Reduction of stain,plaque and gingivitis by mouth rinsing with chlorhexidine and peroxyborate

Aim of the present study was to investigate whether the use of an oxidising mouthrinse as an adjunct to chlorhexidine is efficacious in reducing stain, plaque and gingivitis. This study had a single-blind, 2-group parallel design, including a 14-day experimental non-brushing period during which 1 group (n = 14) used chlorhexidine alone (CHX) and the other (n = 14) used chlorhexidine in combination with an oxidising agent. Patients were randomly assigned to either group. The gingival condition was evaluated at baseline by means of bleeding on marginal probing. The examination after 14 days of rinsing included the evaluation of plaque, bleeding on marginal probing and stain (GMSI: gingival modification of the stain index). The results showed at day 14 a significant difference between the 2 groups for plaque and gingival bleeding. The proportion of stained surfaces was less in the CHX + PER-group (28%), than in the chlorhexidine group. The adjunctive use of an oxidising agent peroxyborate to chlorhexidine, proved to be superior to chlorhexidine alone with regard to the inhibition of plaque and development of gingivitis.     

Effect of Peroxyl mouthrinse on chlorhexidine staining of teeth.

The efficacy of Peroxyl mouthrinse in reducing the extrinsic stain produced by Peridex, a chlorhexidine mouthrinse, was evaluated in a double-blind, three-month clinical study. Intraoral safety, extrinsic tooth stain and plaque accumulation scores were determined on 119 healthy adult subjects at baseline and at 30-, 60- and 90-day intervals following use of Peroxyl or placebo formulations in combination with the Peridex product. Subjects were randomly assigned to two groups. The test group used the chlorhexidine mouthrinse plus Peroxyl mouthrinse, while the control group used the chlorhexidine mouthrinse plus a placebo mouthrinse. All participants were given an oral prophylaxis prior to use of the mouthrinses. The assigned mouthrinse combinations were used by 58 test and 61 control subjects, who followed specific toothbrushing and mouthrinse regimens throughout the three-month period. Both the examiner and the subjects were unaware of the identities of the products tested. Use of Peroxyl mouthrinse significantly reduced extrinsic tooth stain produced by chlorhexidine rinsing. The mean stain scores for all teeth were significantly lower for the Peroxyl/chlorhexidine group, at 60 and 90 days of use, compared to the placebo/chlorhexidine group. At all three time points, the mean stain scores of the anterior teeth of the individuals using Peroxyl/chlorhexidine rinses had significantly less stain compared to the placebo/chlorhexidine rinse group means. No intraoral soft tissue side effects, attributed to product use, were observed or reported throughout the study.     

Staining and calculus formation after 0.12% chlorhexidine rinses in plaque-free and plaque covered surfaces: a randomized trial

Objectives

Studies concerning side effects of chlorhexidine as related to the presence of plaque are scarce. The purpose of this study was to compare the side effects of 0.12% chlorhexidine gluconate (CHX) on previously plaque-free (control group) and plaque-covered surfaces (test group).

Methods

This study had a single-blind, randomized, split-mouth, 21 days-experimental gingivitis design, including 20 individuals who abandoned all mechanical plaque control methods during 25 days. After 4 days of plaque accumulation, the individuals had 2 randomized quadrants cleaned, remaining 2 quadrants with plaque-covered dental surfaces. On the fourth day, the individuals started with 0.12% CHX rinsing lasting for 21 days. Stain index intensity and extent as well as calculus formation were evaluated during the experimental period.

Results

Intergroup comparisons showed statistically higher (p<0.05) stain intensity and extent index as well as calculus formation over the study in test surfaces as compared to control surfaces. Thus, 26.19% of test surfaces presented calculus, whereas calculus was observed in 4.52% in control surfaces.

Conclusion

The presence of plaque increased 0.12% CHX side effects. These results strengthen the necessity of biofilm disruption prior to the start of CHX mouthrinses in order to reduce side effects.     

Clinical efficacy of a chlorhexidine-delivering toothbrush

Objectives: Evaluate the efficacy and safety of an experimental toothbrush with a slow-release system of chlorhexidine (CHX) and determine its ability to inhibit plaque, bleeding, staining and oral tissue abnormalities during 6 weeks of use.
Material and Methods: One hundred and fifty healthy volunteers were randomly assigned to one of three groups: the Test Brush group with a template slow-delivery system of CHX (Ttb), the Control Brush group without CHX (Ctb) and the Control Brush group without CHX but rinsing post-brushing with a 0.2% CHX mouthrinse (Ctb+R). At baseline as well as at 3 and 6 weeks, all clinical parameters were assessed. Following the baseline assessment, a supragingival prophylaxis was provided.
Results: One hundred and forty subjects completed the study. The Ctb+R group had lower plaque and bleeding scores than the Ttb and the Ctb group and significantly ( p =0.0001) higher stain scores. There were no significant differences in plaque, bleeding and stain scores between the Ttb and the Ctb group. No differences were detected in oral tissue changes, except for discoloration of the tongue.
Conclusions: In the present study, no beneficial effect could be demonstrated for the experimental CHX-releasing toothbrush. The use of a 0.2% CHX mouthrinse (in combination with brushing) remains the gold standard for additional chemical plaque control.     

Comparative antiplaque and antigingivitis effectiveness of a chlorhexidine and an essential oil mouthrinse: 6-month clinical trial

OBJECTIVES: The objective of this study was to compare the antiplaque and antigingivitis effectiveness and the side-effect profiles of an essential oil-containing mouthrinse and a chlorhexidine-containing mouthrinse. MATERIAL AND METHODS: One hundred and eight qualifying subjects, aged 20-57 years, were randomized into three groups: essential oil mouthrinse (ListerineAntiseptic); 0.12% chlorhexidine mouthrinse (Peridex); or 5% hydroalcohol negative control. At baseline, subjects received a complete oral soft tissue examination and scoring of the Loe-Silness gingival index (GI), Quigley-Hein plaque index (PI), Volpe-Manhold calculus index (CI), and Lobene extrinsic tooth stain index (SI). Following a complete dental prophylaxis, subjects started rinsing twice daily with their respective mouthrinse as an adjunct to their usual mechanical oral hygiene procedures. One of the rinses on each weekday was supervised. Subjects were reexamined at 3 and 6 months. The treatment groups were compared with respect to baseline demographic and clinical variables. The primary efficacy variables were GI and PI. Intergroup differences for all clinical variables were tested at 3 and 6 months using appropriate statistical procedures. RESULTS: All of the 108 randomized subjects were evaluable at 3 months, and 107 subjects were evaluable at 6 months. There were no statistically significant differences among the three groups at baseline, with the exception that the control group PI was significantly lower than that of the essential oil group (p<0.05) and the chlorhexidine group (p<0.001), and the essential oil mouthrinse group had a significantly greater number of subjects than the control group with body region SI scores > or =1.0 (p=0.021). At 6 months, the essential oil and chlorhexidine mouthrinses produced statistically significant (p<0.001) GI reductions of 14.0% and 18.2%, respectively, and statistically significant (p<0.001) PI reductions of 18.8% and 21.6%, respectively, compared with the control and were not statistically significantly different from each other with respect to plaque and gingivitis reduction. The chlorhexidine mouthrinse group had significantly more calculus and extrinsic tooth stain than either the essential oil mouthrinse group or the control group. CONCLUSION: This 6-month controlled clinical study demonstrated that the essential oil mouthrinse and the chlorhexidine mouthrinse had comparable antiplaque and antigingivitis activity. Insofar as side effects associated with the chlorhexidine mouthrinse may limit patient compliance, it is suggested that each product can have a distinct role in the management of patients with periodontal diseases.     

Six-month study of the effects of a chlorhexidine mouthrinse on gingivitis in adults

The effects of a chlorhexidine gluconate mouthrinse on plaque and gingivitis were studied among 430 adults in a six-month clinical trial. Subjects were divided in two comparable treatment groups matched for age, sex, and initial gingivitis severity. Following a thorough oral prophylaxis, they were instructed to rinse twice a day for 30 seconds with 15 ml of a 0.12% chlorhexidine gluconate mouthrinse or a placebo mouthrinse. After three and six months of mouthrinse use, the chlorhexidine group had significantly less gingivitis, gingival bleeding, and plaque accumulation compared to the placebo group. As expected, accumulation of dental calculus and extrinsic dental stain increased in the chlorbexidine group. No significant differences in adverse oral soft tissue effects were observed between the two groups.
Since use of oral antimicrobial agents has been reported to produce tooth and tongue stain, gingivitis examinations were done with and without tooth covers to eliminate the potential for examiner bias. Comparable reductions in the Gingival Index scores and gingival bleeding were obtained when the evaluations were conducted with or without the tooth covers.
It was concluded that a 0.12% chlorhexidine gluconate mouthrinse can provide an important adjunct to the prevention and control of gingivitis when used with regular personal oral hygiene procedures and professional care.     

Experiments with two-phase plaque-inhibiting mouthrinses

Reports indicate that oil/water mouthrinses with an aqueous phase containing an antibacterial agent, reduce the amount of volatile bacterial products in expiration air compared with aqueous mouthrinses. These systems have not, however, been tested concerning antiplaque activity. The aim of the present study was to examine the plaque-inhibiting effect of a mouthrinse with an aqueous phase containing 0.2% chlorhexidine (CHX) and an oily phase (soya oil) containing 0.3% triclosan. A test panel rinsed with the mouthrinses twice daily for 4 d. The mouthrinse containing CHX and triclosan in two phases was significantly better than the negative control (water). However, it was not as effective as the rinse consisting of an aqueous phase with chlorhexidine combined with an oily phase without triclosan. A two-phase mouthrinse with soya oil containing 0.3% triclosan was not superior to soya oil alone, and the combination of CHX and triclosan in a two-phase rinse was not as effective as 0.1% CHX alone in water. No beneficial effect on plaque inhibition could thus be found by using a two-phase system with two different antibacterial agents (one water soluble and one lipid soluble). Soya oil without triclosan rendered higher plaque inhibition than the control, presumably due to formation of a hydrophobic layer on the tooth surfaces.     

A comparison of mouthrinses containing two concentrations of chlorhexidine

A 3-month clinical trial was conducted to compare the effects of two concentrations of a chlorhexidine mouthrinse on gingivitis and plaque accumulation. Six hundred (600) adults were divided into three treatment groups matched for age, sex, and initial gingivitis severity. Following a thorough examination and prophylaxis at baseline, subjects were given a mouthrinse containing either 0.12% or 0.20% chlorhexidine gluconate or a placebo mouthrinse. Subjects were evaluated after 6 weeks and 3 months of mouthrinse use. After 3 months, both chlorhexidine groups showed significantly less gingivitis and plaque than the placebo group. The group using the 0.12% chlorhexidine gluconate mouthrinse demonstrated 27–27 % less gingivitis occurrence and 28–28% less gingivitis severity than the placebo group. The 0.12% chlorhexidine gluconate group also had 48–48% less gingival bleeding and 36% less plaque than the placebo group. There were no significant advantages for the 0.20% mouthrinse over the 0.12% mouthrinse. It is therefore concluded that a 0.12% chlorhexidine gluconate mouthrinse offers the same clinical benefits as a 0.20% chlorhexidine gluconate mouthrinse.     

三氯羟苯醚漱口液作用特点的研究

目的 研究新型三氯羟苯醚（triclosan）漱口液－力博漱口液的作用特点。方法 ①检查并记录受检者用药前后的牙菌斑指数和牙龋出血指数,观察临床疗效。②采集受检者用药前后受检者的龋下菌斑标本,厌氧环境下培养,计数菌落数（CUF／L）。对比用药前后的抑菌效果。③选择变形链球菌C、牙龋卟啉单胞菌等为实验菌株,以倍比稀释后的三氯羟苯醚漱口液和酸氯己定漱口液为抑菌物,厌氧培养后,观察抑菌环大小,对比两种漱口液对不同菌株的最低抑菌浓度。④在光滑附着板上培养变形链球菌,形成细菌斑膜后,将附着板置于三氯羟苯醚漱口液、醋酸氯己定漱口液和生理盐水中,观察细菌脱落情况。结果 ①三氯羟苯醚漱口液含漱治疗牙龋炎症临床有效,可降低牙菌斑指数及牙龋出血指数。②使用三氯羟苯醚漱口后,口腔致病菌的培养计数有所减少。③三氯羟苯醚漱口液对变形链球菌C的最低抑菌浓度低于醋酸氯己定漱口液,对牙龋卟啉单胞菌的最低抑菌浓度高于醋酸氯己定漱口液。④在三氯羟苯醚漱口液中,附着板上的细菌膜最容易脱落,三氢羟苯醚漱口液的抗细菌附着作用强于醋酸氯己定漱口液和生理盐水。结论     

Clinical study to compare the effectiveness of a test whitening toothpaste with a commercial whitening toothpaste at inhibiting dental stain

AIMS: A single centre, randomised single-blind, three-way crossover study was performed, to compare the effect of an experimental test toothpaste with a commercially available whitening toothpaste and water control at inhibiting extrinsic stain promoted by repeated chlorhexidine/tea rinses. METHODS: This study used 23 subjects. During the week before the study the subjects received a prophylaxis to remove all staining, plaque and calculus deposits. On the Monday of the following week subjects returned to the clinic to receive their rinses and to check their dentition was stain free. Under direct supervision at both 09:00 and 13:00 hours they rinsed with either a toothpaste slurry or water control that was repeated daily up to and including the following Thursday. Additionally from the Monday to the Thursday each subject rinsed with a 0.2% chlorhexidine mouthrinse, immediately followed by a rinse with a warm black tea solution. This cycle was repeated hourly eight times throughout the day and on the following days until the Friday. Throughout this period volunteers omitted all other forms of oral hygiene except rinsing with the chlorhexidine mouthwash. On the Friday the level of stain on the teeth and dorsum of tongue was assessed using the Lobene stain index for both stain area and intensity. At the end of each trial period each subject received a thorough prophylaxis to remove all plaque, calculus and staining before starting the second and third period of the study. RESULTS: As expected appreciable amounts of extrinsic stain accumulated on the teeth over each study period. The amount of stain following use of the toothpastes and water control was least with the experimental toothpaste, followed by water control and lastly the commercial whitening paste. For all sites combined there was evidence that the experimental paste was significantly superior to both the commercial paste and water control at reducing stain area (p<0.001), a product of stain area and intensity (p<0.001 and 0.05, respectively) but not stain intensity (p>0.05). CONCLUSIONS: In this stain-prevention model the use of an experimental paste showed a significant reduction in stain accumulation on the teeth compared with a (placebo) negative water control and a commercially available whitening paste. As such the experimental paste would be expected to be of benefit in controlling extrinsic dental staining.     

In Situ Chlorhexidine Substantivity on Saliva and Plaque‐Like Biofilm: Influence of Circadian Rhythm

Background: The aim of the present study is to assess in situ substantivity of a single mouthrinse with 0.2% chlorhexidine (CHX) on saliva and on undisturbed de novo plaque‐like biofilm (PL‐biofilm), differentiating between two times of application: 1) CHX mouthrinse in the morning; and 2) CHX mouthrinse at night. Methods: The study participants were 10 healthy volunteers who wore an individualized splint with glass disks for 48 hours to boost the growth of PL‐biofilm. Saliva samples were collected, and two disks were removed from each volunteer's splint at 8, 10, and 12 hours after performing a mouthrinse with 0.2% CHX at 7:00 am (M‐0.2% CHX‐diurnal) and 1:00 am (M‐0.2% CHX‐nocturnal). The saliva and plaque samples were analyzed by epifluorescence and confocal laser scanning microscopy, respectively, using a green fluorescent nucleic acid stain/propidium iodide staining. Results: With M‐0.2% CHX‐diurnal, the frequency of vital bacteria in saliva was significantly higher than in the PL‐biofilm at 8, 10, and 12 hours after mouthrinse. After M‐0.2% CHX‐nocturnal, the frequency of vital bacteria in saliva was significantly lower than in the PL‐biofilm at 8 hours and higher than in the PL‐biofilm at 12 hours after mouthrinse. Conclusion: These results support the more active physiologic dynamics of the salivary flora and the possible reservoir function associated with the structure of undisturbed de novo PL‐biofilm.     

Inhibition of de novo plaque growth by a new 0.03 % chlorhexidine mouth rinse formulation applying a non-brushing model: a randomized,double blind clinical trial

Objectives

The aim of this study was to investigate the plaque inhibitory effect of a new 0.03 % chlorhexidine digluconate (CHX) and 0.05 % cetylpyridinium chloride (CPC) mouthrinse formulation and to explore patients’ experience and side effects after its use.

Materials and methods

This short-term, randomized, double blind, parallel, clinical trial enrolled 150 periodontally healthy patients. These volunteers were randomly allocated to one of following mouthrinse groups (n = 50/group): 0.12 % CHX + 0.05 % CPC (Perio-Aid® Treatment alcohol-free), 0.03 % CHX + 0.05 % CPC new test formulation or to the placebo group. Clinical parameters (plaque, gingival, and stain indexes) and microbiological samples were taken at baseline, before supragingival cleaning, and after 4 days of undisturbed plaque growth, rinsing twice/day with one of the mouthrinses.

Results

Plaque reduction was similar for the 0.12 % CHX (?0.52 ± 0.55) and 0.03 % CHX (?0.47 ± 0.49) groups. Both showed significant reductions in plaque accumulation compared to the placebo (p < 0.001). The new formulation had less of a negative impact on taste perception when compared to the 0.12 % CHX solution. The new CHX mouthrinse was also able to control bacterial loads and reduce some periodontopathogens.

Conclusions

This study indicated that the new 0.03 % CHX + 0.05 % CPC formulation exerted clinical efficacy similar to that achieved by an already-marketed 0.12 % CHX + 0.05 % CPC mouthrinse, but with slightly fewer side effects.

Clinical relevance

Lower CHX mouthrinse formulations could be effective in the inhibition of plaque regrowth with reduced unpleasant subjective side effects.

     

The Effectiveness of a Preprocedural Mouthrinse Containing Cetylpyridinium Chloride in Reducing Bacteria in the Dental Office

BackgroundDuring oral procedures, microorganisms from the oral cavity may contaminate nearby surfaces. The authors evaluated the efficacy of a commercial preprocedural mouthrinse containing 0.05 percent cetylpyridinium chloride (CPC) in reducing the levels and composition of viable bacteria in oral spatter.MethodsThe authors randomly assigned 60 participants receiving oral prophylaxis with an ultrasonic scaler to one of four groups: a preprocedural rinse solution containing 0.05 percent CPC, 0.12 percent chlorhexidine (CHX) or water, or no rinsing. Airborne microorganisms were collected on blood agar plates. The composition of the spatter was analyzed for 39 oral bacterial species by means of checkerboard DNA-DNA hybridization.ResultsCPC and CHX were equally effective in lowering the levels of spatter bacteria and performed better than water and no rinsing (P < .05, Kruskal-Wallis test). The composition of the spatter from the control groups showed higher proportions (P < .05, Kruskal-Wallis test) of Fusobacterium species and lower proportions of Capnocytophaga species when compared with the spatter from the CPC and CHX groups.ConclusionA commercial mouthrinse containing 0.05 percent CPC when used as a preprocedural mouthrinse was equally effective as CHX in reducing the levels of spatter bacteria generated during ultrasonic scaling.Clinical ImplicationsOwing to its strong antibacterial effect and the fact that it has fewer side effects than CHX, a solution containing 0.05 percent CPC may be a good alternative to that containing 0.12 CHX as a preprocedural mouthrinse used to help decrease the level of contamination in spatter.     

Efficacy of chlorhexidine mouthrinses with and without alcohol: a clinical study

BACKGROUND: Plaque control is the main method for preventing periodontal diseases. Chlorhexidine digluconate mouthrinse is widely recognized as helping to maintain plaque control. Most of these mouthrinses contain alcohol, making them impractical for many patients, including those with oral mucosal hypersensitivity. Mouthrinses without alcohol might cause fewer side effects, but also be less efficient. In this study, we evaluated the efficacy of a 0.12% chlorhexidine mouthrinse without alcohol against one with 11% ethanol and a placebo. METHODS: This a double-blind, parallel group study with 96 patients who tested 3 mouthrinses containing 1) chlorhexidine digluconate 0.12% sodium fluoride 0.05%, and ethanol 11% (group 1; CHX-A); 2) the same solution without alcohol (group 2; CHX-NA); and a placebo (group 3; P). Plaque and bleeding indexes were recorded in all patients prior to treatment and at 14 and 28 days. RESULTS: There were significant differences in plaque, gingivitis, and papilla bleeding indexes in both chlorhexidine rinses compared to placebo, but no differences between the 2 CHX products. CONCLUSIONS: In this study, the alcohol-free rinse was as effective as one containing alcohol in controlling plaque and reducing gingival inflammation. Therefore, it would seem that its use can be recommended in all patients, but especially in patients for whom the use of alcohol is contraindicated.     

Supragingival irrigation with 0.06% chlorhexidine in naturally occurring gingivitis. I. 6 month clinical observations

The purpose of this study was to assess the efficacy of supragingival irrigation with 0.06% chlorhexidine gluconate (CHX) on naturally occurring gingivitis. The relative benefit of CHX irrigation in comparison with CHX rinsing, water irrigation, and normal oral hygiene was evaluated. In a blind, placebo-controlled 6-month study 222 patients were assigned to one of four groups: Group 1: Once daily irrigation with 300 ml water followed by irrigation with 200 ml 0.06% chlorhexidine gluconate (experimental); Group 2: Twice daily rinsing with 15 ml 0.12% chlorhexidine (positive control); Group 3: Once daily irrigation with 500 ml water (irrigation control) and Group 4: Sodium fluoride dentifrice for normal oral hygiene only (negative control). All groups used the same sodium fluoride dentifrice for tooth brushing. At baseline, 3 months, and 6 months patients were examined for Gingival Index (GI), Bleeding on Probing (BOP), Plaque Index (PLI), Pocket probing depth (PD), Calculus Index (CI), and stain. After the baseline visit all patients received a supra- and subgingival oral prophylaxis. At 6 months GI and BOP were significantly (P less than or equal to 0.05) reduced by adjunctive CHX irrigation (42.5% and 35.4%, respectively), CHX rinse (24.1% and 15.0%), and water irrigation (23.1% and 24.0%) compared to tooth brushing alone. Plaque was significantly (P less than or equal to 0.05) reduced only by CHX irrigation (53.2%) and CHX rinse (43.3%) while calculus and staining were significantly (P less than or equal to 0.05) increased in the two chlorhexidine groups (276.4% (irrigation) and 273.2% (rinse)). Although significant (P less than or equal to 0.05), pocket probing depth reduction was minimal after CHX irrigation (4.6%).(ABSTRACT TRUNCATED AT 250 WORDS)     

Clinical studies to determine the effectiveness of a whitening toothpaste at reducing stain (using a forced stain model)

Aims: Two single centre, randomized single‐blind, crossover studies were performed, to compare the effect of a test toothpaste with a conventional fluoride paste in the inhibition and removal of extrinsic dental stain promoted by repeated chlorhexidine/tea rinses. Methods: These studies used 24 subjects in each of two separate clinical trials. On the Friday before each trial period, the subjects received a prophylaxis to remove all staining, plaque and calculus deposits. On the following Monday, subjects were checked whether they were stain free and then under direct supervision they rinsed with a 0.2% chlorhexidine mouthrinse, immediately followed by a rinse with a warm black tea solution. This cycle was repeated hourly eight times throughout the day and on the following days until the Friday. In addition subjects also received daily a single toothpaste slurry rinse or control water rinse in the morning and lunchtime. No other form of oral hygiene was permitted during this period. On the Friday, both stain area and intensity was assessed using the Lobene Stain Index. For the stain removal study, stain was promoted again using chlorhexidine and tea rinses. After 4 days, stain was measured both prior to and immediately after brushing with the allocated toothpaste for 2 min. Subjects were then instructed to use the toothbrush at home according to their normal oral hygiene practices. On the following Wednesday, the amount of stain present was re‐assessed. Each subject subsequently received a thorough prophylaxis to remove all plaque calculus and staining before starting the following periods of the study. Results: The study showed no difference in the ability of the test whitening toothpaste, control toothpaste and water control at inhibiting stain. There was also only a small difference (3.5% for product of area and intensity) between the ability of the two toothpastes to help remove stain after a single brushing. The difference was however in favour of the test product which approached a conventional level of significance (P = 0.089). There was no evidence of superiority for either of the pastes after normal home usage. Conclusions: This study has suggested that the test product may have some advantage over the conventional paste at removing stain but the magnitude of difference would appear to be small and of little clinical relevance.     

The effect of 0.12% chlorhexidine gluconate rinsing on previously plaque-free and plaque-covered surfaces: a randomized, controlled clinical trial

BACKGROUND: Previous in vitro studies showed little bactericidal effect on structured oral biofilm after exposure to chlorhexidine (CHX). In vivo evidence of a CHX effect against structured biofilm is scarce. The purpose of this study was to compare the efficacy of 0.12% CHX gluconate on previously plaque-free and plaque-covered surfaces. METHODS: This study had a single-masked, randomized split-mouth, 21-day experimental gingivitis design including 20 individuals who refrained from all mechanical plaque control methods for 25 days. On day 4 of plaque accumulation, the individuals had two randomized quadrants cleaned; the other two quadrants served as the plaque-covered surfaces. Also, on day 4, the individuals started rinsing with 0.12% CHX gluconate for 21 days. The Quigley and Hein plaque index (PI), gingival index (GI), and gingival crevicular fluid (GCF) volume were assessed at baseline and days 21 and 25. The PI also was assessed at days 4, 11, and 18. RESULTS: Intergroup comparisons showed statistically higher PI throughout the study on the plaque-covered surfaces compared to the plaque-free surfaces. When the inflammatory response over time was analyzed, a statistically greater increase in GI (from 0.21+/-0.02 to 0.93+/-0.03 versus from 0.18+/-0.01 to 0.52+/-0.03 on plaque-covered and plaque-free surfaces, respectively) and GCF volumes (from 48.09 to 94.28 microl versus from 46.94 to 64.99 microl on plaque-covered and plaque-free surfaces, respectively) occurred on plaque-covered surfaces after 21 days of plaque accumulation. CONCLUSIONS: A 0.12% CHX gluconate mouthrinse had little antiplaque and antigingivitis effect on previously plaque-covered surfaces. These results confirm the diminished effect of CHX on structured biofilm and reinforce the necessity of biofilm disruption before the initiation of CHX mouthrinse.     

Acidogenicity of buccal plaque after a single rinse with amine fluoride - stannous fluoride mouthrinse solution

Caries and gingivitis prevention may benefit from chemotherapeutic plaque control, therefore we compared in a cross-over study with 5 subjects the anti-acidogenic effects of a single use of AmF-SnF2 mouthrinse solutions (Meridol with and without 5% alcohol) with baseline and with the effects of a placebo and a chlorhexidine mouthrinse (CHX). Buccal plaque was collected 0.5, 3 and 8 h after the subjects used one of the mouthrinses, each time before and after a rinse with 10% sucrose to induce lactic acid production. Samples were analysed for acid anions by capillary electrophoresis and for protein. At 0.5 h after the use of AmF-SnF2 or CHX, the concentration of acetate in resting plaque was 70% lower than at baseline or after using the placebo. Average post-sucrose acetate and lactate concentrations in the placebo group were 30-80% higher than at baseline; up to 3 h this difference was significant. 8 h after using AmF-SnF2 or CHX, the post-sucrose acetate and lactate concentrations were still 30-50% lower than after the placebo, and up to 40% lower than at baseline. To conclude, AmF-SnF2 in both Meridol formulations and CHX were shown to have a similar potency to inhibit acid production after a single rinse.     

In vivo substantivity of 0.12% and 0.2% chlorhexidine mouthrinses on salivary bacteria

The in vivo antimicrobial activity of 0.12% and 0.2% chlorhexidine (CHX) on the salivary flora up to 7 h after its application, using epifluorescence microscopy with the SYTO 9/propidium iodide dual staining, was evaluated. Fifteen volunteers performed a single mouthrinse with sterile water (SM-water), a single mouthrinse with 0.12% CHX (0.12% SM-CHX) and a single and double mouthrinse with 0.2% CHX (0.2% SM-CHX and 0.2% DM-CHX). Samples of saliva were taken at 30 s, and 1, 3, 5, and 7 h after each application. In comparison with SM-water, 0.2% CHX (SM and DM) showed a significant antibacterial effect up to 7 h after the mouthrinse, whereas this effect only persisted up to 5 h after the 0.12% SM-CHX mouthrinse. On comparing the two concentrations of CHX, significantly higher percentages of bacterial vitality were observed in all the saliva samples after the use of 0.12% CHX than after 0.2% CHX. On comparison of the 0.2% SM-CHX and 0.2% DM-CHX, significantly higher percentages of live bacteria were observed in the saliva samples taken at 1, 3, 5, and 7 h after the single mouthrinse compared with the double mouthrinse. The 0.2% CHX mouthrinse had the greatest antimicrobial activity on the salivary flora up to 7 h after its application, with a progressive recovery in bacterial vitality. The differences observed with respect to the 0.12% CHX mouthrinse demonstrate the influence of the concentration on its immediate antimicrobial activity and substantivity.     

The effect of herbal,essential oil and chlorhexidine mouthrinse on de novo plaque formation

To cite this article:
Int J Dent Hygiene DOI: 10.1111/j.1601‐5037.2012.00556.x
Singh A, Daing A, Dixit J. The effect of herbal, essential oil and chlorhexidine mouthrinse on de novo plaque formation. Abstract: Background: Brushing and flossing are the most widely accepted procedures, the ‘gold standard’, for controlling bacterial plaque, but these mechanical methods have limitations. Based on results derived from several clinical trials, essential oil (EO) mouthrinse (Listerine^®) and a chlorhexidine mouthrinse have been accepted by ADA to be used as an adjunct to routine mechanical oral hygiene measures however, both of them are associated with side effects, therefore, the present study was undertaken to evaluate the antiplaque efficacy of a new herbal formulation as compared to an EO and chlorhexidine rinse. Materials and method: The study was a single blind parallel randomized controlled trial involving four groups. 48 volunteers refrained from all oral hygiene measures for 4 days, but rinsed instead twice daily with 10 ml of a herbal (HM), EO, chlorhexidine (CHX) or a placebo (PL) solution. Plaque index and plaque area (PA) was assessed on Day 4. Results: The HM and EO showed a significant inhibition of plaque regrowth compared to PL (P < 0.001), but the lowest values of PI and PA were obtained with CHX. Statistically significant difference in plaque parameters was observed when CHX was compared to HM and EO, and HM to EO rinse. Conclusion: The new herbal mouthrinse had a promising plaque inhibitory potential but it not as efficacious as chlorhexidine in preventing plaque regrowth.