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McGrath C, Clarkson J, Glenny AM, Walsh LJ, Hua F. Effectiveness of Mouthwashes in Managing Oral Diseases and Conditions: Do They Have a Role? Int Dent J 2023; 73 Suppl 2:S69-S73. [PMID: 37867064 PMCID: PMC10690548 DOI: 10.1016/j.identj.2023.08.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/21/2023] [Indexed: 10/24/2023] Open
Abstract
Antimicrobial mouthwashes are considered to reduce dental plaque biofilm and thus the potential to prevent plaque-induced oral diseases, particularly periodontal diseases. The effectiveness of mouthwashes relates to this antiplaque role, as well as, their tooth-whitening potential and ability to mask/mange malodour (halitosis). There is also a growing interest in the use of mouthwashes as an adjunctive measure in post surgical and post-dental care, while the COVID-19 pandemic has given a new lease of life to mouthwashes as an oral antispetic that may be useful in reducing the oral viral load. The mode of action of mouthwashes varies, depending on their active ingredients, concentrations, and mode and frequency of use, as does their potential effectiveness. This article aims to provide a narrative overview of the evidence of the effectiveness of the most widely used mouthwashes in managing oral diseases, oral conditions, and adjunctive care roles.
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Affiliation(s)
- Colman McGrath
- Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China.
| | | | - Ann-Marie Glenny
- Division of Dentistry, School of Medical Sciences, University of Manchester, UK
| | | | - Fang Hua
- School & Hospital of Stomatology, Wuhan University, China
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Ting M, Dahlkemper A, Schwartz JJ, Woodfork M, Suzuki JB. Preprocedural Viral Load Effects of Oral Antiseptics on SARS-CoV-2 in Patients with COVID-19: A Systematic Review. Biomedicines 2023; 11:1694. [PMID: 37371789 DOI: 10.3390/biomedicines11061694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
(1) There are limited clinical trials to support the effectiveness of mouth rinses when used as a preprocedural rinse against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This systematic review aims to evaluate the efficacy of antiseptic mouth rinses as a preprocedural rinse in reducing SARS-CoV-2 oral viral load in-vivo. (2) Methods: A literature search was conducted through November 2022 for the following databases: PubMed, Web of Science, Cochrane Library, and Google Scholar. The evaluated outcomes were quantitative changes in viral load and the statistical significance of that change after using antiseptic mouth rinses. (3) Results: 14 randomized controlled trials (RCT) were selected for risk of bias assessment and data extraction. (4) Conclusion: Within the limits of this systematic review, preprocedural mouth rinses may significantly reduce SARS-CoV-2 in the mouth, thus, reducing the viral particles available for airborne dispersion. Preprocedural mouth rinses may be an effective strategy for reducing airborne SARS-CoV-2 dispersion in the environment. Their use may be a preventive strategy to reduce the spread of COVID-19 in selected medical and healthcare facilities, including dental clinics. Potential preprocedural mouth rinses are identified for use as an integral part of safe practice for healthcare protocols. This systematic review was registered with the National Institute for Health Research, international prospective register of systematic reviews (PROSPERO): CRD42022315177.
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Affiliation(s)
- Miriam Ting
- Department of Periodontics, University of Pennsylvania, Philadelphia, PA 19104, USA
- General Practice Residency, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
- Think Dental Learning Institute, Paoli, PA 19301, USA
| | - Alex Dahlkemper
- General Practice Residency, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
| | - Jeremy J Schwartz
- General Practice Residency, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
| | - Manzel Woodfork
- General Practice Residency, Albert Einstein Medical Center, Philadelphia, PA 19141, USA
| | - Jon B Suzuki
- Department of Graduate Periodontics, University of Maryland, Baltimore, MD 21201, USA
- Department of Graduate Prosthodontics, University of Washington, Seattle, WA 98015, USA
- Department of Graduate Periodontics, Nova Southeastern University, Ft. Lauderdale, FL 33314, USA
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Alves D, Borges P, Grainha T, Rodrigues CF, Pereira MO. Tailoring the immobilization and release of chlorhexidine using dopamine chemistry to fight infections associated to orthopedic devices. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2021; 120:111742. [PMID: 33545884 DOI: 10.1016/j.msec.2020.111742] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 11/03/2020] [Accepted: 11/17/2020] [Indexed: 11/30/2022]
Abstract
A crucial factor in the pathogenesis of orthopedics associated infections is that bacteria do not only colonize the implant surface but also the surrounding tissues. This study aimed to engineer an antimicrobial release coating for stainless steel (SS) surfaces, to impart them with the ability to prevent Staphylococci colonization. Chlorhexidine (CHX) was immobilized using two polydopamine (pDA)-based approaches: a one-pot synthesis, where CHX is dissolved together with dopamine before its polymerization; and a two-step methodology, comprising the deposition of a pDA layer to which CHX is immobilized. To modulate CHX release, an additional layer of pDA was also added for both strategies. Immobilization of CHX using a one-step approach yielded surfaces with a more homogenous coating and less roughness than the other strategies. The amount of released CHX was lower for the one-step approach, as opposed to the two-step approach yielding the higher release, which could be decreased by applying an outward layer of pDA. Both one and two-step approaches provided the surfaces with the ability to prevent bacterial colonization of the surface itself and kill most of bacteria in the bulk phase up to 10 days. This long-term antimicrobial performance alluded a stable and enduring immobilization of CHX. In terms of biocompatibility, the amount of CHX released from the one-step approach did not compromise the growth of mammalian cells, contrary to the two-step strategy. Additionally, the few bacteria that managed to adhere to surfaces modified with one-step approach did not show evidence of resistance towards CHX. Overall data underline that one-step immobilization of CHX holds great potential to be further applied in the fight against orthopedic devices associated infections.
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Affiliation(s)
- Diana Alves
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
| | - Patrick Borges
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Tânia Grainha
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Célia F Rodrigues
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - Maria Olívia Pereira
- CEB - Centre of Biological Engineering, LIBRO - Laboratório de Investigação em Biofilmes Rosário Oliveira, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
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Liu Y, Ren Y, Li Y, Su L, Zhang Y, Huang F, Liu J, Liu J, van Kooten TG, An Y, Shi L, van der Mei HC, Busscher HJ. Nanocarriers with conjugated antimicrobials to eradicate pathogenic biofilms evaluated in murine in vivo and human ex vivo infection models. Acta Biomater 2018; 79:331-343. [PMID: 30172935 DOI: 10.1016/j.actbio.2018.08.038] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 08/06/2018] [Accepted: 08/29/2018] [Indexed: 10/28/2022]
Abstract
Conventional antimicrobials are becoming increasingly ineffective for treating bacterial infection due to the emergence of multi-drug resistant (MDR) pathogens. In addition, the biofilm-mode-of-growth of infecting bacteria impedes antimicrobial penetration in biofilms. Here, we report on poly(ethylene)glycol-poly(β-amino esters) (PEG-PAE) micelles with conjugated antimicrobials, that can uniquely penetrate biofilms, target themselves to bacterial cell surfaces once inside the low-pH environment of a biofilm and release conjugated antimicrobials through degradation of their ester-linkage with PAE by bacterial lipases. In vitro, PEG-PAE micelles with conjugated Triclosan (PEG-PAE-Triclosan) yielded no inadvertent leakage of their antimicrobial cargo and better killing of MDR Staphylococcus aureus, Escherichia coli and oral streptococcal biofilms than Triclosan in solution. In mice, PEG-PAE-Triclosan micelles with conjugated Triclosan yielded better eradication efficacy towards a MDR S. aureus-infection compared with Triclosan in solution and Triclosan-loaded micelles at equal Triclosan-equivalent concentrations. Ex vivo exposure of multi-species oral biofilms collected from orthodontic patients to PEG-PAE-Triclosan micelles, demonstrated effective bacterial killing at 30-40 fold lower Triclosan-equivalent concentrations than achieved by Triclosan in solution. Importantly, Streptococcus mutans, the main causative organism of dental caries, was preferentially killed by PEG-PAE-Triclosan micelles. Thus PEG-PAE-Triclosan micelles present a promising addendum to the decreasing armamentarium available to combat infection in diverse sites of the body. STATEMENT OF SIGNIFICANCE: pH-adaptive polymeric micelles with conjugated antimicrobials can efficiently eradicate infectious biofilms from diverse body sites in mice and men. An antimicrobial was conjugated through an ester-linkage to a poly(ethylene glycol) (PEG)/poly(β-amino ester) block copolymer to create micellar nanocarriers. Stable micelle structures were formed by the hydrophobic poly(β-amino ester) inner core and a hydrophilic PEG outer shell. Thus formed PEG-PAE-Triclosan micelles do not lose their antimicrobial cargo underway to an infection site through the blood circulation, but penetrate and accumulate in biofilms to release antimicrobials once inside a biofilm through degradation of its ester-linkage by bacterial lipases, to kill biofilm-embedded bacteria at lower antimicrobial concentrations than when applied in solution. PEG-PAE-Triclosan micelles effectively eradicate biofilms of multi-drug-resistant pathogens and oral bacteria, most notably highly cariogenic Streptococcus mutans, in mice and men respectively, and possess excellent clinical translation possibilities.
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Schmidt J, Zyba V, Jung K, Rinke S, Haak R, Mausberg RF, Ziebolz D. Effects of octenidine mouth rinse on apoptosis and necrosis of human fibroblasts and epithelial cells - an in vitro study. Drug Chem Toxicol 2017; 41:182-187. [PMID: 28669220 DOI: 10.1080/01480545.2017.1337124] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
This study aimed at comparing the cytotoxicity of a new octenidine mouth rinse (MR) on gingival fibroblasts and epithelial cells using different established MRs. Octenidol (OCT), Chlorhexidine 0.2% (CHX), Meridol (MER), Oral B (OB), and control (PBS only) were used. Human primary gingival fibroblasts (HGFIBs) and human primary nasal epithelial cells (HNEPCs) were cultivated in cell-specific media (2 × 105 cells/well) and treated with a MR or PBS for 1, 5, and 15 min. All tests were performed in duplicate and repeated 12 times. The apoptosis and necrosis were determined using a Caspase-3/7 assay and LDH assay, respectively. The data were analyzed using two-way analysis of variance with subsequent Mann-Whitney U-test. No significant differences could be found between the incubation times of the MR, neither for apoptosis nor necrosis (p > 0.05). Regarding apoptosis of HGFIBs, MRs had no influence at all. In HNEPCs, OCT induced relevantly lower apoptosis than CHX (p = 0.01). Considering necrosis, MER showed the lowest numbers of necrotic HGFIBs and HNEPCs, whereas OB induced the highest number of necrotic cells. The differences between both MR were statistically relevant (p < 0.01). OCT did neither differ from the other MRs nor from the control (PBS) in induction of necrosis in both cell types. In conclusion, the slightly negative effect of OCT considering apoptosis and necrosis of HGFIBs and HNEPCs is nearly the same or even lower compared to the established MRs included in this study. The results confirm that OCT is a potential alternative to CHX.
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Affiliation(s)
- J Schmidt
- a Department of Cariology, Endodontology, and Periodontology , University of Leipzig , Leipzig , Germany
| | - V Zyba
- b Department of Preventive Dentistry, Periodontology, and Cariology , University Medical Centre Goettingen , Goettingen , Germany
| | - K Jung
- c Department of Medical Statistics , University Medical Centre Goettingen , Goettingen , Germany
| | - S Rinke
- d Department of Prosthodontics , University Medical Centre Goettingen , Goettingen , Germany
| | - R Haak
- a Department of Cariology, Endodontology, and Periodontology , University of Leipzig , Leipzig , Germany
| | - R F Mausberg
- b Department of Preventive Dentistry, Periodontology, and Cariology , University Medical Centre Goettingen , Goettingen , Germany
| | - D Ziebolz
- a Department of Cariology, Endodontology, and Periodontology , University of Leipzig , Leipzig , Germany
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Steinberg D, Friedman M. Sustained-release drug delivery of antimicrobials in controlling of supragingival oral biofilms. Expert Opin Drug Deliv 2016; 14:571-581. [PMID: 27454813 DOI: 10.1080/17425247.2016.1213239] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Dental caries, a bacterial biofilm-associated disease, is a prevalent oral health problem. It is a bacterial biofilm-associated disease. Conventional means of combating this disease involves oral hygiene, mostly tooth brushing. Supplementary means of prevention and treatment is often necessary. The use of sustained-release delivery systems, locally applied to the oral cavity appears to be one of the most acceptable avenues for the delivery of antimicrobial agents. Area covered: The development and current approaches of local sustained delivery technologies applied to the oral cavity for treatment and prevention of dental caries is discussed. The use of polymeric drug delivery systems, varnishes, liposomes and nanoparticles is presented. Expert opinion: The use of local sustained-release delivery systems applied to the oral cavity has numerous clinical, pharmacological and toxicological advantages over conventional means. Various sustained-release technologies have been suggested over the course of several years. The current research on oral diseases concentrates predominantly on improving the drug delivery. With progress in pharmaceutical technology, sophisticated controlled-release platforms are being developed. The sustained release concept is innovative and there are few products available for the benefit of all populations. Harmonizing academic research with the dental industry will surely expedite the development and commercialization of more products of such pharmacological nature.
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Affiliation(s)
- Doron Steinberg
- a Biofilm Research Laboratory, Institute of Dental Sciences , Hebrew University-Hadassah , Jerusalem , Israel
| | - Michael Friedman
- b Institute for Drug Research, School of Pharmacy , Hebrew University , Jerusalem , Israel
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Schmidt J, Zyba V, Jung K, Rinke S, Haak R, Mausberg RF, Ziebolz D. Cytotoxic effects of octenidine mouth rinse on human fibroblasts and epithelial cells - an in vitro study. Drug Chem Toxicol 2015; 39:322-30. [PMID: 26654138 DOI: 10.3109/01480545.2015.1121274] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES This study compared the cytotoxicity of a new octenidine mouth rinse (MR) against gingival fibroblasts and epithelial cells with different established MRs. METHODS The following MRs were used: Octenidol (OCT), Chlorhexidine 0.2% (CHX), Listerine (LIS), Meridol (MER), Betaisodona (BET); and control (medium only). Human primary gingiva fibroblasts and human primary nasal epithelial cells were cultivated in cell-specific media (2 × 10(5) cells/ml) and treated with MR for 1, 5, and 15 min. Each test was performed 12 times. Metabolism activity was measured using a cytotoxicity assay. A cellometer analyzed cell viability, cell number, and cell diameter. The data were analyzed by two-way analysis of variance with subsequent Dunnett's test and additional t-tests. RESULTS The cytotoxic effects of all MRs on fibroblasts and epithelial cells compared to the control depended on the contact time (p < 0.001). OCT and BET showed less influence on cell metabolism in fibroblasts than other MRs. OCT also demonstrated comparable but not significant results in epithelial cells (p > 0.005). Cell numbers of both cell types at all contact times revealed that OCT showed a less negative effect (p > 0.005), especially for epithelial cells compared to CHX after 15 min (p < 0.005). OCT and BET showed the best results for viability in fibroblasts (p > 0.005), but MER showed less influence than OCT in epithelial cells (p < 0.005). CONCLUSIONS OCT is a potential alternative to CHX regarding cytotoxicity because of its lower cell-toxic effect against fibroblasts and epithelial cells.
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Affiliation(s)
- J Schmidt
- a Department of Cariology, Endodontology and Periodontology , University of Leipzig , Leipzig , Germany
| | - V Zyba
- b Department of Preventive Dentistry, Periodontology and Cariology , University Medical Centre Goettingen , Goettingen , Germany
| | - K Jung
- c Department of Medical Statistics , University Medical Centre Goettingen , Goettingen , Germany , and
| | - S Rinke
- d Department of Prosthodontics , University Medical Centre Goettingen , Goettingen , Germany
| | - R Haak
- a Department of Cariology, Endodontology and Periodontology , University of Leipzig , Leipzig , Germany
| | - R F Mausberg
- b Department of Preventive Dentistry, Periodontology and Cariology , University Medical Centre Goettingen , Goettingen , Germany
| | - D Ziebolz
- a Department of Cariology, Endodontology and Periodontology , University of Leipzig , Leipzig , Germany
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Dehghani M, Abtahi M, Sadeghian H, Shafaee H, Tanbakuchi B. Combined chlorhexidine-sodiumfluoride mouthrinse for orthodontic patients: Clinical and microbiological study. J Clin Exp Dent 2015; 7:e569-75. [PMID: 26644831 PMCID: PMC4663057 DOI: 10.4317/jced.51979] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 12/11/2014] [Indexed: 11/06/2022] Open
Abstract
Background Orthodontic appliances impede good dental plaque control by brushing. Antimicrobial mouth rinses were suggested to improve this performance. We therefore aimed to investigate the effects of combined mouthrinse containing chlorhexidine (CHX) and sodium fluoride (NaF) on clinical oral hygiene parameters,and plaque bacterial level. Material and Methods In this double-blind clinical study, 60 fixed orthodontic patients aged 14-25 years were randomly assigned to one of four mouthrinses groups: 1- combined CHX /NaF 2- CHX 0.06% 3- NaF0.05% 4-placebo. Following baseline examination patients were instructed to use the assigned mouthrinse twice daily for 21 days. Bleeding index (BI), modified gingival index (MGI) and plaque index (PI) were determined at the baselineand after three weeks of rinsing. Samples from supragingival plaque were obtained for the assessment of total bacterial, Streptococcus mutans and Lactobacilli colony counts. Data were analyzed by Wilcoxon, Kruskal-Wallis, and Mann-Whitney tests. Results Clinical parameters; All three active mouth rinses induced significant improvements of BI, MGI, and PI (P<0.05). Results of CHX/NaF were slightly, but not significantly, better than CHX. CHX/NaF and CHX induced significantly more changes than NaF and placebo. Microbiological measurements; Except placebo, other mouthrinses reduced total bacterial, Streptococcus mutans, and Lactobacilli counts significantly (P<0.05). CHX/NaF acted against Lactobacilli significantly more than others. Conclusions Adding CHX0.06%/NaF0.05% combined mouth rinse to daily oral hygiene regimen of orthodontic patients significantly improved oral hygiene status. Effect of this combined mouth rinse on dental plaque Lactobacilli was remarkable. However, large controlled trials could provide more definitive evidence. Key words:Mouthrinse, fluoride, chlorhexidine, plaque.
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Affiliation(s)
- Mahboobe Dehghani
- Assistant professor of orthodontics, Dental research center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mostafa Abtahi
- Associate professor of orthodontics, Dental research center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hamed Sadeghian
- Pathologist, Department of general Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hooman Shafaee
- Assistant professor of orthodontics, Dental research center, School of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Behrad Tanbakuchi
- Assistant professor of orthodontics, Department of orthodontics, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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In situ neutralisation of the antibacterial effect of 0.2% Chlorhexidine on salivary microbiota: Quantification of substantivity. Arch Oral Biol 2015; 60:1109-16. [DOI: 10.1016/j.archoralbio.2015.04.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2014] [Revised: 04/11/2015] [Accepted: 04/13/2015] [Indexed: 11/24/2022]
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Kitagawa H, Takeda K, Kitagawa R, Izutani N, Miki S, Hirose N, Hayashi M, Imazato S. Development of sustained antimicrobial-release systems using poly(2-hydroxyethyl methacrylate)/trimethylolpropane trimethacrylate hydrogels. Acta Biomater 2014; 10:4285-95. [PMID: 24952074 DOI: 10.1016/j.actbio.2014.06.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 05/23/2014] [Accepted: 06/11/2014] [Indexed: 12/19/2022]
Abstract
Reconstructive materials with sustained antimicrobial effects could be useful for preventing infectious diseases in an environment containing indigenous bacteria or fungi such as the oral cavity. With the objective of applying a non-biodegradable hydrogel to resin-based materials as a reservoir for water-soluble antimicrobials, novel hydrogels consisting of 2-hydroxyethyl methacrylate (HEMA) and trimethylolpropane trimethacrylate (TMPT) were fabricated. Cetylpyridinium chloride (CPC) was loaded into five hydrogels comprising different ratios of HEMA/TMPT, and their ability to release as well as to be recharged with CPC was examined in vitro. A polyHEMA/TMPT hydrogel comprising 50% HEMA/50% TMPT could be effectively loaded and recharged with CPC by immersion into a CPC solution, demonstrating the longest release of CPC, above the concentration required to inhibit bacteria and fungi. The binding of CPC to the hydrogels was mainly through hydrophobic interaction. Loading of CPC into a hydrogel by mixing CPC powder with the HEMA/TMPT monomer before polymerization resulted in marked extension of the initial CPC-release period. The CPC-pre-mixed hydrogel was confirmed to exhibit antibacterial activity by agar diffusion tests. It is possible to achieve a sustained release system for antimicrobials by pre-mix loading and recharging CPC into a 50% HEMA/50% TMPT hydrogel.
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Affiliation(s)
- Haruaki Kitagawa
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Kahoru Takeda
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Ranna Kitagawa
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Naomi Izutani
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Saeki Miki
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Nanako Hirose
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan; Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Mikako Hayashi
- Department of Restorative Dentistry and Endodontology, Osaka University Graduate School of Dentistry, Osaka, Japan
| | - Satoshi Imazato
- Department of Biomaterials Science, Osaka University Graduate School of Dentistry, Osaka, Japan.
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Johnson NR, Kazoullis A, Bobinskas AM, Jones L, Hutmacher DW, Lynham A. Bacterial comparison of preoperative rinsing and swabbing for oral surgery using 0.2% chlorhexidine. ACTA ACUST UNITED AC 2014; 6:193-6. [DOI: 10.1111/jicd.12099] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 02/15/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Nigel R. Johnson
- Department of Maxillofacial Surgery; Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
| | - Andrea Kazoullis
- School Of Dentistry; University of Queensland; Brisbane Queensland Australia
| | - Alexander M. Bobinskas
- Department of Maxillofacial Surgery; Royal Melbourne Hospital; Melbourne Victoria Australia
| | - Lee Jones
- Queensland Institute of Medical Research; Brisbane Queensland Australia
| | - Dietmar W. Hutmacher
- Institute of Health and Biomedical Innovation; Queensland University of Technology; Brisbane Queensland Australia
| | - Anthony Lynham
- Department of Maxillofacial Surgery; Royal Brisbane and Women's Hospital; Brisbane Queensland Australia
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Ren Y, Jongsma MA, Mei L, van der Mei HC, Busscher HJ. Orthodontic treatment with fixed appliances and biofilm formation—a potential public health threat? Clin Oral Investig 2014; 18:1711-8. [DOI: 10.1007/s00784-014-1240-3] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2013] [Accepted: 03/27/2014] [Indexed: 01/29/2023]
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13
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Netuschil L, Auschill TM, Sculean A, Arweiler NB. Confusion over live/dead stainings for the detection of vital microorganisms in oral biofilms--which stain is suitable? BMC Oral Health 2014; 14:2. [PMID: 24410850 PMCID: PMC3898065 DOI: 10.1186/1472-6831-14-2] [Citation(s) in RCA: 75] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Accepted: 12/27/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is confusion over the definition of the term "viability state(s)" of microorganisms. "Viability staining" or "vital staining techniques" are used to distinguish live from dead bacteria. These stainings, first established on planctonic bacteria, may have serious shortcomings when applied to multispecies biofilms. Results of staining techniques should be compared with appropriate microbiological data. DISCUSSION Many terms describe "vitality states" of microorganisms, however, several of them are misleading. Authors define "viable" as "capable to grow". Accordingly, staining methods are substitutes, since no staining can prove viability.The reliability of a commercial "viability" staining assay (Molecular Probes) is discussed based on the corresponding product information sheet: (I) Staining principle; (II) Concentrations of bacteria; (III) Calculation of live/dead proportions in vitro. Results of the "viability" kit are dependent on the stains' concentration and on their relation to the number of bacteria in the test. Generally this staining system is not suitable for multispecies biofilms, thus incorrect statements have been published by users of this technique.To compare the results of the staining with bacterial parameters appropriate techniques should be selected. The assessment of Colony Forming Units is insufficient, rather the calculation of Plating Efficiency is necessary. Vital fluorescence staining with Fluorescein Diacetate and Ethidium Bromide seems to be the best proven and suitable method in biofilm research.Regarding the mutagenicity of staining components users should be aware that not only Ethidium Bromide might be harmful, but also a variety of other substances of which the toxicity and mutagenicity is not reported. SUMMARY - The nomenclature regarding "viability" and "vitality" should be used carefully.- The manual of the commercial "viability" kit itself points out that the kit is not suitable for natural multispecies biofilm research, as supported by an array of literature.- Results obtained with various stains are influenced by the relationship between bacterial counts and the amount of stain used in the test. Corresponding vitality data are prone to artificial shifting.- As microbiological parameter the Plating Efficiency should be used for comparison.- Ethidium Bromide is mutagenic. Researchers should be aware that alternative staining compounds may also be or even are mutagenic.
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Affiliation(s)
- Lutz Netuschil
- Department of Periodontology, Dental School, Philipps-University Marburg, Marburg, Germany.
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He Y, Peterson BW, Ren Y, van der Mei HC, Busscher HJ. Antimicrobial penetration in a dual-species oral biofilm after noncontact brushing: an in vitro study. Clin Oral Investig 2013; 18:1103-1109. [PMID: 24019117 DOI: 10.1007/s00784-013-1097-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 08/21/2013] [Indexed: 12/13/2022]
Abstract
OBJECTIVES Oral biofilm is inevitably left behind, even after powered brushing. As a special feature, powered brushing removes biofilm in a noncontact mode. When the brushing distance becomes too large, biofilm is left behind. We hypothesize that biofilm left behind after brushing has different viscoelastic properties than before brushing, impacting antimicrobial penetration. MATERIALS AND METHODS In vitro grown dual-species biofilms were subjected to 20 % mechanical deformation before and after powered brushing at 4-mm brushing distance. Biofilm thickness and stress relaxation were measured for unbrushed and brushed biofilms. Stress relaxation was analyzed with a three-element Maxwell model. Antimicrobial penetration from five mouthrinses was microscopically evaluated for unbrushed and brushed biofilms. RESULTS Thicknesses of unbrushed and brushed biofilms were similar. Brushing decreased the prevalence of fast and increased the prevalence of slow relaxation elements, which was accompanied by deeper penetration of chlorhexidine and cetylpyridinium chloride. Penetration of antimicrobials from other mouthrinses was relatively low in unbrushed and brushed biofilms. CONCLUSIONS This confirmation of our hypothesis points to an additional advantage of powered toothbrushing in a noncontact mode, changing the viscoelastic properties of biofilm in a direction that increases antimicrobial penetration of chlorhexidine and cetylpyridinium. CLINICAL RELEVANCE The biofilm left behind after noncontact powered toothbrushing may have less recalcitrance toward penetration of chlorhexidine and cetylpyridinium chloride than prior to brushing.
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Affiliation(s)
- Y He
- Department of Biomedical Engineering, University of Groningen and University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - B W Peterson
- Department of Biomedical Engineering, University of Groningen and University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
| | - Y Ren
- Department of Orthodontics, University of Groningen and University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - H C van der Mei
- Department of Biomedical Engineering, University of Groningen and University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.
| | - H J Busscher
- Department of Biomedical Engineering, University of Groningen and University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands
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Berry AM. A comparison of Listerine® and sodium bicarbonate oral cleansing solutions on dental plaque colonisation and incidence of ventilator associated pneumonia in mechanically ventilated patients: a randomised control trial. Intensive Crit Care Nurs 2013; 29:275-81. [PMID: 23692975 DOI: 10.1016/j.iccn.2013.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 01/18/2013] [Accepted: 01/19/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND Effective oral hygiene has been proposed as a key factor in the reduction of dental plaque colonisation and subsequent development of ventilator associated pneumonia (VAP). Listerine(®) oral rinse, while used extensively in dental practice has rarely been tested in mechanically ventilated patients. Sodium bicarbonate as an oral rinse has been more commonly utilised in oral hygiene regimens in intensive care patients. AIM To test the efficacies of the essential oil mouth rinse, Listerine(®) (Pfizer) and sodium bicarbonate in the reduction of dental plaque colonisation with respiratory pathogens and the subsequent development of VAP. METHODS The study design was a prospective, single blind randomised comparative study of adult patients mechanically ventilated for at least 4 days. Patients were randomised to Listerine(®) (Pfizer) oral rinse twice daily, sodium bicarbonate oral rinse 2/24 or sterile water 2/24 (control group). All groups received tooth brushing 3 times a day. Dental plaque colonisation (primary outcome) and incidence of ventilator associated pneumonia (secondary outcome) were studied. RESULTS Three hundred and ninety-eight patients were randomised to either the Listerine group (127), sodium bicarbonate group (133) or the control group (138). Baseline characteristics were similar for all groups. There were no significant differences between the control and study groups in colonisation of dental plaque at Day 4 (p=0.243). Ventilator associated pneumonia was diagnosed in 18 patients. The incidence was, Listerine(®) group 4.7%, sodium bicarbonate group 4.5% and control 4.3% [OR, 0.99; 95% CI, 0.31 to 3.16; p=0.92]. CONCLUSIONS Compared to the control group, Listerine(®) or sodium bicarbonate oral rinses were not more effective in the reduction of colonisation of dental plaque or the incidence of VAP. Given the low incidence of VAP, the common factor of a small, soft toothbrush as part of an oral hygiene regimen suggests possible benefit in mechanically ventilated patients.
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Affiliation(s)
- A M Berry
- Intensive Care Unit, Westmead Hospital, Sydney, Australia.
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16
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Hannig C, Gaeding A, Basche S, Richter G, Helbig R, Hannig M. Effect of Conventional Mouthrinses on Initial Bioadhesion to Enamel and Dentin in situ. Caries Res 2013. [DOI: 10.1159/000345083] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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17
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Otten MPT, Busscher HJ, Abbas F, van der Mei HC, van Hoogmoed CG. Plaque-left-behind after brushing: intra-oral reservoir for antibacterial toothpaste ingredients. Clin Oral Investig 2011; 16:1435-42. [PMID: 22160537 PMCID: PMC3443356 DOI: 10.1007/s00784-011-0648-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2011] [Accepted: 11/18/2011] [Indexed: 12/01/2022]
Abstract
Objectives Plaque is never fully removed by brushing and may act as a reservoir for antibacterial ingredients, contributing to their substantive action. This study investigates the contribution of plaque-left-behind and saliva towards substantivity of three antibacterial toothpastes versus a control paste without antibacterial claims. Materials and methods First, volunteers brushed 2 weeks with a control or antibacterial toothpaste. Next, plaque and saliva samples were collected 6 and 12 h after brushing and bacterial concentrations and viabilities were measured. The contributions of plaque and saliva towards substantivity were determined by combining control plaques with experimental plaque or saliva samples and subsequently assessing their viabilities. Bacterial compositions in the various plaque and saliva samples were compared using denaturing gradient gel electrophoresis. Results The viabilities of plaques after brushing with Colgate-Total® and Crest-Pro-Health® were smaller than of control plaques and up to 12 h after brushing with Crest-Pro-Health® plaques still contained effective, residual antibacterial activity against control plaques. No effective, residual antibacterial activity could be measured in saliva samples after brushing. There was no significant difference in bacterial composition of plaque or saliva after brushing with the different toothpastes. Conclusions Plaque-left-behind after mechanical cleaning contributes to the substantive action of an antibacterial toothpaste containing stannous fluoride (Crest-Pro-Health®). Clinical relevance The absorptive capacity of plaque-left-behind after brushing is of utmost clinical importance, since plaque is predominantly left behind in places where its removal and effective killing matter most. Therewith this study demonstrates a clear and new beneficial effect of the use of antibacterial toothpastes.
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Affiliation(s)
- Marieke P. T. Otten
- Department of Biomedical Engineering, University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Henk J. Busscher
- Department of Biomedical Engineering, University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Frank Abbas
- Center for Dentistry and Oral Hygiene, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Henny C. van der Mei
- Department of Biomedical Engineering, University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
| | - Chris G. van Hoogmoed
- Department of Biomedical Engineering, University Medical Center Groningen and University of Groningen, A. Deusinglaan 1, 9713 AV Groningen, The Netherlands
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Yang J, Deol G, Myangar N. Retention of o-cymen-5-ol and zinc on reconstructed human gingival tissue from a toothpaste formulation. Int Dent J 2011; 61 Suppl 3:41-5. [DOI: 10.1111/j.1875-595x.2011.00048.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Otten MPT, Busscher HJ, van der Mei HC, van Hoogmoed CG, Abbas F. Acute and substantive action of antimicrobial toothpastes and mouthrinses on oral biofilm in vitro. Eur J Oral Sci 2011; 119:151-5. [DOI: 10.1111/j.1600-0722.2011.00812.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Verkaik MJ, Busscher HJ, Jager D, Slomp AM, Abbas F, van der Mei HC. Efficacy of natural antimicrobials in toothpaste formulations against oral biofilms in vitro. J Dent 2011; 39:218-24. [DOI: 10.1016/j.jdent.2010.12.007] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2010] [Revised: 12/20/2010] [Accepted: 12/21/2010] [Indexed: 11/26/2022] Open
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