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The formation of stain on acrylic surfaces by the interaction of cationic antiseptic mouthwashes and tea.

Clinical and in vitro studies have implicated dietary components as major aetiological factors in staining of teeth and acrylic materials associated with chlorhexidine use, a local side effect not unique to this antiseptic. These experiments studied the precipitation and surface staining reactions of the cationic antiseptics alexidine, cetyl pyridinium chloride (CPC), chlorhexidine, and hexetidine, with the beverage tea. All of the antiseptics precipitated a standard tea solution and for alexidine and chlorhexidine acetate and gluconate, this was at concentrations greater than 100 mumol/L, for hexetidine greater than 200 mumol/L, and for CPC greater than 400 mumol/L. With the exception of CPC precipitation was reduced with decreasing pH and for chlorhexidine was inhibited below pH 3. The addition of polymethylmethacrylate (PMMA) to the antiseptic solutions increased the precipitation concentrations by an amount calculated to be adsorbed by polymer. Acrylic blocks treated with equimolar solutions of the antiseptics became progressively and significantly more stained by tea than control specimens over a 5-day period. Alexidine induced significantly greater staining and hexetidine significantly less than the other antiseptics. Staining was pH dependent and significantly reduced as the pH decreased. Both stain and precipitates were insoluble in strong acids and alkalis. It is concluded that staining observed clinically may represent a precipitation reaction with the complexing of antiseptics with dietary chromogenic material.

Acrylates↗

Pre-clinical evaluation of the anticaries effect of an experimental Malva sylvestris extract mouthwash using a cariogenic model in situ.

OBJECTIVE: The aim of this study was to evaluate the antimicrobial and anticariogenic potential of Malva sylvestris extract on enamel and dentin in situ. METHODS: A double-blind crossover in situ study was conducted with 12 participants wearing palatal appliances containing two bovine enamel and two dentin specimens per 3 phases, a total of 72 enamel and dentin specimens. Biofilm formation and daily sucrose exposure were allowed. Treatments were applied twice daily in three phases: Malva sylvestris (2.5%, MS); fluoride (225 ppm, F); and placebo (P). After seven days, biofilm was collected from the bovine specimens for analysis of Lactobacillus spp. and mutans streptococci by Colony Forming Unit counts (CFU log₁₀/mL). Dental demineralization of the bovine specimens was assessed by transverse microradiography (TMR). RESULTS: MS did not reduce Lactobacillus spp. counts (CFU log₁₀/mL: enamel 6.63±0.81; dentin 6.68±0.92) compared to P (6.63±0.70; 6.62±0.51). F also did not differ (6.29±0.75; 6.32±0.41; ANOVA/Tukey, p>0.38). Mutans streptococci data were inconclusive. In enamel, both MS (2320.8±768.2 %vol·µm; 101.6±27.0 µm) and F (1777.3±733.3 %vol·µm; 95.8±23.5 µm) significantly reduced integrated mineral loss and lesion depth compared to P (3517.2±1119.9 %vol·µm; 138.6±19.5 µm; ANOVA/Tukey, p≤0.0003). In dentin, MS significantly reduced integrated mineral loss (322.5 [250-580] %vol·µm) and lesion depth (30.1 [15-42.2] µm) compared to P (880 [580-1705]; 58.3 [32.2-88.6] µm; Kruskal-Wallis/Dunn, p≤0.001), while F (587.5 [305-720]; 25.2 [16.5-38.8] µm) did not differ significantly (p>0.05). CONCLUSIONS: Malva sylvestris extract had no antimicrobial effect on Lactobacillus spp. counts, but significantly reduced enamel and dentin demineralization, showing anticaries effect comparable to fluoride. CLINICAL RELEVANCE: Malva sylvestris has demonstrated promising biological activity. This study investigates the antimicrobial efficacy of Malva sylvestris against cariogenic microorganisms in situ. Our findings provide relevant evidence that M. sylvestris exert significant anticaries effects using an in situ model.

Biofilms↗

Clinical effects of chlorhexidine mouthwashes on patients undergoing orthodontic treatment.

This study compared the short-term clinical effect of 0.12% chlorhexidine gluconate and placebo mouthrinses in 30 adolescents (ages 11 to 15) undergoing orthodontic treatment. Subjects were randomized into experimental (CHX) and control (C) groups. Baseline values were recorded 10 days after prophylaxis and included Plaque index (PI), Gingival index (GI), Rentention Index (RI), Discoloration index (DI), and probing depths (PD). Both groups (CHX and C) received soft toothbrushes with instructions to brush twice daily, as well as the CHX and placebo mouthrinses, respectively, with oral and written instructions for rinsing twice daily with 15 ml for 30 seconds. Reevaluations were performed 1, 2, and 3 months after baseline, except for the DI and PD, which were only assessed at 3 months. The Student's t test and the paired t test were used to analyze the data at the P < 0.05 level of significance. No differences between groups were seen at baseline for any of the parameters. At 30 days, there was a significant difference for the RI between CHX (0.15 +/- 0.16; mean +/- SD) and C (0.05 +/- 0.06) at the mesial buccal, and for CHX (0.07 +/- 0.10) and C (0.02 +/- 0.05) at the midbuccal. The 60-day evaluation showed similar results. At 90 days, lower PI were observed in the CHX group at the distal buccal (0.38 +/- 0.19), midbuccal (0.22 +/- 0.17), and mesial buccal (0.47 +/- 0.22) sites as compared with the C group (0.97 +/- 0.38, 0.83 +/- 0.40, and 0.95 +/- 0.43, respectively). A similar trend was noted with the GI, as the lower values were related to the CHX group. The changes of the PI and GI, at 30, 60, and 90 days, as analyzed by the paired t test, were statistically significant in the case of the experimental group, as the changes in the means were a reflection of significantly lower scores observed in the experimental group. After 3 months, the DI showed higher scores in the experimental group as compared with the control, but they were not statistically significant. Deeper PD were detected in the C group at 90 days, and they were statistically significant, except for the midlingual site. The RI did not show significant differences at 90 days, but higher values were recorded in the CHX group. The data indicate that the use of the CHX, in addition to regular oral hygiene habits, was effective in reducing plaque and gingivitis in adolescents undergoing orthodontic treatment.

Adolescent↗