Antimicrobial Efficacy of the Use of Mouthwash with Cetylpiridinium Chloride for Aerosol Producing Procedures. A Systematic Review / Eficacia antimicrobiana del uso del enjuague bucal con cloruro de cetilpiridinio en procedimientos que generan aerosoles. Revisión sistemática

Abstract The present research aims to determine the antimicrobial efficacy of the mouthwashes based on cetylpyridinium chloride (CPC), before aerosol producing dental procedures. A data search was performed during August 2021 in five databases MEDLINE (PubMed), SCOPUS, SCIELO, Cochrane Central Register of Controlled Trials (CENTRAL) and Google Scholar. Randomized clinical trials (RCTs) were included based on the PICO question, comparing the efficacy of the mouthwashes based on cetylpyridinium chloride (CPC), versus other mouthwashes and water, before aerosol producing dental procedures, papers in English, Spanish and Portuguese were included without time limits. The risk of the included studies was evaluated with the tool RoB 2.0. Number of registration PROSPERO N° CRD42021275982. 120 papers were obtained in the preliminary search, discarding those that didn't comply with the selection criteria, leaving only 3 studies. These papers reported the use of cetylpyridinium chloride (CPC) was effective for the reduction of bacteria during the ultrasonic prophylactic procedure. The use of CPC mouthwashes previous to the dental treatment with ultrasonic prophylaxis showed only antibacterial capacity.

Resumen El presente trabajo de investigación tiene como objetivo determinar la eficacia antimicrobiana de los colutorios a base de cloruro de Cetilpiridinio (CPC), previo a tratamientos dentales que generen aerosol. Se realizó una búsqueda bibliográfica hasta agosto del 2021 en cinco bases de datos: MEDLINE (vía PubMed), SCOPUS, SCIELO, Cochrane Central Register of Controlled Trials (CENTRAL) y Google Scholar. Se incluyeron ensayos clínicos aleatorizados (ECAs), basándose en la pregunta PICOS, que compare la eficacia del colutorio a base de cloruro de Cetilpiridinio (CPC) con otro colutorio, placebo o agua, previo a un tratamiento dental que genere aerosol, en los idiomas español, inglés o portugués y sin límite de tiempo. El riesgo de los estudios incluidos se evaluó con la herramienta RoB 2.0. Número de registro PROSPERO N° CRD42021275982. Se obtuvo un total de 120 artículos en la búsqueda preliminar, descartando aquellos que no cumplían con los criterios de selección, quedando sólo 3articulos. Estos artículos informaron que el uso de CPC es efectivo para la reducción de bacterias durante el procedimiento de profilaxis con ultrasonido. El uso de los enjuagues bucales a base de CPC previo al tratamiento dental de profilaxis con ultrasonido sólo tiene eficacia antibacteriana.

Evaluation of the effects of different mouthrinses on dental remineralization.

BACKGROUND: Dental caries occurs with the release of organic acids from the fermentable carbohydrates metabolized by cariogenic microorganisms. Microbial, genetic, immunological, behavioral, and environmental factors play a role in the development and severity of dental caries. OBJECTIVES: The aim of the present study was to investigate the possible effects of different mouthwash solutions on dental remineralization. MATERIAL AND METHODS: This in vitro study compared the remineralization capacity of different mouthwash solutions applied topically to the enamel surface. A total of 50 tooth specimens were prepared from the buccal and lingual halves, with 10 teeth in each group: G1 (control); G2 (Listerine®); G3 (Sensodyne®); G4 (Oral B® Pro-Expert); and G5 (DentaSave® Zinc). Remineralization capacity was evaluated in all groups. The one-way analysis of variance (ANOVA) and the paired samples t test were used for statistical analysis, with a p-value <0.05 considered significant. RESULTS: There were significant differences in the calcium (Ca)/phosphorus (P) atomic percentage (at%) ratio between the demineralized and remineralized dentin (p = 0.001), and between the demineralized and remineralized enamel (p = 0.006). Similarly, there were significant differences in the at% of P (p = 0.017) and zinc (Zn) (p = 0.010) between the demineralized and remineralized dentin. There was a significant difference in the at% of P (p = 0.030) between the demineralized and remineralized enamel. The Zn at% in enamel was significantly higher after remineralization in G5 as compared to the control group (p < 0.05). The images of the demineralized enamel showed the usual keyhole prism appearance, with intact prism sheaths and negligible inter-prism porosity. CONCLUSIONS: The scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDS) findings seem to confirm the effectiveness of DentaSave Zinc for the remineralization of enamel lesions.

Can salivary lactate be used as an anaerobic biomarker?

Background: Salivary lactate has been suggested as a non-invasive anaerobic biomarker in sports medicine for decades, yet has not been widely applied until now. This study aimed to explore possible issues related to its application and suggest directions for future method improvement. Methods: A liquid chromatography-mass spectrometry (LC-MS) method for the determination of salivary lactate was developed, validated and applied on saliva samples collected from a group of professional sprinters (n = 20). The samples were collected via chewing a cotton ball for one minute and centrifuging it afterwards. The evaluation included variation with mouth rinse times, consistency at different sampling times, change after treadmill or cycle ergometer trainings, and association with blood lactate. Sample sizes were calculated prior to the study. One-way analysis of variance (ANOVA), intra-class correlation coefficients (ICC) and relative standard deviation (RSD) were used to evaluate data variances. Pearson correlation was applied to show correlation between salivary and blood lactate. Effect sizes and power were calculated following ANOVA and correlation analyses. Results: The RSD of the LC-MS method was 19.70%. Salivary lactate concentration was affected by mouth rinse times before sampling (ANOVA p = 0.025, η 2 = 0.40, 1 - ß = 0.99, ICC = 0.23, mean RSD of four sampling = 55.30%), and stabilized after mouth rinsing for three times. The concentrations at resting state across three weeks were consistent at group level (ANOVA p = 0.57, η 2 = 0.03, 1 - ß = 0.20), but varied greatly individually (ICC = 0.22, mean RSD = 56.16%). Salivary lactate level significantly increased after treadmill and cycle ergometer trainings (ANOVA p = 0.0002, η 2 = 0.46, 1 - ß = 0.9999 and ANOVA p = 0.0019, η 2 = 0.40, 1 - ß = 0.9993, respectively), and displayed positive correlation with blood lactate concentration (r = 0.61, p = 0.0004, 1 - ß = 0.9596). Significant difference between male and female participants was observed in none of the tests conducted in this study. Discussion: Salivary lactate was found to be a potential anaerobic biomarker. However, reproducible methods for sample collection and analysis, as well as more knowledge on the secretion mechanism and pattern of salivary lactate are required to make it a practical anaerobic biomarker.

Use of Ionized Monocalcium phosphate and enameline derivatives to reduce dentin hypersensitivity after periondontal therapy / Uso de Fostato Monocálcio y derivados en Enamelina para reducir la hipersensibilidad dentaria después de terapia periodontal

Abstract This study aimed to evaluate the effectiveness of using an ionized monocalcium phosphate and enamelin derivatives (IMP+ED) based mouthwash for the treatment of dentin hypersensitivity (DH) after scaling and root planing (SRP). 47 patients who reported DH after SRP treatment were included in this prospective cohort study. The Schiff Cold Air Sensitivity Scale (SCASS) was applied to classify their degree of pain in mild, moderate or intense at two times: after SRP (T0), and after one month of using a IMP+ED-based mouthwash (T1). The McNemar-Bowker test was used to compare the correlated proportions between both times (p<0.05). After the SRP therapy (T0), all the sample members reported pain distributed in the following manner: 12.8% were mild, 27.6% moderate, and 59.6% intense. At one month since treatment and with the use of the IMP+ED-based mouthwash (T1), the distribution of pain levels changed to 83% mild, 12.8% moderate, and 4.3% intense, this change was statistically significant (p<0.001). IMP+ED-based mouthwash produces a positive effect in reducing painful responses caused by exposure of the dentin tubules to the oral environment after SRP therapy.

Resumen El objetivo de este estudio fue evaluar la efectividad de un enjuague bucal a base de fosfato monocálcico ionizado y derivados de enamelina (FCI+DE) para el tratamiento de hipersensibilidad dentinaria (HD) posterior al tratamiento de raspado y alisado radicular (RAR). 47 pacientes que reportaron tener HD posterior al tratamiento de RAR fueron incluidos en este estudio prospectivo de cohorte. Con el fin de clasificar la HD de los pacientes en leve, moderada o intensa se utilizó la Escala de Sensiblidad al Aire Frío de Schiff (ESAFS). Los pacientes fueron evaluados después del tratamiento de RAR (T0) y posterior al uso de un enjuague bucal basado en FCI+DE (T1). Para comparar las proporciones correlacionadas se utilizó la prueba de McNemar-Bowker (p<0.05). La distribución del dolor de los pacientes posterior al tratamiento de RAR (T0) fue la siguiente: 12.8% fueron leves, 27.6% moderado, and 59.6% intenso. Un mes después del uso del enjuague buccal basado en FCI+DE (T1) la distribución en los niveles de dolor cambio a 83% leve, 12.8% moderado, and 4.3% intenso, este cambio fue estadísticamente significativo (p<0.001). El uso del enjuague bucal basado en FCI+DE produce una reducción significativa a la respuesta de dolor causada por la exposición de la dentina al ambiente oral como consecuencia del tratamiento de RAR.

Comparison of oral metabolome profiles of stimulated saliva, unstimulated saliva, and mouth-rinsed water.

Saliva includes a substantial amount of biological information, which has enabled us to understand the relationship between oral metabolites and various oral and systemic disorders. However, collecting saliva using a controlled protocol is time-consuming, making saliva an unsuitable analyte in large cohort studies. Mouth-rinsed water (MW), the water used to rinse the mouth, can be collected easily in less time with less difference between subjects than saliva and could be used as an alternative in oral metabolome analyses. In this study, we investigated the potential of MW collection as an efficient alternative to saliva sample collection for oral metabolome profiling. MW, stimulated saliva, and unstimulated saliva were collected from 10 systemically healthy participants. The samples were subjected to metabolome analysis using capillary electrophoresis time-of-flight mass spectrometry, and the types and amounts of metabolites in the samples were compared. Qualitatively, MW contained the same metabolites as unstimulated and stimulated saliva. While the quantity of the metabolites did not drastically change between the sampling methods, all three reflected individual differences, and the features of MW were the same as those of the unstimulated saliva. Overall, these results suggest that MW may be an appropriate alternative to saliva in oral metabolome profile analysis.

Development of novel mucoadhesive gels containing nanoparticle for buccal administration of dexamethasone

Abstract This study aimed to develop promising and innovative mucoadhesive gel systems containing dexamethasone-loaded nanoparticle to increase the effectiveness of treatment for oral precancerous lesions and to reduce side effects. In this respect, a dexamethasone-loaded nanoparticle formulation was prepared by using emulsification/solvent evaporation method. The nanoparticle has high zeta potential (-10.3±0.5 mV), low particle size (218.42±2.1), low polydispersity index (0.070±0.014) and high encapsulation efficiency (95.018±2.982%). To improve the mucosal retention time, the dexamethasone-loaded nanoparticle was dispersed in mucoadhesive gel using gellan gum. The developed gels offered appropriate pH value, high drug content, suitable mechanical and mucoadhesive performance and appropriate viscosity for mucosal administration. All formulations exhibited plastic flow and typical gel-type mechanical spectra after the determined frequency value. The developed formulations exhibited extended drug release as intended for these systems. Cytotoxicity was tested by MTT assay in human epithelioid carcinoma cell (HeLa) in vitro. The MTT assay showed that the blank formulations were non-toxic to cells. It was observed that the bioactivity of the free dexamethasone was potentiated by mucoadhesive gels containing dexamethasone-loaded nanoparticle in HeLa cells. Results from this study indicate that mucoadhesive gels are effective for the local treatment of precancerous lesions. Our findings showed that the developed formulations were worthy of further studies.

Simple concentration method enables the use of gargle and mouthwash instead of nasopharyngeal swab sampling for the diagnosis of COVID-19 by PCR.

Since its emergence in December 2019, SARS-CoV-2 is causing one of the most devastating pandemics in human history. Currently, the most important method for definitive diagnosis of COVID-19 is identification of SARS-CoV-2 RNA in nasopharyngeal swab samples by RT-PCR. Nasopharyngeal swab sampling is a discomforting procedure sometimes with adverse effects, which also poses a risk for infection for the personnel performing the sampling. We have developed a new method for concentrating biological samples, which enabled us to use gargle and mouthwash samples to be used in RT-PCR, for the diagnosis of COVID-19, as an alternative to nasopharyngeal swab samples. We have analyzed nasopharyngeal and gargle and mouthwash samples, before and after concentration, of 363 patients by RT-PCR for the presence of SARS-CoV-2. Among 114 patients in which SARS-CoV-2 was identified in at least one of their samples, the virus was identified in 76 (66.7%), 67 (58.8%), and 101 (88.6%) of nasopharyngeal swab, gargle, and mouthwash samples before and after concentration, respectively. When concentrated by our new method, gargle and mouthwash samples can be used instead of nasopharyngeal samples in identification of SARS-CoV-2 by RT-PCR, with the same or better sensitivity. Eliminating the need for nasopharyngeal sampling will save the patients from an invasive and painful procedure and will lower the risk of infection for the healthcare personnel taking the sample. This easy sampling procedure may decrease the workload of hospitals, shorten the turnaround time of obtaining test results, and thus enable rapid isolation of infected patients.

The role of mouthwash sampling in SARS-CoV-2 diagnosis.

BACKGROUND: The current practice of COVID-19 diagnosis worldwide is the use of oro-nasopharyngeal (ONP) swabs. Our study aim was to explore mouthwash (MW) as an alternative diagnostic method, in light of the disadvantages of ONP swabs. METHODS: COVID-19 outpatients molecular-confirmed by ONP swab were repeatedly examined with ONP swab and MW with normal saline (0.9%). Other types of fluids were compared to normal saline. The Cq values obtained with each method were compared. RESULTS: Among 137 pairs of ONP swabs and MW samples, 84.6% (116/137) of ONP swabs were positive by at least one of the genes (N, E, R). However MW detected 70.8% (97/137) of samples as positive, which means 83.6% (97/116) out of positive ONP swabs, missing mainly Cq value > 30. In both methods, the N gene was the most sensitive one. Therefore, MW samples targeting N gene, which was positive in 95/137 (69.3%), are comparable to ONP swabs targeting E and R genes which gave equal results-95/137 (69.3%) and 90/137 (65.7%), respectively. Comparing saline MW to distilled water gave equal results, while commercial mouth-rinsing solutions were less sensitive. CONCLUSIONS: MW with normal saline, especially when tested by N gene, can effectively detect COVID-19 patients. Furthermore, this method was not inferior when compared to R and E genes of ONP swabs, which are common targets in many laboratories around the world.

Recent Development of Active Ingredients in Mouthwashes and Toothpastes for Periodontal Diseases.

Periodontal diseases like gingivitis and periodontitis are primarily caused by dental plaque. Several antiplaque and anti-microbial agents have been successfully incorporated into toothpastes and mouthwashes to control plaque biofilms and to prevent and treat gingivitis and periodontitis. The aim of this article was to review recent developments in the antiplaque, anti-gingivitis, and anti-periodontitis properties of some common compounds in toothpastes and mouthwashes by evaluating basic and clinical studies, especially the ones published in the past five years. The common active ingredients in toothpastes and mouthwashes included in this review are chlorhexidine, cetylpyridinium chloride, sodium fluoride, stannous fluoride, stannous chloride, zinc oxide, zinc chloride, and two herbs-licorice and curcumin. We believe this comprehensive review will provide useful up-to-date information for dental care professionals and the general public regarding the major oral care products on the market that are in daily use.

The Effects of Mouthwashes on the Color Stability of Resin-Based Restorative Materials / Efecto de los enjuagues orales en la estabilidad del color de materiales restauradores a base de resina

Abstract: Objective: This study investigated the effects of three types of mouthwash on the color stability of three resin-based restorative materials (nanohybrid resin composite, sonic-activated bulk-fill material, and compomer). Materials and Methods: To this end, 120 cylindrical disc specimens were prepared and polished, after which they were incubated in distilled water for 24 hours for post-polymerization. The baseline color values of each specimen were measured with a spectrophotometer, then the specimens were randomly divided into four groups. Following immersion in the mouthwashes for 24 hours, the specimens were rinsed with distilled water and dried before the color measurement was repeated. The values of color change (ΔE₀₀) were subsequently calculated. A two-way analysis of variance and Duncan's post hoc multiple comparison tests were conducted to determine statistically significant differences among the restorative materials. Results: All samples showed discoloration after immersion, albeit some instances of discoloration were imperceptible. In this respect, a statistically significant difference was found among the restorative materials and mouthwashes (p<0.05). Imperceptible ΔE₀₀ values were derived on the nanohybrid resin composite and compomer, but perceptible and acceptable ΔE₀₀ values were detected on the sonic-activated bulk-fill materials (p<0.05). The clinically unacceptable discoloration was observed on the sonic-activated bulk-fill composite immersed in Listerine®. Conclusions: Clinicians should make recommendations based on the potential staining capacity of mouthwashes prescribed for daily use in restorative materials. In this way, the need for renewal of restorations due to discoloration could be avoided.

Resumen: Objetivo: Este estudio investigó los efectos de tres tipos de enjuague bucal en la estabilidad del color de tres materiales de restauración a base de resina (resina nanohíbrida, resina bulk-fill de activación sónica y compómero). Materiales y Métodos: Para ello se prepararon y pulieron 120 muestras de discos cilíndricos, después de lo cual se incubaron en agua destilada durante 24 horas pospolimerización. Los valores de color de base de cada muestra se midieron con un espectrofotómetro, después las muestras se dividieron aleatoriamente en cuatro grupos. Tras la inmersión en los enjuagues bucales durante 24 horas, los especímenes se enjuagaron con agua destilada y se secaron antes de repetir la medición del color. Posteriormente se calcularon los valores de cambio de color (ΔE₀₀). Se llevó a cabo un análisis bidireccional de la varianza y las pruebas de comparación múltiple post hoc de Duncan para determinar las diferencias estadísticamente significativas entre los materiales de restauración. Resultados: Todas las muestras mostraron decoloración después de la inmersión, aunque algunos casos esta fue imperceptible. Se encontró una diferencia estadísticamente significativa entre los materiales de restauración y los enjuagues bucales (p<0,05). Se obtuvieron valores imperceptibles de ΔE₀₀ en el compuesto de resina nanohíbrida y el compómero, pero se detectaron valores perceptibles y aceptables de ΔE₀₀ en la resina bulk-fill activada sónicamente (p<0,05). Se observó una decoloración clínicamente inaceptable en la resina bulk-fill activada sónicamente inmersa en Listerine®. Conclusiones: Los clínicos deben hacer recomendaciones basadas en la capacidad potencial de coloración de los enjuagues bucales prescritos para uso diario en los materiales de restauración. De esta manera, se podría evitar la necesidad de renovar las restauraciones debido a la decoloración.

Choosing the Right Essential Oil for a Mouthwash: Chemical, Antimicrobial and Cytotoxic Studies.

Thirteen commercial essential oils were assessed for their possible inclusion in a mouthwash formulation based on their inhibitory effect against potentially pathogenic anaerobic oral bacterial isolates from subgingival plaque, and their cytotoxicity towards gingival cells. The essential oils, originating from species belonging to seven major aromatic plant families, were chosen to provide the necessary diversity in chemical composition that was analyzed in detail by GC and GC/MS. Multivariate statistical analysis, performed using the in vitro microbiological/toxicological assays and compositional data, revealed that the major components of the essential oils were probably not the main carriers of the activities observed. A formulation of 'designer' mouthwashes is proposed based on the selective action of certain essential oils towards specific bacterial isolates (e. g., Citrus bergamia vs. Parvimonas micra), and non-toxicity to gingival cells at antimicrobially active concentrations.

Comparative efficacy of honey 12.5% and chlorhexidine 0.2% mouthwashes on the oropharyngeal bacterial colonization in mechanically-ventilated patients: a randomized controlled trial.

OBJECTIVE: To compare the efficacy of honey mouthwash 12.5% and chlorhexidine solution 0.2% to reduce the rate of oropharyngeal bacterial colonization in mechanically-ventilated patients. METHODS: This study was a randomized, single blind, phase Ⅲ controlled clinical trial. Sixty patients newly admitted to internal and trauma Intensive Care Units of the two educational hospitals of Sanandaj city affiliated with Kurdistan University of Medical Sciences were selected by convenience sampling and allocated to two groups of 30 patients using random blocks design. In each group, the mouthwash was applied twice a day for four consecutive days. Swab samples were taken from the mouth and throat of all patients three times a day (pre- intervention, two days, and four days after the intervention) and then the samples were transferred onto the blood agar and eosin methylene blue (EMB) culture plates and investigated for bacterial growth and colonization after 24-48 h. RESULTS: The findings showed that oropharyngeal colonization was not significantly different between the two groups, pre-intervention, two days, and four days after the intervention (P > 0.05). Rinsing with honey mouthwash 12.5% led to the inhibition of Staphylococcus aureus and Pseudomonas aeruginosa on the fourth day of the intervention in all samples. CONCLUSION: None of the studied solutions contributed to the reduction of oropharyngeal bacterial colonization. It seems that the growth inhibition of Staphylococcus aureus and Pseudomonas aeruginosa by the honey 12.5% mouthwash in mechanically-ventilated patients need further investigation.

Oropharyngeal HPV Detection Techniques in HPV-associated Head and Neck Cancer Patients.

BACKGROUND/AIM: The incidence of human papilloma virus (HPV)-related head and neck squamous cell carcinoma (HNSCC) has been increasing in the last decades. Analysis of oral brushing or rinsing samples for screening or stratification could potentially improve screening and prevention. PATIENTS AND METHODS: Oral brushes and mouthwashes were taken from 20 patients with HPV-associated HNSCC before definite therapy. HPV genotyping was performed for the detection of 14 high-risk HPV subtypes and correlated to DNA isolated from tumor tissue. RESULTS: Ten of 20 patients were tested HPV positive by using either method. There was a significant correlation between macroscopic visibility of tumor and positive HPV detection (p<0.001) and HPV detection and tumor size (p<0.001). HPV was detected in all macroscopically visible tumors. Half of the HPV cases who had macroscopically invisible tumors were missed by both methods. CONCLUSION: Both techniques are limited in the detection of macroscopically non-visible and small tumors. Therefore, the application of these techniques for screening or diagnosis of HNSCC is not recommended.

Smartphone colorimetric determination of hydrogen peroxide in real samples based on B, N, and S co-doped carbon dots probe.

In this paper, we report the use of a smartphone and B, N, and S co-doped carbon dots (BNS-CDs) as a promising peroxidase mimic to quantify hydrogen peroxide (H2O2). The synthesized BNS-CDs exhibited excellent peroxidase-like activity to catalyze the reaction of the chromogenic substrate 3,3',5,5'-tetramethylbenzidine (TMB) with H2O2 to generate a blue oxide product (ox-TMB) with maximum absorption at 652 nm. Steady-state kinetic analysis demonstrated that the BNS-CDs showed much higher affinity than natural horseradish peroxidase (HRP) for H2O2 due to their small size and larger specific surface area. A smartphone colorimetric readout device was employed to record the RGB (red green blue) value of the ox-TMB solution via the Android application Color Grab for quantitative detection. A good linear relationship (R2 = 0.9970) between the H2O2 concentration and |R-Rblank| value was obtained in the range of 3-30 µM with a limit of detection (LOD) of 0.8 µM. The current method was successfully applied to determine H2O2 in mouthwash and milk with recoveries of 92.70-108.30%. The developed assay is a promising portable detection platform for H2O2 with good sensitivity and selectivity, simple operation, fast response, and low cost. Graphical abstract.

Effect of Listerine Mouthwash with Green Tea on the Inhibition of Streptococcus Mutans: A Microbiologic Study

Abstract Objective: To evaluate in vitro the antimicrobial effect of Listerine-green tea mouthwash on Streptococcus mutans (SM) in comparison with 0.12% Chlorhexidine (CHX) and Listerine-Zero. Material and Methods: The sensitivity and growth inhibition of SM bacterial species were evaluated and compared between Listerine-green tea, 0.12% CHX and Listerine-Zero mouthwashes. Sixty plates containing SM colonies were prepared in three groups (n=20), and growth inhibition zones were measured using the disk diffusion agar test in mm. Data were analyzed with SPSS 21. One-way ANOVA was used to compare the efficacy of the three mouthwashes tested. Post hoc Tukey tests were used for two-by-two comparisons. Statistical significance was defined at P<0.05. Results: Analysis of data showed significant differences between the three groups (p<0.001); 0.12% CHX was the most effective mouthwash, and Listerine-Zero exhibited the least effect on the growth inhibition of SM (p<0.004). Conclusion: All three mouthwashes were significantly effective in inhibiting the growth of SM. The effect of Listerine-green tea mouthwash was higher than that of Listerine-Zero and less than that of 0.12% CHX.

Formulation and evaluation of a mucoadhesive buccal tablet of mefenamic acid

Buccal route of administration has many advantages such as improving patient compliance, bypassing the GIT and hepatic first pass effect. The objectives are to formulate mucoadhesive buccal tablet using Mefenamic acid and compatible excipients, and to evaluate the product using quality control tests and in vitro tests. The ingredients were subjected to Differential Scanning Calorimetry and Fourier Transform Infrared Spectroscopy studies for compatibility test and the results showed no interaction. Two batches of mefenamic buccal tablet were prepared. The tablet thickness and diameter are 3.75 mm and 12 mm respectively. All tablets are within the specification of +/- 5%. The in-house tablet hardness is 6.8-15kg and percent friabilation is not more than 0.8%. The disintegration test showed that all tablets disintegrated within 4 hours. The content uniformity showed that tablets are within the range of 85%-115%. The tablet weight is within the 5% range. The percent swelling is 53.83% to 58.86% and moisture absorption is 14.79% to 15.56%. The surface pH of the tablet is close to the salivary pH, which means that it would not irritate the buccal mucosa. The buccal tablet has a mucoadhesiveness of 0.196 to 0.200. There was no change in pH and size after subjecting it to stability studies in human saliva. Drug release studies showed 80.7% to 83.4% after 3 hours. Even after 3 months of subjecting the tablets to 40 ºC and 75% RH, results are within acceptable range. The results show the potential of the formulation as a mucoadhesive buccal tablet.

An in Vitro Effectiveness Evaluation of Chemical Agents for Toothbrushes Disinfection

Objective: To evaluate in the vitro effectiveness of three chemical agents for toothbrush disinfection. Material and Methods: Sixteen new toothbrushes were evaluated, previously sterilized and classified in five experimental groups (n=3) and one item as control. Three chemical agents were assessed: 0.12% Chlorhexidine gluconate (CHX), essential oil mouth rinse (Listerine) and 3.5% Sodium hypochlorite (NaOCl). The five selected strains were inoculated on toothbrushes and incubated for a 24 hours period and 37°C temperature in aerobic conditions. The incubated toothbrushes were immersed for a 15 min period into selected chemical agents and after drying in a controlled air stream, again re-cultured into enriched broth. A comparison was made between the initial and final microorganisms density recovered after chemical disinfection based on Mc Farland scale. The data obtained was compared by descriptive analysis and ANOVA methodology. Results: 3.5% NaOCl was the most effective chemical agent for toothbrush disinfection followed by CHX; Listerine was not effective to eliminate the inoculated bacteria in toothbrushes. Conclusion: 3.5% NaOCl and 0.12% CHX are the most effective chemical agents for toothbrush disinfection and Listerine was only effective against C. albicans.

Comparative analysis of oral rinse-based cytology and conventional exfoliative cytology: A pilot study.

BACKGROUND: Oral exfoliative cytology is a novel technique of using cells to detect dysplastic changes in the oral cavity in potentially malignant disorders and malignant oral lesions in resourced challenged areas. The aim of this study was to compare specimen adequacy and cellular clarity between oral rinse-based smears and conventional smears in normal controls, histologically confirmed and clinically diagnosed squamous cell carcinoma, and oral leukoplakia. For many years, oral rinse-based cytology has been used to detect candidal colonization in microbiology. Emphasis has been placed to detect changes in oral rinse-based cytology. From this research and development, oral rinse-based cytology has evolved as a method of preparing samples for examination in cytopathology. MATERIALS AND METHODS: Oral exfoliated cells from 10 cases of smears of potentially malignant disorders (oral leukoplakia), 10 cases of histologically confirmed and clinically diagnosed squamous cell carcinoma, and 10 controls with healthy mucosa were taken. Smears were stained with the Papanicolaou stain and were examined independently by two different oral pathologists. The results were compared to assess four parameters such as nuclear cytoplasmic ratio, sample adequacy, cellular distribution, and cellular clarity in both the smears. The results were then analyzed with SPSS (version 20) software using the descriptive statistics such as mean and standard deviation and inferential statistics such as t-test and one-way ANOVA. The level of significance was set at 5%. RESULTS: Oral rinse-based cytology was significantly more efficient than conventional exfoliative cytology in terms of cellular clarity (P < 0.001), cellular distribution (P < 0.001), and sample adequacy (P < 0.001). CONCLUSION: Oral rinse-based cytology shows overall improvement in cellular clarity, sample adequacy as compared to traditional exfoliative cytology.

Reduction of FENO by tap water and carbonated water mouthwashes: magnitude and time course.

Fractional exhaled nitric oxide (FENO) assesses eosinophilic inflammation of the airways, but FENO values are also influenced by oral nitric oxide (NO). The aim of this pilot study was to measure FENO and compare the effect of two different mouthwashes on FENO and analyse the duration of the effect. FENO was measured in 12 randomized volunteers (healthy or asthmatic subjects) with a NIOX VERO® analyser at an expiratory flow rate of 50 mL/s. After a baseline measurement, a mouthwash was performed either with tap water or carbonated water and was measured during 20 min in 2 min intervals. The procedure was repeated with the other mouthwash. We found that both mouthwashes reduced FENO immediately at the beginning compared to the baseline (p < .001). The carbonated water mouthwash effect lasted 12 min (p ranging from <0.001 to <0.05). The tap water mouthwash reduced FENO statistically significantly only for 2 min compared with the baseline. We conclude that a single carbonated water mouthwash can significantly reduce the oropharyngeal NO contribution during a 12 min time interval.

Efficacy of Mouthwash from Aloe vera Juice after Scaling Treatment on Patient with Gingivitis: A Clinical Study

Objective: To determine the effectiveness effectivity of mouthwash from Aloe vera juice after scaling treatment on patient with gingivitis. Material and Methods: This was an experimental research using pretest and posttest design with control group. The number of samples of 30 people selected using sampling method quota sampling. Samples were divided into two groups: test (n = 15 skeletons with Aloe vera juice) and control (n = 15 just scaling). Gingival inflammation is measured using a gingival index according to Loe and Sillness on the first day before scaling treatment and 7th day after scaling. Data analysis was conducted using SPSS version 20. Independent-samples t-test and paired-samples t-test were used for data analysis. The statistical test performed has a significance level of 0.05 (p = 0.05) and confidence level of 95% (α = 0,05). Results: There was a significant decrease in the mean score of the gingival index in the control group (1.1 to 0.5) and the test group (1.2 to 0.4) significantly (p<0.05). Conclusion: The use of mouthwash from Aloe vera juice can decrease gingival inflammation, which can be seen from the gingival index score on all test subjects. The decrease in gingival index in the test group using the Aloe vera juice was greater than that of the control group, which was not given the mouthwash.