Efficacy of mouthrinses in inhibiting the development of supragingival plaque over a 4-day period of no oral hygiene.

This study was a first stage evaluation of the plaque inhibitory properties of an experimental cetylpyridinium chloride (CPC)/essential oil mouthrinse. The study was a formulation, not ingredient, evaluation and comparisons were made with established mouthrinse products. The 5 rinses tested were: the experimental formulation; a triclosan/copolymer prebrushing mouthrinse; two negative control rinses, which differed only in color; and as a positive control, a 0.2% chlorhexidine mouthrinse. The study used a 5 cell, 4-day plaque regrowth, double-blind crossover design in which 15 subjects participated. Allocation of mouthrinse sequences was accomplished using 3 replicates of a 5 x 5 Latin square, incorporating balance for carryover. On Day 1, subjects received a scaling and polishing to reduce plaque, ceased toothcleaning, and commenced rinsing twice daily, under supervision, with the randomly assigned rinse. Rinsing time for the experimental and one negative control rinse was 30 seconds and for the other rinses was 60 seconds. On Day 5, plaque was scored by both index and area. Differences in plaque regrowth between the rinse groups were highly significant. The order of efficacy from the most effective was: chlorhexidine rinse (positive control); experimental CPC/essential oil rinse; triclosan/copolymer rinse; and the negative control rinses. From the calculated confidence intervals each rinse differed significantly from each other rinse, except for the two negative control rinses which were comparable to each other. Proportionately, the CPC/essential oil rinse was positioned 30 to 50% between the triclosan/copolymer rinse and the chlorhexidine (positive control). These findings suggest that the CPC/phenolic rinse would seem worthy of further evaluation for adjunctive benefits to oral hygiene.

A study of a pre-brushing mouthrinse as an adjunct to oral hygiene.

A previous clinical screening study demonstrated that a cetylpyridinium chloride (CPC) essential oil mouthrinse inhibited plaque regrowth to a significantly greater extent than a negative control or a triclosan/copolymer rinse when used without toothbrushing. The purpose of this study was to evaluate the same ingredient combination as a pre-brushing rinse over a 6-week period. The study employed a 4 group parallel design with a minimum of 50 subjects per group. Subjects with a minimum baseline plaque index of 1.95 were recruited. The formulations employed were two variations of a CPC/essential oil rinse, a triclosan/copolymer product, and a hydroalcohol negative control. Subjects were rendered plaque free at baseline and then rinsed twice daily before toothbrushing with their allocated product. Plaque was scored at 6 days and 6 weeks. Plaque scores were reduced at 6 days compared to baseline but there were no significant differences between any of the groups. At 6 weeks, plaque scores were significantly lower in both CPC/essential oil groups compared to control. Although both CPC/essential oil groups showed plaque scores which were lower than the triclosan group, in only one of the groups was the difference significant. The triclosan product was not significantly different from control. The results support the previous findings that a CPC/essential oil rinse could be a useful adjunct to oral hygiene when used prior to normal toothbrushing.

Short-term microbiological and clinical effects of subgingival irrigation with an antimicrobial mouthrinse.

Fifty chronic adult periodontitis patients completed a 6-week controlled, double-blind, split mouth clinical study to determine the effects of subgingival irrigation with an antimicrobial mouthrinse on periodontal microflora, supragingival plaque, and gingivitis when used as an adjunct to normal oral hygiene. Qualifying subjects had at least four sites, two on each side of the mouth, with probing depths between 4 and 6 mm, which bled on gentle probing. Following baseline examinations, subjects received a half mouth scaling and prophylaxis and full mouth subgingival irrigation with either the antimicrobial mouthrinse or sterile colored water control professionally delivered. Subjects continued irrigation at home once daily for 42 days with their assigned rinse delivered via a subgingival delivery system. All sites in the mouth were scored at baseline and at day 42 for supragingival plaque, bleeding on probing, and redness. For the four selected periodontitis sites, probing depth and attachment level were measured at baseline and on day 42; additionally, supragingival plaque and gingival redness were scored on days 7 and 21. Subgingival plaque samples for microbiological analysis were harvested from the selected periodontal sites at baseline and on days 7, 21, and 42. Microbiologically, irrigation with the antimicrobial mouthrinse resulted in statistically significant reductions compared to control in putative periodontopathogens, including black pigmenting species, which persisted at 42 days. Clinically, subgingival irrigation with the antimicrobial mouthrinse produced a significant reduction in supragingival plaque (P < 0.001), bleeding on probing (P = 0.019), and redness (P = 0.017) compared to the control, whether or not the area irrigated received a prophylaxis.(ABSTRACT TRUNCATED AT 250 WORDS)

Enzyme activity in crevicular fluid for detection and prediction of clinical attachment loss in patients with chronic adult periodontitis. Six month results.

Previous reports have described a method by which multiple constituents can be analyzed from a sample of gingival crevicular fluid (GCF) collected with a precut filter paper strip. In this study the relationship of changes in GCF levels of the vertebrate (lysosomal) enzymes beta-glucuronidase (BG) and arylsulfatase (AS) and the cytoplasmic enzyme lactate dehydrogenase (LDH) was evaluated longitudinally in reference to loss of clinical attachment in patients with existing chronic adult periodontitis. Thirty-six patients were followed for six months. Clinical attachment loss was recorded as the change between the baseline and three month examinations, and the three- and six-month examinations. GCF analysis was performed at baseline and three months. Three groups of patients were identified based on disease progression. Group I patients (N = 5) displayed a generalized form of disease activity. In these patients we observed clinical attachment loss of at least 2.0 mm at a minimum of three unrelated sites. Group II patients (N = 4) displayed a localized form of disease activity. In these patients clinical attachment loss of at least 2.5 mm occurred at one site, or two anatomically related sites. Group III patients (N = 27) did not display clinical attachment loss as defined here. Enzyme analysis was evaluated as a whole mouth score (the per cent of samples from a patient in which enzyme activity was at least twice the population mean) and at individual samples. Group I patients could be identified by elevated whole mouth scores for BG, while Group II patients could not be identified by whole mouth scores for any of the enzymes.(ABSTRACT TRUNCATED AT 250 WORDS)