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Clinical and Experimental Dental... Aug 2021Octenidine dihydrochloride is an antimicrobial cationic surfactant compound. We conducted a systematic review to determine the efficacy of octenidine-based mouthwash on...
OBJECTIVE
Octenidine dihydrochloride is an antimicrobial cationic surfactant compound. We conducted a systematic review to determine the efficacy of octenidine-based mouthwash on plaque formation, gingivitis, and oral microbial growth in subjects with or without periodontal disease.
MATERIALS AND METHODS
PubMed/MEDLINE, ScienceDirect, Google Scholar, and Cochrane Library were searched for relevant studies. The review was conducted per PRISMA guidelines. Only randomized controlled trials and observational studies comparing octenidine with placebo or other mouthwashes in healthy subjects with or without periodontal disease, were considered for this review. The endpoints included percentage reduction in plaque index (PI), gingival index (GI), absolute reduction in the mean number of colony-forming units (CFU/ml [log ]) and adverse effects (AEs; tooth staining/mucosal tolerance).
RESULTS
Ten randomized controlled and six observational studies fulfilled the selection criteria. Twice or thrice daily rinsing with 0.1% octenidine for 30-60 s produced significant reduction in plaque, gingivitis and oral microbial growth. Compared to control mouthwash or baseline, 0.1% octenidine inhibited plaque formation by ~38.7%-92.9%, which was either equal or greater than that of chlorhexidine gluconate. 0.1% octenidine reduced gingivitis by ~36.4%-68.37% versus control mouthwash or baseline and microbial growth by 0.37-5.3 colony-forming units (vs. chlorhexidine: 0.4-4.23 colony-forming units). Additional benefits of 0.1% octenidine were significant reduction in the number of bleeding sites, papilla bleeding index, sulcus bleeding index, and gingival fluid flow.
CONCLUSION
Within the limitations of this study, there exists moderate evidence that 0.1% OCT was found to be an effective antiplaque agent. Octenidine inhibited plaque formation upto 93% and gingivitis upto 68% versus placebo and was either superior or comparable to chlorhexidine. Octenidine was well-tolerated and safe and can be an effective alternative to CHX and other contemporary mouthwashes.
Topics: Chlorhexidine; Dental Plaque; Gingivitis; Humans; Imines; Mouthwashes; Periodontal Diseases; Pyridines
PubMed: 34227746
DOI: 10.1002/cre2.386 -
PloS One 2021Silver diamine fluoride (SDF) is used in minimally invasive dentistry for arresting dental caries. However, discoloration of teeth is a significant side effect that has...
The effect of the combined use of silver diamine fluoride and potassium iodide in disrupting the plaque biofilm microbiome and alleviating tooth discoloration: A systematic review.
Silver diamine fluoride (SDF) is used in minimally invasive dentistry for arresting dental caries. However, discoloration of teeth is a significant side effect that has limited the use of SDF. Hence, the application of potassium iodide (KI) following SDF has been proposed to ameliorate the staining. Although antimicrobial activity is one of the major mechanisms of the caries-arresting effect of SDF, the antimicrobial potency of SDF/KI combination is unclear. Thus, the primary objective of this systematic review was to appraise the studies on the antimicrobial efficacy of SDF/KI combination on cariogenic microbes. The secondary objective was to summarize the evidence on the potential of KI in reducing the discoloration associated with the application of SDF. Electronic databases of Medline via PubMed, Cochrane Library, Web of Science, and EBSCO host were searched for English language manuscripts from January 2005 to 15th November 2020. The reference lists of these manuscripts were manually searched for additional studies. Twelve studies were included in the final analysis, seven of which have investigated the antimicrobial efficacy of SDF/KI, and the rest have examined the anti-staining potential of KI. The exploratory findings from the reviewed articles revealed the promising antimicrobial potential of SDF/KI on cariogenic microbes associated with dentine caries. There is, however, contradictory evidence on the effect of SDF/KI on tooth color. The reviewed in-vitro studies indicated significant effectiveness of KI in preventing staining. A clinical trial on primary dentition showed 25% reduction in the incidence of staining by SDF after applying KI, while a clinical study on root caries in adults showed no significant effect. Within the methodological limitations of this review, we conclude that for arresting dental caries, SDF could be combined with KI, as there may be a lower likelihood of staining. Further, well-designed clinical trials on the antimicrobial and anti-staining effect of SDF/KI are needed to obtain more robust evidence.
Topics: Biofilms; Dental Plaque; Drug Combinations; Fluorides, Topical; Humans; Microbiota; Potassium Iodide; Quaternary Ammonium Compounds; Silver Compounds; Tooth Discoloration
PubMed: 34115788
DOI: 10.1371/journal.pone.0252734 -
International Journal of Dental Hygiene Feb 2022The present study aimed to establish the efficacy of sodium hypochlorite mouthwash (NaOCl-MW) compared with a control mouthwash on plaque and clinical parameters of... (Review)
Review
OBJECTIVE
The present study aimed to establish the efficacy of sodium hypochlorite mouthwash (NaOCl-MW) compared with a control mouthwash on plaque and clinical parameters of periodontal disease.
METHODS
MEDLINE-PubMed, Embase and Cochrane-CENTRAL databases were searched for clinical trials on patients with gingivitis or periodontitis that assessed the effect of NaOCl-MW in comparison with a negative or positive control on plaque index (PI), gingival index (GI), and bleeding index (BI) scores and probing pocket depth (PPD). Data were extracted from the eligible studies.
RESULTS
Seven eligible papers were retrieved, which together represented six clinical trials. The studies showed considerable heterogeneity regarding methodological and clinical aspects that did not permit a meta-analysis. Two of the three studies in which NaOCl-MW was compared with a negative control showed that NaOCl-MW significantly reduced PI, GI and BI, and no effect was found on PPD. In three studies, NaOCl-MW was assessed using chlorhexidine mouthwash (CHX-MW) as a positive control; no difference was found for GI and BI. One of the three comparisons showed a statistically significant PI score favouring NaOCl-MW. One study measured PPD and found it to be significant in favour of NaOCl-MW.
CONCLUSIONS
Studies with a negative control group provided very weak quality evidence for a very small beneficial effect of NaOCl-MW on PI, GI and BI scores. Studies with a positive control group provided very weak quality evidence that NaOCl-MW had a similar effect as CHX-MW on PI, GI and BI scores. The outcome for PPD was inconclusive.
Topics: Chlorhexidine; Dental Plaque; Gingivitis; Humans; Mouthwashes; Periodontal Diseases; Sodium Hypochlorite
PubMed: 33971082
DOI: 10.1111/idh.12510 -
Clinical and Experimental Dental... Oct 2021The aim of this systematic review is to summarize the available data on the effects of organic unprocessed products in treating gingivitis during treatment with fixed...
OBJECTIVES
The aim of this systematic review is to summarize the available data on the effects of organic unprocessed products in treating gingivitis during treatment with fixed orthodontic appliances.
MATERIALS AND METHODS
Multiple electronic databases were searched up to October 1, 2020. Randomized controlled trials (RCTs), controlled clinical trials, cohort studies of prospective and retrospective design, and cross-sectional studies reporting on natural products for controlling gingivitis in orthodontic patients were eligible for inclusion. The quality of the included RCTs was assessed per the revised Cochrane risk of bias tool for randomized trials (RoB 2.0).
RESULTS
Three RCTs were finally eligible for inclusion, yielding a total of 135 patients with an age range of 12-40 years. Organic products used were Aloe vera mouth rinse, ingestion of honey and chamomile mouthwash. Treatment follow-up period varied from 30 min to 15 days. The results indicated that the use of the aforementioned organic products significantly reduced plaque and gingival bleeding levels as early as treatment started. The reduction in biofilm accumulation and gingival bleeding was significant throughout the studies' follow-up.
CONCLUSIONS
Owing to their antimicrobial and anti-inflammatory properties, nonpharmacological formulations successfully controlled gingival inflammation and plaque indices in orthodontic patients.
Topics: Adolescent; Adult; Child; Dental Plaque; Dental Plaque Index; Gingivitis; Humans; Mouthwashes; Orthodontic Appliances, Fixed; Randomized Controlled Trials as Topic; Young Adult
PubMed: 33942562
DOI: 10.1002/cre2.417 -
Community Dental Health May 2021Oral lichen planus (OLP) is a chronic autoimmune disease that frequently affects the oral mucosa. Patients with OLP tend to present with plaque accumulation which may... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Oral lichen planus (OLP) is a chronic autoimmune disease that frequently affects the oral mucosa. Patients with OLP tend to present with plaque accumulation which may further exacerbate the lichenoid lesion, thus plaque control may improve the quality of life of patients. The aim of this review was to test the effect of plaque control on OLP with gingival manifestations.
METHODS
Systematic review following the PRISMA checklist. A search was conducted through Medline, Embase and the Cochrane Library Database up to March 2020 and complemented by a manual search in some relevant journals. Randomised Controlled Trials (RCTs) reporting plaque interventions and their effects in populations with gingival manifestations of OLP, with a follow-up period of at least 3 months were included. Risk of Bias was assessed using the Cochrane Collaboration Tool in Randomised Trials.
RESULTS
The initial search generated 89 sources, resulting in final inclusion of three RCTs following full-text reading. The control groups were asked to continue their regular oral hygiene routine, while test groups received additional tailored oral hygiene advice as the intervention. Two of the included papers had sufficiently similar design to be included in meta-analysis. The oral hygiene intervention was associated with improvements in clinical disease status (Escudier index) and patient-reported outcomes (OHIP-14) from baseline compared with the control group. Differences in visual analogue scores for pain between groups were not statistically different between test and control groups. Two studies were judged to have low risk of bias, while one (not included in meta-analysis) had high risk of bias.
CONCLUSION
Improvements in disease and patient-reported outcomes can occur as a result of oral hygiene instruction in patients with gingival manifestations of OLP.
Topics: Dental Care; Dental Plaque; Dental Plaque Index; Humans; Lichen Planus, Oral; Oral Hygiene
PubMed: 33848405
DOI: 10.1922/CDH_00202Albaghli07 -
International Journal of Dental Hygiene Feb 2022This study aimed to establish the efficacy of a rubber bristles interdental cleaner (RBIC) as an adjunct to toothbrushing (TB) compared to that of the adjuvant use of... (Meta-Analysis)
Meta-Analysis Review
AIM
This study aimed to establish the efficacy of a rubber bristles interdental cleaner (RBIC) as an adjunct to toothbrushing (TB) compared to that of the adjuvant use of other interdental cleaning devices and TB alone on plaque and gingivitis parameters. Additionally, the safety aspects and panellists' appreciation were evaluated.
MATERIALS AND METHODS
Databases were searched for randomized controlled clinical trials (RCTs) evaluating plaque (PI), bleeding (BS), and gingival index (GI) scores, safety assessments, and participants' appreciation. Extracted data were summarized in a descriptive and, if possible, a meta-analysis.
RESULTS
The search retrieved 142 unique papers; six studies with 10 comparisons were included in a descriptive analysis. Five RCTs compared RBICs with interdental brushes (IDBs), four with dental floss (DF) and one with manual TB only. No comparisons to wood sticks were retrieved. Using an RBIC resulted in no difference in plaque scores compared to DF and IDBs. For overall bleeding scores, no difference was found. Two studies analysing the accessible sites separately found RBICs to be more favourable than DF and IDBs. Conversely, one study evaluating the efficacy of RBICs compared to IDBs, according to the GI scores, showed that IDBs achieved significantly greater reduction. Moreover, RBICs caused fewer gingival abrasions and were preferred by the study participants.
CONCLUSION
Based on a descriptive and a meta-analysis of the available literature, it is synthesized that in gingivitis patients, a weak to very weak certainty exists that a RBIC is indicated for gingivitis and plaque reduction. The evidence supports user safety and participants' preferences.
Topics: Dental Devices, Home Care; Dental Plaque; Dental Plaque Index; Gingivitis; Humans; Rubber; Toothbrushing
PubMed: 33630360
DOI: 10.1111/idh.12492 -
The Cochrane Database of Systematic... Dec 2020For people with physical, sensory and cognitive limitations due to stroke, the routine practice of oral health care (OHC) may become a challenge. Evidence-based... (Meta-Analysis)
Meta-Analysis
BACKGROUND
For people with physical, sensory and cognitive limitations due to stroke, the routine practice of oral health care (OHC) may become a challenge. Evidence-based supported oral care intervention is essential for this patient group.
OBJECTIVES
To compare the effectiveness of OHC interventions with usual care or other treatment options for ensuring oral health in people after a stroke.
SEARCH METHODS
We searched the Cochrane Stroke Group and Cochrane Oral Health Group trials registers, CENTRAL, MEDLINE, Embase, and six other databases in February 2019. We scanned reference lists from relevant papers and contacted authors and researchers in the field. We handsearched the reference lists of relevant articles and contacted other researchers. There were no language restrictions.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) that evaluated one or more interventions designed to improve the cleanliness and health of the mouth, tongue and teeth in people with a stroke who received assisted OHC led by healthcare staff. We included trials with a mixed population provided we could extract the stroke-specific data. The primary outcomes were dental plaque or denture plaque. Secondary outcomes included presence of oral disease, presence of related infection and oral opportunistic pathogens related to OHC and pneumonia, stroke survivor and providers' knowledge and attitudes to OHC, and patient satisfaction and quality of life.
DATA COLLECTION AND ANALYSIS
Two review authors independently screened abstracts and full-text articles according to prespecified selection criteria, extracted data and assessed the methodological quality using the Cochrane 'Risk of bias' tool. We sought clarification from investigators when required. Where suitable statistical data were available, we combined the selected outcome data in pooled meta-analyses. We used GRADE to assess the quality of evidence for each outcome.
MAIN RESULTS
Fifteen RCTs (22 randomised comparisons) involving 3631 participants with data for 1546 people with stroke met the selection criteria. OHC interventions compared with usual care Seven trials (2865 participants, with data for 903 participants with stroke, 1028 healthcare providers, 94 informal carers) investigated OHC interventions compared with usual care. Multi-component OHC interventions showed no evidence of a difference in the mean score (DMS) of dental plaque one month after the intervention was delivered (DMS -0.66, 95% CI -1.40 to 0.09; 2 trials, 83 participants; I = 83%; P = 0.08; very low-quality evidence). Stroke survivors had less plaque on their dentures when staff had access to the multi-component OHC intervention (DMS -1.31, 95% CI -1.96 to -0.66; 1 trial, 38 participants; P < 0.0001; low-quality evidence). There was no evidence of a difference in gingivitis (DMS -0.60, 95% CI -1.66 to 0.45; 2 trials, 83 participants; I = 93%; P = 0.26: very low-quality evidence) or denture-induced stomatitis (DMS -0.33, 95% CI -0.92 to 0.26; 1 trial, 38 participants; P = 0.69; low-quality evidence) among participants receiving the multi-component OHC protocol compared with usual care one month after the intervention. There was no difference in the incidence of pneumonia in participants receiving a multi-component OHC intervention (99 participants; 5 incidents of pneumonia) compared with those receiving usual care (105 participants; 1 incident of pneumonia) (OR 4.17, CI 95% 0.82 to 21.11; 1 trial, 204 participants; P = 0.08; low-quality evidence). OHC training for stroke survivors and healthcare providers significantly improved their OHC knowledge at one month after training (SMD 0.70, 95% CI 0.06 to 1.35; 3 trials, 728 participants; I = 94%; P = 0.03; very low-quality evidence). Pooled data one month after training also showed evidence of a difference between stroke survivor and providers' oral health attitudes (SMD 0.28, 95% CI 0.01 to 0.54; 3 trials, 728 participants; I = 65%; P = 0.06; very low-quality evidence). OHC interventions compared with placebo Three trials (394 participants, with data for 271 participants with stroke) compared an OHC intervention with placebo. There were no data for primary outcomes. There was no evidence of a difference in the incidence of pneumonia in participants receiving an OHC intervention compared with placebo (OR 0.39, CI 95% 0.14 to 1.09; 2 trials, 242 participants; I = 42%; P = 0.07; low-quality evidence). However, decontamination gel reduced the incidence of pneumonia among the intervention group compared with placebo gel group (OR 0.20, 95% CI 0.05 to 0.84; 1 trial, 203 participants; P = 0.028). There was no difference in the incidence of pneumonia in participants treated with povidone-iodine compared with a placebo (OR 0.81, 95% CI 0.18 to 3.51; 1 trial, 39 participants; P = 0.77). One OHC intervention compared with another OHC intervention Twelve trials (372 participants with stroke) compared one OHC intervention with another OHC intervention. There was no difference in dental plaque scores between those participants that received an enhanced multi-component OHC intervention compared with conventional OHC interventions at three months (MD -0.04, 95% CI -0.33 to 0.25; 1 trial, 61 participants; P = 0.78; low-quality evidence). There were no data for denture plaque.
AUTHORS' CONCLUSIONS
We found low- to very low-quality evidence suggesting that OHC interventions can improve the cleanliness of patient's dentures and stroke survivor and providers' knowledge and attitudes. There is limited low-quality evidence that selective decontamination gel may be more beneficial than placebo at reducing the incidence of pneumonia. Improvements in the cleanliness of a patient's own teeth was limited. We judged the quality of the evidence included within meta-analyses to be low or very low quality, and this limits our confidence in the results. We still lack high-quality evidence of the optimal approach to providing OHC to people after stroke.
Topics: Attitude to Health; Caregivers; Dental Plaque; Gingivitis; Health Education, Dental; Health Knowledge, Attitudes, Practice; Humans; Nursing Homes; Oral Hygiene; Pneumonia; Randomized Controlled Trials as Topic; Stomatitis, Denture; Stroke
PubMed: 33314046
DOI: 10.1002/14651858.CD003864.pub3 -
Journal of Dentistry Dec 2020People with Cystic Fibrosis (PWCF) may be presumed to be at lower risk of periodontal disease due to long term antibiotic use but this has not been comprehensively... (Review)
Review
INTRODUCTION AND OBJECTIVES
People with Cystic Fibrosis (PWCF) may be presumed to be at lower risk of periodontal disease due to long term antibiotic use but this has not been comprehensively investigated. The oral hygiene and periodontal status of PWCF in comparison to the general population is not well established. The objective of this systematic review was to critically evaluate the literature on periodontal and oral hygiene status in PWCF to see if this group are at increased risk of periodontal disease (gingivitis or periodontitis).
DATA SOURCES
5 databases were searched: Scopus, MEDLINE, Embase, Cochrane Library and Web of Science.
STUDY SELECTION
The search resulted in 614 publications from databases with one more publication identified by searching bibliographies. 13 studies were included in the qualitative analysis.
CONCLUSIONS
The majority of studies showed better oral hygiene, with lower levels of gingivitis and plaque among people with Cystic Fibrosis (PWCF) than controls. Interestingly, despite this, many studies showed that PWCF had higher levels of dental calculus. Three studies found there was no difference in Oral Hygiene between PWCF and controls. One study found that PWCF aged between 6 and 9.5 years had increased levels of clinical gingivitis, and one study showed that PWCF with gingivitis had more bleeding on probing than people without CF. The vast majority of PWCF examined were children- only five studies included people over 18 years, and only one looked exclusively at adults. There is a need for further study into the periodontal health of PWCF- particularly those over the age of 18.
CLINICAL SIGNIFICANCE
There are currently no guidelines referring to oral care in PWCF. Studies have suggested that the oral cavity acts as a reservoir of bacteria which may colonise the lungs. If PWCF are at increased risk of periodontal disease, they should attend for regular screenings to facilitate early detection.
Topics: Adult; Child; Cystic Fibrosis; Dental Plaque; Gingivitis; Humans; Middle Aged; Oral Health; Oral Hygiene; Periodontal Diseases
PubMed: 33129998
DOI: 10.1016/j.jdent.2020.103509 -
International Journal of Dental Hygiene Feb 2021To establish the effect of a single-brushing exercise on dental plaque removal using an oscillating-rotating power toothbrush (OR-PTB) as compared to a high-frequency... (Meta-Analysis)
Meta-Analysis
Dental plaque score reduction with an oscillating-rotating power toothbrush and a high-frequency sonic power toothbrush: a systematic review and meta-analysis of single-brushing exercises.
AIM
To establish the effect of a single-brushing exercise on dental plaque removal using an oscillating-rotating power toothbrush (OR-PTB) as compared to a high-frequency sonic power toothbrush (HFS-PTB).
MATERIALS AND METHODS
The MEDLINE-PubMed and Cochrane-CENTRAL databases were searched up to September 2019. The inclusion criteria contained (randomized) controlled clinical trials involving healthy adult participants brushing with an OR-PTB as compared to an HFS-PTB. Plaque index (PI) scores were evaluated after a single-brushing exercise.
RESULTS
A total of 15 publications were included, representing 34 comparisons, of which 8 were professional brushing exercises and 26 participant brushing exercises. The potential risk of bias was estimated to be low. In the overall descriptive analysis of 34 comparisons, 19 comparisons showed a statistically significant difference in favour of the OR-PTB and 4 in favour of the HFS-PTB. The meta-analysis using the professional brushing study design showed a significant difference of means (DiffM) in favour of the OR-PTB (PI score) (DiffM 0.19; P < .0001) (95% CI [013; 0.25]). In those studies where the participants brushed themselves, the data were inconclusive. PI scores showed no difference between the two brushes (P = .15), while one plaque index (the Rustogi Modified Navy plaque index) indicated significant favour for the OR-PTB (DiffM 0.06; P = .002) (95% CI [0.02; 0.09]).
CONCLUSION
Based on the estimated evidence profile, there is moderate certainty of evidence of a very small but significant beneficial effect on plaque removal after a single-brushing exercise with the OR-PTB over the HFS-PTB.
Topics: Adult; Dental Plaque; Dental Plaque Index; Equipment Design; Humans; Periodontal Index; Single-Blind Method; Toothbrushing
PubMed: 32940391
DOI: 10.1111/idh.12463 -
BMC Oral Health Jul 2020This systematic review of randomized clinical trials aimed to evaluate the available evidence regarding the efficacy of propolis-based mouthwash on dental plaque and...
BACKGROUND
This systematic review of randomized clinical trials aimed to evaluate the available evidence regarding the efficacy of propolis-based mouthwash on dental plaque and gingival inflammation.
METHODS
PubMed, Scopus, and Web of Science databases were searched up to November 2019. Clinical trials that evaluated the efficacy of propolis mouthwashes compared with chlorhexidine (CHX) were included. The primary outcomes comprised dental plaque and/or gingival inflammation. Two authors assessed the risk of bias using the Cochrane tool. Due to marked heterogeneity of the available data, studies were assessed qualitatively, and no metaanalysis was performed.
RESULTS
Nine clinical trials, comprising 333 subjects, fulfilled the eligibility criteria. Most of the included studies showed high risk of bias. Overall, propolis mouthwashes showed good efficacy on plaque and gingivitis in all of the included studies. Out of the eight studies that reported on plaque index, 5 studies found equal efficacy of propolis and CHX in reducing plaque, two studies found superior efficacy in favor of CHX, while one study found superior efficacy in favor of propolis. Six studies assessed gingival inflammation outcome, four of which reported better results with propolis, while two studies reported comparable results.
CONCLUSIONS
The results suggest that propolis-based mouthwashes have potential benefits in reducing plaque and gingival inflammation. However, methodological limitations along with small sample sizes in some of the included studies weaken the strength of the evidence. Therefore, further well-designed clinical trials with large sample sizes and adequate follow-up period are recommended to discern the efficacy of propolis mouthwash on plaque and gingivitis.
Topics: Anti-Infective Agents, Local; Chlorhexidine; Cross-Over Studies; Dental Plaque; Dental Plaque Index; Double-Blind Method; Gingivitis; Humans; Inflammation; Mouthwashes; Propolis; Single-Blind Method
PubMed: 32650754
DOI: 10.1186/s12903-020-01185-5