofilm producers. The reduction rate of biofilm formation decreased with an increase in the concentration of disinfectants (p = 0.05 for BAC). WGS revealed multiple AMR genes including bla DIM-1, disinfectant-resistant gene and efflux pump genes. Conclusion: The study emphasized the various adaptation strategies of these isolates for survival in disinfectant environment, thus posing a huge challenge for their control in the hospital environment.

Molecular typing of reduced susceptibility of Acinetobacter calcoaceticus-baumannii complex to Chlorhexidine in Turkey by pulsed-field gel electrophoresis.

Introduction. The global spread of Acinetobacter spp., particularly the Acinetobacter calcoaceticusbaumannii (ACB) complex, has led to its recognition as a significant pathogen by the World Health Organization (WHO). The increasing resistance of the ACB complex to multiple antibiotics presents a challenge for treatment, necessitating accurate antibiotic susceptibility profiling after isolation.Hypothesis or gap statement. There is limited understanding of the antimicrobial resistance and chlorhexidine, a biocide, susceptibility profiles of ACB complex strains, especially in clinical settings in Turkey.Aim. This study aimed to identify ACB complex strains recovered from various clinical specimens at Hacettepe University Hospitals in Ankara, Turkey, in 2019, and to assess identification, their antibiotic and chlorhexidine susceptibility profiles, and genomic relatedness.Methodology. Eighty-two ACB complex strains were identified using MALDI-TOF MS. Susceptibility testing to 12 antibiotics was conducted using the disc diffusion method, and colistin, chlorhexidine susceptibility was assessed using the broth microdilution technique, following the latest EUCAST and CLSI guidelines. ACB complex members with reduced chlorhexidine sensitivity were further analyzed by pulsed-field gel electrophoresis (PFGE) for bacterial typing.Results. Among the isolates, 1.2% were multidrug-resistant (MDR), 73.2% were extensively drug-resistant (XDR), and 12.2% were pandrug-resistant (PDR). Carbapenem resistance was found in 86.7% of MDR, PDR, and XDR strains. Colistin resistance was observed in 15.8% of isolates, and 18.2% exhibited decreased susceptibility to chlorhexidine. PFGE revealed seven different clones among strains with reduced chlorhexidine sensitivity, indicating vertical transmission within the hospital.Conclusion. This study highlights the reduced susceptibility to chlorhexidine in ACB complex members and provides epidemiological insights into their spread. The findings underscore the importance of screening for antimicrobial resistance and biocide susceptibility profiles to effectively manage healthcare-associated infections.

New Insights Regarding the Use of Relevant Synthetic Compounds in Dentistry.

Worldwide, synthetic compounds are used for both in-office and at-home dental care. They are a valuable resource for both prophylactic and curative treatments for various dental problems, such as tooth decay, periodontal diseases, and many more. They are typically preferred due to their broad range of actions and ability to produce targeted, rapid, and long-lasting effects. Using a 0.12% chlorhexidine mouthwash is capable of reducing the plaque index from 47.69% to 2.37% and the bleeding index from 32.93% to 6.28% after just 2 weeks. Mouthwash with 0.1% OCT is also highly effective, as it significantly lowered the median plaque index and salivary bacterial counts in 152 patients in 5 days compared to a control group (p < 0.0001), while also reducing the gingival index (p < 0.001). When povidone-iodine was used as an irrigant during the surgical removal of mandibular third molars in 105 patients, it resulted in notably lower pain scores after 2 days compared to a control group (4.57 ± 0.60 vs. 5.71 ± 0.45). Sodium hypochlorite is excellent for root canal disinfection, as irrigating with 1% NaOCl completely eliminated the bacteria from canals in 65% patients. A 0.05% CPC mouthwash proved effective for perioperative patient care, significantly decreasing gingival bleeding (p < 0.001) and suppressing Streptococcus levels even one week post-surgery. Lastly, a 6% H2O2 paint-on varnish and 6% H2O2 tray formulations successfully bleached the teeth of 40 patients, maintaining a noticeably whiter appearance up to the 6-month follow-up, with significant color differences from the baseline (p < 0.005). Synthetic compounds have a large research base, which also provides a greater awareness of their mechanism of action and potential adverse effects. For a better understanding of how they work, several methods and assays are performed. These are protocolary techniques through which a compound's efficacy and toxicity are established.

Mangostanin hyaluronic acid hydrogel as an effective biocompatible alternative to chlorhexidine.

Periodontal disease (PD) prevention and treatment products typically demonstrate excellent antibacterial activity, but recent studies have raised concerns about their toxicity on oral tissues. Therefore, finding a biocompatible alternative that retains antimicrobial properties is imperative. In this study, a chemically modified hyaluronic acid (HA) hydrogel containing mangostanin (MGTN) was developed. Native HA was chemically modified, incorporating amino and aldehyde groups in different batches of HA, allowing spontaneous crosslinking and gelation when combined at room temperature. MGTN at different concentrations was incorporated before gelation. The structure, swelling characteristics MGTN release, rheological parameters, and in vitro degradation performance of the loaded hydrogel were first evaluated in the study. Then, antimicrobial properties were tested on Porphyromonas gingivalis and its biocompatibility in 3D-engineered human gingiva. HA hydrogel was very stable and showed a sustained release for MGTN for at least 7 days. MGTN-loaded HA hydrogel showed equivalent antimicrobial activity compared to a commercial gel of HA containing 0.2 % chlorhexidine (CHX). In contrast, while MGTN HA hydrogel was biocompatible, CHX gel showed high cytotoxicity, causing cell death and tissue damage. Modified HA hydrogel allows controlled release of MGTN, resulting in a highly biocompatible hydrogel with antibacterial properties. This hydrogel is a suitable alternative therapy to prevent and treat PD.