Antimicrobial potential of essential oils mouthrinses with and without alcohol: a randomized clinical trial

Aim: This study aimed to compare the microbiological potential and gustatory perception of essential oils (EO) mouthrinses containing and not containing alcohol. Methods: Twenty healthy adult volunteers rinsed with 10mL of the following test solutions: EO with alcohol, EO without alcohol, or a control solution (saline solution with mint essence). A washout period of at least seven days was adopted after a single-use protocol of the respective solution. All participants used all three tested substances. Antimicrobial potential was assessed by counting salivary total viable bacteria both before and after each rinse. Gustatory perception was evaluated using the Visual Analogue Scale (VAS). Multiple comparisons were performed with the Wilcoxon test, using Bonferroni correction. Results: Both EO solutions presented a higher antimicrobial potential in comparison to the control solution (p<0.017). However, no significant difference in antimicrobial potential was observed between EO containing or not containing alcohol (p=0.218). VAS of EO with alcohol (median: 2.7) was similar to control solution (median: 1.6) (p=0.287). A better gustatory perception was observed of the EO without alcohol (median 7.6) when compared to the control solution (p<0.0001). When EO groups were compared, EO without alcohol also demonstrated a significantly better gustatory perception (p=0.001). Conclusion: Mouthrinse containing EO without alcohol presented a better taste perception when compared to the EO with alcohol, but no difference was observed in the antimicrobial potential of both EO solutions after a single rinse protocol

Is alteration in single drug anticoagulant/antiplatelet regimen necessary in patients who need minor oral surgery? A systematic review with meta-analysis.

OBJECTIVE: This study aimed to systematically review literature about the effect of alteration of the pharmacological regimen in adult patients using anticoagulants or antiplatelets who need minor oral surgery. MATERIAL AND METHODS: A search strategy was performed in three databases-PubMed-Medline, Scopus, and Embase-and included randomized clinical trials (either parallel or crossover), involving individuals under anticoagulant or antiplatelet therapy who underwent oral surgeries. Studies comprised two groups: those who stopped their medication prior to the dental procedure (control) or those who did not (test). Meta-analyses were conducted for the pooled risk ratio (RR) between the groups. Subgroup analyses were performed for anticoagulant and antiplatelet therapies. RESULTS: Thirteen studies were included. It was found that patients who did not stop therapy had 157% higher intraoperative bleeding occurrences (95%CI: 1.40-4.71). In the subgroup analysis, warfarinazed patients showed significantly higher occurrences of intraoperative bleeding when compared with the control (RR: 1.79; 95%CI: 1.00-3.21). Conversely, there was no statistically significant difference in postoperative bleeding between the groups (RR: 0.81; 95%CI: 0.54-1.22; p = 0.42). CONCLUSION: Minor oral surgeries can be safely performed in patients under antiplatelets or anticoagulants without drug regimen modification. Because these patients tend to bleed more during procedures, use of local hemostatic measures is strongly advised. CLINICAL RELEVANCE: Management of patients under antiplatelet or anticoagulant drugs is still challenging in clinical practice. However, clinicians may perform minor oral surgeries safely without changing the pharmacological regimen. Use of local hemostatic measures is strongly advised during these procedures.

Antiplaque and antigingivitis efficacy of cetylpyridinium chloride with zinc lactate compared with essential oil mouthrinses: Randomized clinical trial.

BACKGROUND: The authors of this study aimed to evaluate the clinical antiplaque and antigingivitis effects of 3 oral hygiene regimens: toothbrushing with standard fluoride toothpaste and manual toothbrush and using a mouthrinse containing cetylpyridinium chloride, zinc lactate, and fluoride (CPC + Zn + F) in an alcohol-free base; toothbrushing with standard fluoride toothpaste and manual toothbrush and using a mouthrinse containing essential oils (EO) in an alcohol-free base; and toothbrushing with manual toothbrush and standard fluoride toothpaste and manual toothbrush (control). METHODS: The participants (N = 120) were randomly assigned to study groups and followed the assigned regimens twice daily for 6 weeks. The participants were examined by a calibrated examiner for the Quigley-Hein plaque index (Turesky modification) and Löe-Silness gingival index at baseline, week 4, and week 6. Statistical analyses were performed separately for plaque and gingival indexes by means of analysis of variance, paired t test, and analysis of covariance (α = 0.05). RESULTS: At week 4, the CPC + Zn + F group presented additional reductions in dental plaque compared with EO and control groups of (21.4% [P < .001] and 31.4% [P < .001], respectively). After 6 weeks, these values were 26.7% (P < .001) and 44.8% (P < .001), respectively. For Löe-Silness gingival index, additional reduction in the CPC + Zn + F group compared with EO were 10.6% (P < .001) and 13.7% (P < .001) at 4 and 6 weeks, respectively. Compared with control, these reductions were 13.6% (P < .001) and 17.8% (P < .001), respectively. CONCLUSIONS: The regimen including a mouthrinse containing CPC + Zn + F presented higher antiplaque and antigingivitis effects than EO and control regimens. PRACTICAL IMPLICATIONS: A mouthrinse containing CPC + Zn + F is an effective protocol for the control of dental plaque and gingivitis.

Effects of Low Molecular Weight Heparin on Alveolar Bone Loss in Wistar Rats.

This study aimed to assess the effects of low molecular weight heparin (LMWH) on alveolar bone loss (ABL), blood count, and counting of megakaryocytes and adipocytes in male Wistar rats. Forty male 60-day Wistar rats were randomly divided into four groups: Control (C), Periodontal Disease (PD), Heparin (Hp) and Heparin + Periodontal Disease (Hp+PD). LMWH was applied for 60 days at doses of 1 ml/kg/day. Blood samples were collected at baseline, 30 and 60. On day-49, PD and Hp+PD groups were subjected to ligature-induced periodontitis around second upper right molar. The left side was assessed as spontaneous alveolar bone loss. Mean ABL in the side with ligature showed significantly different between C (0.35±0.07 mm) and Hp+DP (0.49±0.09 mm) groups (p<0.001), between PD (0.55±0.11 mm) and Hp (0.32±0.06 mm) groups (p<0.001) and between Hp and Hp+DP groups (p<0.001). No significant differences were found among groups for ABL in the side without ligature. Animal weight, food intake, and water consumption showed no statistically significant difference among groups. Megakaryocytes and adipocytes were counted using optical microscopy and no statistically significant differences were found. Within-groups, there were an increase and a decrease, respectively, in the counting of lymphocytes (p=0.005 for C and p=0.009 for Hp+PD groups only) and leukocytes (p=0.003 for C, p=0.001 for PD, p=0.002 for Hp, and p<0.001 for Hp+PD groups). There was no decrease in the number of platelets in the three collection periods. LMWH was not able to affect ABL, but it may change the blood counting, especially increasing lymphocytes.

Effects of low molecular weight heparin on alveolar bone loss in wistar rats

Abstract This study aimed to assess the effects of low molecular weight heparin (LMWH) on alveolar bone loss (ABL), blood count, and counting of megakaryocytes and adipocytes in male Wistar rats. Forty male 60-day Wistar rats were randomly divided into four groups: Control (C), Periodontal Disease (PD), Heparin (Hp) and Heparin + Periodontal Disease (Hp+PD). LMWH was applied for 60 days at doses of 1 ml/kg/day. Blood samples were collected at baseline, 30 and 60. On day-49, PD and Hp+PD groups were subjected to ligature-induced periodontitis around second upper right molar. The left side was assessed as spontaneous alveolar bone loss. Mean ABL in the side with ligature showed significantly different between C (0.35±0.07 mm) and Hp+DP (0.49±0.09 mm) groups (p<0.001), between PD (0.55±0.11 mm) and Hp (0.32±0.06 mm) groups (p<0.001) and between Hp and Hp+DP groups (p<0.001). No significant differences were found among groups for ABL in the side without ligature. Animal weight, food intake, and water consumption showed no statistically significant difference among groups. Megakaryocytes and adipocytes were counted using optical microscopy and no statistically significant differences were found. Within-groups, there were an increase and a decrease, respectively, in the counting of lymphocytes (p=0.005 for C and p=0.009 for Hp+PD groups only) and leukocytes (p=0.003 for C, p=0.001 for PD, p=0.002 for Hp, and p<0.001 for Hp+PD groups). There was no decrease in the number of platelets in the three collection periods. LMWH was not able to affect ABL, but it may change the blood counting, especially increasing lymphocytes.

Resumo O presente estudo objetivou verificar o efeito da heparina de baixo peso molecular (HBPM) sob a perda óssea alveolar (POA), contagem de células sanguíneas, megacariócitos e adipócitos em ratos Wistar machos. Quarenta ratos Wistar de 60 dias foram randomicamente divididos em quatro grupo: Controle (C), Doença Periodontal (DP), Heparina (Hp) e Heparina + Doença Periodontal (Hp+DP). HBPM foi aplicada durante 60 dias em doses de 1 mL/kg/dia. Coletas sanguíneas foram realizadas nos dias 0, 30 e 60. No dia 49, os grupos DP e Hp+DP receberam indução de doença periodontal por ligadura ao redor do segundo molar superior direito. No lado esquerdo, verificou-se perda óssea alveolar espontânea. A média de POA no lado com ligadura mostrou-se estatisticamente diferente entre os grupos C (0,35±0,07 mm) e Hp+PD (0,49±0,09 mm) (p<0,001), entre os grupos DP (0,55±0,11 mm) e Hp (0,32±0,06 mm) (p<0,001) e entre os grupos Hp e Hp+DP (p<0,001). Nenhuma diferente significativa foi observada entre os grupos no lado sem ligadura. Peso dos animais, consumo de ração e ingestão de água não mostraram diferenças significativas entre os grupos. Megacariócitos e adipócitos foram contados por microscopia óptica e nenhuma diferença significativa foi encontrada. Dentro dos grupos, houve um aumento e uma diminuição, respectivamente, na contagem de linfócitos (p=0,005 no grupo C e p=0,009 no grupo Hp+DP somente) e leucócitos (p=0,003 no grupo C, p=0.001 no grupo DP e p=0,002 no grupo Hp e Hp+DP). Não houve diminuição no número de plaquetas nos três períodos de coleta. HBPM não foi capaz de modificar a POA, porém modificou a contagem de células sanguíneas, especialmente aumentando o número de linfócitos.

The effect of periodontal therapy on oxidative stress biomarkers: A systematic review.

AIM: To systematically review the literature about the effect of periodontal treatment on oxidative stress (OxS) biomarkers. MATERIAL AND METHODS: Three databases (PubMed, EMBASE, and Scopus) were searched up to February 2018. Clinical trials with a follow-up of at least 6 weeks after mechanical periodontal treatment were included. Due to the high heterogeneity among the units and indices of measurements used in the studies, a meta-analysis was not performed. RESULTS: Overall, 3,199 studies were retrieved, of which 20 were included. Four studies were randomized clinical trials (RCT), and 16 studies were non-RCTs. The most common OxS biomarkers used were 8-hydroxydeoxiguanosine (8-OHdG), total oxidant status (TOS), and total antioxidant status (TAS). After treatment, most of the studies reported a decrease in 8-OHdG concentration in the gingival crevicular fluid (GCF) and saliva. In addition, the salivary concentration of this biomarker was similar to periodontally healthy patients. Periodontal therapy was effective in reducing TOS in GCF, saliva, and serum in most studies. TAS, however, responded inconsistently to the periodontal intervention. CONCLUSION: Periodontal therapy reduces the levels of OxS biomarkers, even to values similar to those found in periodontally healthy individuals. Additional RCTs are warranted, as the information is mainly based on nonrandomized studies.

Citation Analysis and Trends in review articles in dentistry.

OBJECTIVE: This study aimed to describe the trends in dentistry article reviews as well as to compare citation patterns between systematic and narrative reviews. METHODS: A search strategy was developed, in Scopus database, in order to identify all narrative and systematic reviews published between 2000 and 2015. Original research studies, letters to the editor, editorials, book chapters, and case reports were excluded. From the list of studies available, 30 reviews per year were randomly chosen. The review type, year of publication, number of authors, country of the first author, open access, language, main topic of interest, journal's H index, number of references, and number of citations were extracted by 2 researchers. The number of citations was extracted from the Scopus database. Multivariable regression analysis was used in order to detect the association between citation rate and the independent variables. RESULTS: Overall, 118 and 362 systematic and narrative reviews were included in this study. Throughout the years, the number of systematic reviews has increased from 5.8% to 53.3%. However, the mean number of citations has significantly decreased, and this is affected by the review's year of publication. A trend for lower citation in systematic reviews (Relative risk [RR]: 0.79; 95% confidence interval: 0.75-0.84) has been demonstrated; however, the number of citations of narrative reviews has been increasing over the years (RR: 1.14; 95% confidence interval: 1.08-1.21). CONCLUSION: From 2000 to 2015, the number of systematic reviews increased substantially. On the other hand, a trend for lower citations of these studies has been observed that is affected over time.

Antimicrobial activity of copaiba oil (Copaifera ssp.) on oral pathogens: Systematic review.

Copaifera ssp. produces an oil-resin that presents antiinflammatory, antitumor, antiseptic, germicidal, antifungal, and antibacterial activity. This systematic review aimed to analyze the antimicrobial action of Copaiba oil against oral pathogens, when compared to that of control substances. A search on Medline/PubMed, LILACS, SciELO, EMBASE, and SCOPUS databases were performed up to March 2017. To be included, the studies needed to perform any antimicrobial activity essay, using copaiba oil and a control substance. The antimicrobial effect of each substance, in each study, was extracted. Eleven studies were included, and several copaiba species were used. All studies showed that copaiba oil, regardless of its species, presented a bactericidal and/or bacteriostatic effect in in vitro analyzes. Only one study showed that the antimicrobial effect of the Copaifera officinalis was similar to the one found in chlorhexidine. A higher risk of bias was detected in most of the included studies. The studies demonstrated that the antimicrobial activity of copaiba oil, in most cases, is lower than chlorhexidine, which is considered the gold standard. However, there is great potential against oral bacteria. Further high quality studies are warranted in order to assess the efficacy of copaiba oil on oral pathogens.

Efficacy of two mouthwashes with cetylpyridinium chloride: a controlled randomized clinical trial.

This study aimed to evaluate the anti-plaque and anti-gingivitis effects of two mouthwashes containing cetylpyridinium chloride (CPC), in comparison to negative control mouthwash. One hundred and twenty subjects were randomly assigned to study groups: test (0.075% CPC and 0.28% zinc lactate), positive control (0.07% CPC) and negative control mouthwash without CPC. All volunteers were examined by a calibrated examiner for the Quigley-Hein Plaque Index (Turesky modification) and Löe-Silness Gingival Index (GI). Gingival severity was also measured by the percentage of sites with positive gingival bleeding. During six weeks, oral hygiene consisted of brushing twice daily with a toothbrush and toothpaste and rising with their assigned mouthwash. Plaque and gingival parameters were assessed at baseline, after four and six weeks of product use. Statistical analyses were performed separately for plaque and gingival indices, by ANOVA, paired t-test and ANCOVA (α < 0.05). After 4 and 6 weeks, all mouthwashes groups presented statistically significant reductions in plaque and gingival parameters as compared to baseline. In comparison to the positive control, the test group presented additional reductions in dental plaque of 19.8% and 16.8%, after 4 and 6 weeks, respectively. For GI, the additional reductions in the test group were 9.7% and 14.3%, at 4 and 6 weeks, respectively. The test group showed additional reduction of 35.3% and 54.5% in the gingival severity, at week 4 and 6, respectively. It is concluded that the mouthwash containing CPC and zinc lactate presents significant anti-plaque and anti-gingivitis effects as compared to positive and negative control mouthwashes.

Efficacy of two mouthwashes with cetylpyridinium chloride: a controlled randomized clinical trial

Abstract This study aimed to evaluate the anti-plaque and anti-gingivitis effects of two mouthwashes containing cetylpyridinium chloride (CPC), in comparison to negative control mouthwash. One hundred and twenty subjects were randomly assigned to study groups: test (0.075% CPC and 0.28% zinc lactate), positive control (0.07% CPC) and negative control mouthwash without CPC. All volunteers were examined by a calibrated examiner for the Quigley-Hein Plaque Index (Turesky modification) and Löe-Silness Gingival Index (GI). Gingival severity was also measured by the percentage of sites with positive gingival bleeding. During six weeks, oral hygiene consisted of brushing twice daily with a toothbrush and toothpaste and rising with their assigned mouthwash. Plaque and gingival parameters were assessed at baseline, after four and six weeks of product use. Statistical analyses were performed separately for plaque and gingival indices, by ANOVA, paired t-test and ANCOVA (α < 0.05). After 4 and 6 weeks, all mouthwashes groups presented statistically significant reductions in plaque and gingival parameters as compared to baseline. In comparison to the positive control, the test group presented additional reductions in dental plaque of 19.8% and 16.8%, after 4 and 6 weeks, respectively. For GI, the additional reductions in the test group were 9.7% and 14.3%, at 4 and 6 weeks, respectively. The test group showed additional reduction of 35.3% and 54.5% in the gingival severity, at week 4 and 6, respectively. It is concluded that the mouthwash containing CPC and zinc lactate presents significant anti-plaque and anti-gingivitis effects as compared to positive and negative control mouthwashes.

Efficacy of two soft-bristle toothbrushes in plaque removal: a randomized controlled trial.

The aim of this study was to compare the efficacy in supragingival plaque removal of two soft-bristle toothbrushes. Seventy volunteers were allocated randomly to the Colgate Slim Soft or Curaprox CS5460 toothbrush grourps. At baseline appointment, volunteers underwent plaque examination using the Rustogi Modification of the Navy Plaque Index. Under supervision, they then brushed their teeth for 1minute with their assigned toothbrushes and the plaque examination was repeated. Volunteers performed daily oral hygiene with their assigned toothbrush and a regular dentifrice provided by the researchers for 7 days. The baseline experimental procedures were then repeated. Separate analyses of variance were performed for the whole-mouth, interproximal, and gumline plaque scores (p < 0.05). No difference in baseline pre-brushing scores was found between groups. After a single toothbrushing, the mean plaque score was significantly reduced in both groups (p < 0.05), with greater reduction of whole-mouth and interproximal plaque scores observed in the SlimSoft group compared with the Curaprox group (p < 0.05). After 7 days, the SlimSoft group showed greater reduction of the whole-mouth and interproximal plaque scores compared with the Curaprox group (p < 0.05). In conclusion, the SlimSoft toothbrush presented greater efficacy in supragingival plaque removal than did the Curaprox CS5460 toothbrush, as reflected by whole-mouth and interproximal plaque scores.

Efficacy of two soft-bristle toothbrushes in plaque removal: a randomized controlled trial

Abstract The aim of this study was to compare the efficacy in supragingival plaque removal of two soft-bristle toothbrushes. Seventy volunteers were allocated randomly to the Colgate Slim Soft or Curaprox CS5460 toothbrush grourps. At baseline appointment, volunteers underwent plaque examination using the Rustogi Modification of the Navy Plaque Index. Under supervision, they then brushed their teeth for 1minute with their assigned toothbrushes and the plaque examination was repeated. Volunteers performed daily oral hygiene with their assigned toothbrush and a regular dentifrice provided by the researchers for 7 days. The baseline experimental procedures were then repeated. Separate analyses of variance were performed for the whole-mouth, interproximal, and gumline plaque scores (p < 0.05). No difference in baseline pre-brushing scores was found between groups. After a single toothbrushing, the mean plaque score was significantly reduced in both groups (p < 0.05), with greater reduction of whole-mouth and interproximal plaque scores observed in the SlimSoft group compared with the Curaprox group (p < 0.05). After 7 days, the SlimSoft group showed greater reduction of the whole-mouth and interproximal plaque scores compared with the Curaprox group (p < 0.05). In conclusion, the SlimSoft toothbrush presented greater efficacy in supragingival plaque removal than did the Curaprox CS5460 toothbrush, as reflected by whole-mouth and interproximal plaque scores.

Effects of alcohol and/or tobacco exposure on spontaneous alveolar bone loss in rat.

The aim of the present study was to evaluate the effect of alcohol and/or tobacco exposure on spontaneous alveolar bone loss in Wistar rats. Twenty-four, male, 60 day-old, Wistar rats were assigned to 4 groups: Group 1 received 10 mL/kg of glucose solution (5%). Group 2 received 2 g/kg alcohol (20%). Group 3 was exposed to tobacco smoke (6 cigarettes/60 min). Group 4 received both interventions of groups 2 and 3. Alcohol was given by gastric gavage and cigarette exposure was performed using a forced ventilation chamber. After 30 days, animals were sacrificed and the upper maxillae removed and defleshed. Morphometric analysis of alveolar bone loss (ABL) around the second molar was performed in standardized digital photographs. Statistical analysis was conducted using paired t-test, one-way ANOVA and occurrence of spontaneous periodontal disease (ABL ≥ 0.39 mm) was analyzed by Fisher's exact test. Significant differences in body weight were observed between all groups. Group 2 presented higher body weight as compared to the 3 other groups at 4 weeks (p≤0.05). Mean ABL values were 0.31 mm (±0.08), 0.29 mm (±0.07), 0.33 mm (±0.10), and 0.33 mm (±0.08) for groups 1, 2, 3, and 4, respectively. No significant differences were found among groups. In the analysis of occurrence of periodontal breakdown, alcohol exposure decreased the occurrence of ABL and cigarette exposure increased ABL. The combination of alcohol and cigarette exposure did not differ from the control group. Alcohol consumption decreased the occurrence of periodontal breakdown, while tobacco increased this rate.

Effects of Alcohol and/or Tobacco Exposure on Spontaneous Alveolar Bone Loss in Rat

The aim of the present study was to evaluate the effect of alcohol and/or tobacco exposure on spontaneous alveolar bone loss in Wistar rats. Twenty-four, male, 60 day-old, Wistar rats were assigned to 4 groups: Group 1 received 10 mL/kg of glucose solution (5%). Group 2 received 2 g/kg alcohol (20%). Group 3 was exposed to tobacco smoke (6 cigarettes/60 min). Group 4 received both interventions of groups 2 and 3. Alcohol was given by gastric gavage and cigarette exposure was performed using a forced ventilation chamber. After 30 days, animals were sacrificed and the upper maxillae removed and defleshed. Morphometric analysis of alveolar bone loss (ABL) around the second molar was performed in standardized digital photographs. Statistical analysis was conducted using paired t-test, one-way ANOVA and occurrence of spontaneous periodontal disease (ABL ≥ 0.39 mm) was analyzed by Fisher's exact test. Significant differences in body weight were observed between all groups. Group 2 presented higher body weight as compared to the 3 other groups at 4 weeks (p≤0.05). Mean ABL values were 0.31 mm (±0.08), 0.29 mm (±0.07), 0.33 mm (±0.10), and 0.33 mm (±0.08) for groups 1, 2, 3, and 4, respectively. No significant differences were found among groups. In the analysis of occurrence of periodontal breakdown, alcohol exposure decreased the occurrence of ABL and cigarette exposure increased ABL. The combination of alcohol and cigarette exposure did not differ from the control group. Alcohol consumption decreased the occurrence of periodontal breakdown, while tobacco increased this rate.

O objetivo do presente estudo foi avaliar o efeito da exposição do álcool e/ou tabaco sobre a perda óssea alveolar (POA) espontânea em ratos Wistar. Vinte e quatro ratos, machos, com 60 dias de vida foram divididos em 4 grupos: Grupo 1 recebeu 10 mL/kg de solução de glicose (5%). Grupo 2 recebeu 2 g/kg de álcool (20%). Grupo 3 foi exposto a fumaça do tabaco (6 cigarros/60 min). Grupo 4 recebeu a mesma intervenção dos grupos 2 e 3. A solução de álcool foi dada por meio de gavagem e a exposição ao tabaco foi realizada por meio de câmara de ventilação forçada. Após 30 dias de experimento, os animais foram sacrificados e as maxilas removidas. Análise morfométrica da POA ao redor do segundo molar superior foi realizada de modo padronizada. A análise estatística dos dados foi realizada por meio de teste t pareado e ANOVA. Ocorrência de doença periodontal espontânea (POA ≥ 0,39 mm) foi realizada pelo teste exato de Fisher. Diferenças significativas no peso corporal médio foram observadas em todos os grupos. Grupo 2 apresentou maior peso corporal médio quando comparado aos outros 3 grupos ao fim do experimento (p≤0,05). A média de POA foi 0,31 mm (±0,08); 0,29 mm (±0,07); 0,33 mm (±0,10) e 0,33 mm (±0,08) para os grupos 1, 2, 3 e 4, respectivamente. Não houve diferenças significativas entre os grupos. Na análise de ocorrência de destruição periodontal, a exposição de álcool diminuiu sua ocorrência, enquanto que exposição ao tabaco aumentou a POA espontânea. A combinação de álcool e tabaco não diferiu do grupo controle.