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Cureus May 2024Red clover, a perennial herbaceous plant, has been demonstrated to possess blood-purifying, expectorant, and calming properties. This research endeavors to create and...
INTRODUCTION
Red clover, a perennial herbaceous plant, has been demonstrated to possess blood-purifying, expectorant, and calming properties. This research endeavors to create and evaluate the antimicrobial, antioxidant characteristics, and cytotoxic effects of the ethanolic extract derived from red clover.
METHODS
A water-based solution of red clover was formulated and subjected to centrifugation. Various concentrations of the extract were applied to the wells of agar plates inoculated with and and then left to incubate. The inhibition zones for each concentration were subsequently measured. The antioxidant properties were evaluated using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay, while the cytotoxicity of the extract was assessed through the brine shrimp lethality assay.
RESULTS
Initially, the extract was tested with a volume of 10 μL, which was subsequently incremented to 20 μL, 30 μL, 40 μL, and 50 μL. According to the DPPH assay, as the concentration of the extract solution increased incrementally by 10 μL, its antioxidant activity also exhibited a corresponding rise. The cytotoxicity assay indicated that the mouthwash formulated with red clover had minimal cytotoxic effects within the range of 5-20 µL. Antibacterial analysis revealed a similar zone of inhibition between the test and control groups.
CONCLUSION
The ethanolic extract obtained from red clover was identified as a powerful antioxidant, antibacterial, and biocompatible substance. Hence, it can be a potential candidate for application as a mouthwash.
PubMed: 38854355
DOI: 10.7759/cureus.59762 -
Clinical Oral Investigations Jun 2024This randomized clinical trial aimed to compare the effect of intracanal medicaments on the incidence of postoperative pain and flare-up with posttreatment apical... (Randomized Controlled Trial)
Randomized Controlled Trial
The incidence and intensity of postoperative pain and Flare-up following the use of three different intracanal medicaments in teeth with posttreatment apical periodontitis: a randomized clinical trial.
OBJECTIVES
This randomized clinical trial aimed to compare the effect of intracanal medicaments on the incidence of postoperative pain and flare-up with posttreatment apical periodontitis (PTAP) of retreatment cases.
MATERIALS AND METHODS
One hundred twenty patients diagnosed with PTAP with single-rooted teeth with single-canal without spontaneous pain or swellings were included and randomly divided into three groups according to the intracanal medicament used. Intracanal medicaments were placed into the root canals following the removal of previous root canal fillings and re-instrumentation. Calcium hydroxide (Ca (OH)), chlorhexidine gel (CHX), calcium hydroxide and chlorhexidine gel combinations were used as intracanal medicaments. Postoperative pain scores were recorded at 6 and 12 h and 1, 2, 3, 4, 5, 6, and 7 days using a visual analog scale (VAS). Sensitivity on percussion, spontaneous pain, swelling, antibiotic and analgesic requirements of the patients were evaluated during clinical examinations performed postoperatively after 2 and 7 days.
RESULTS
There were no statistically significant differences between groups in terms of VAS scores following the intracanal medicament application (p > 0.05). However, compared to the patients of 20-34 and 50-65 age groups, greater VAS scores were observed in patients of 35-49 age groups at 12 h, and 3, 4, 7 days (p < 0.05). Flare-up was observed in only one patient in the CHX gel group, and no flare-up was observed in other groups.
CONCLUSIONS
Similar postoperative pain incidence in all experimental groups indicates that all three medicaments are clinically acceptable in inter-appointment management of retreatment cases in terms of post-endodontic pain and flare-up.
CLINICAL RELEVANCE
In this randomized clinical trial, three different intracanal medicaments were utilized in nonsurgical endodontic retreatment and their effect on postoperative pain and flare-up incidence was examined. Thus, this study will be a significant contribution in the decision-making during clinical practice; since there are a limited number of prospective clinical trials in the literature about the severity of pain following retreatment procedures including intracanal medicament use.
Topics: Humans; Periapical Periodontitis; Pain, Postoperative; Female; Male; Calcium Hydroxide; Chlorhexidine; Root Canal Irrigants; Adult; Pain Measurement; Incidence; Middle Aged; Treatment Outcome; Retreatment; Root Canal Therapy
PubMed: 38849655
DOI: 10.1007/s00784-024-05760-w -
PloS One 2024The recommendation for Chlorhexidine (CHX) as a traditional oral care solution is decreasing, and herbal oral care products are being considered as a potential... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The recommendation for Chlorhexidine (CHX) as a traditional oral care solution is decreasing, and herbal oral care products are being considered as a potential alternative. This network meta-analysis aims to determine if herbal oral care products for oral care in mechanically ventilated patients are superior to CHX and provide direction for future research by comparing the effectiveness of herbal oral care products currently available.
MATERIALS AND METHODS
We searched for English-language published and grey literature sources of randomized clinical trials involving herbal oral care solutions in intensive care unit (ICU) oral care (until September 2023). The primary outcome was the incidence of ventilator-associated pneumonia (VAP); the secondary outcome was the oral microbiota quantity. Data were pooled by pairwise meta-analysis and Bayesian network meta-analysis. The risk of bias was assessed using the Cochrane risk of bias tool, and the certainty of evidence was evaluated using the GRADE framework.
RESULTS
Our network meta-analysis included 29 studies, and the results showed that Chinese herb (OR: 0.39, 95% CI: 0.2-0.75) and Miswak (OR: 0.27, 95% CI: 0.07-0.91) were more effective in reducing VAP incidence than CHX. In terms of reducing bacterial counts, Chinese herb (OR: 0.3, 95% CI: 0.19-0.48) was superior to CHX, and all herbal oral care products, including Persica® (alcoholic extract of S. persica, Achillea millefolium, and Mentha spicata), Matrica® (Chamomile extract), and Listerine® (main components include Menthol, Thymol, and Eucalyptol), were better than saline in all aspects but without significant differences.
CONCLUSION
Based on our network meta-analysis, we have observed that Chinese herbal medicine and Miswak are superior to CHX in reducing the incidence of VAP. However, the safety and feasibility of traditional Chinese herbal medicine require further high-quality research for validation. Simultaneously, Matrica® demonstrates a significant reduction in microbial counts but does not exhibit a significant advantage in lowering the incidence of VAP. This observation aligns with the results of clinical double-blind trials. Therefore, we identify Miswak and Matrica® as promising herbal oral care products with the potential to replace CHX. It is essential to emphasize that our study provides guidance for future research rather than conclusive determinations.
REGISTRATION
PROSPERO no. CRD42023398022.
Topics: Pneumonia, Ventilator-Associated; Humans; Randomized Controlled Trials as Topic; Network Meta-Analysis; Chlorhexidine; Mouthwashes; Bayes Theorem; Intensive Care Units
PubMed: 38848351
DOI: 10.1371/journal.pone.0304583 -
Antimicrobial Resistance and Infection... Jun 2024Although uncommon, infections associated with peripheral intravenous catheters (PIVCs) may be responsible for severe life-threatening complications and increase... (Randomized Controlled Trial)
Randomized Controlled Trial
Insertion site and risk of peripheral intravenous catheter colonization and/or local infection: a post hoc analysis of the CLEAN 3 study including more than 800 catheters.
AIM
Although uncommon, infections associated with peripheral intravenous catheters (PIVCs) may be responsible for severe life-threatening complications and increase healthcare costs. Few data are available on the relationship between PIVC insertion site and risk of infectious complications.
METHODS
We performed a post hoc analysis of the CLEAN 3 database, a randomized 2 × 2 factorial study comparing two skin disinfection procedures (2% chlorhexidine-alcohol or 5% povidone iodine-alcohol) and two types of medical devices (innovative or standard) in 989 adults patients requiring PIVC insertion before admission to a medical ward. Insertion sites were grouped into five areas: hand, wrist, forearm, cubital fossa and upper arm. We evaluated the risk of risk of PIVC colonization (i.e., tip culture eluate in broth showing at least one microorganism in a concentration of at least 1000 Colony Forming Units per mL) and/or local infection (i.e., organisms growing from purulent discharge at PIVC insertion site with no evidence of associated bloodstream infection), and the risk of positive PIVC tip culture (i.e., PIVC-tip culture eluate in broth showing at least one microorganism regardless of its amount) using multivariate Cox models.
RESULTS
Eight hundred twenty three PIVCs with known insertion site and sent to the laboratory for quantitative culture were included. After adjustment for confounding factors, PIVC insertion at the cubital fossa or wrist was associated with increased risk of PIVC colonization and/or local infection (HR [95% CI], 1.64 [0.92-2.93] and 2.11 [1.08-4.13]) and of positive PIVC tip culture (HR [95% CI], 1.49 [1.02-2.18] and 1.59 [0.98-2.59]).
CONCLUSION
PIVC insertion at the wrist or cubital fossa should be avoided whenever possible to reduce the risk of catheter colonization and/or local infection and of positive PIVC tip culture.
Topics: Humans; Female; Male; Catheterization, Peripheral; Catheter-Related Infections; Middle Aged; Aged; Chlorhexidine; Adult; Disinfection; Povidone-Iodine; Risk Factors; Anti-Infective Agents, Local; Equipment Contamination; Wrist
PubMed: 38840171
DOI: 10.1186/s13756-024-01414-4 -
Clinical Oral Investigations Jun 2024This single-center randomized, parallel design, clinical trial with a 2-week follow-up involved patients affected by periodontitis undergoing periodontal surgery. The... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVES
This single-center randomized, parallel design, clinical trial with a 2-week follow-up involved patients affected by periodontitis undergoing periodontal surgery. The aim was to evaluate periodontal surgical wound healing with the use of chlorhexidine-based mouth rinses versus an untreated control group.
MATERIALS AND METHODS
Periodontal surgery was performed following a standardized protocol. Patients were randomly prescribed i) chlorhexidine (CHX) + anti-discoloration system (ADS) + hyaluronic acid (HA), ii) CHX + ADS or iii) no treatment (control group). Plaque score, gingival inflammation, and Early Healing Index (EHI), assessing the degree of wound closure and the presence of fibrin and necrosis, were evaluated at 3, 7 and 14 days after surgery.
RESULTS
In total, 33 patients were enrolled. Patients were comparable at baseline for all measured clinical parameters. At 3-days wound healing was significantly improved in all patients treated with CHX + ADS-based mouth rinses with a lower EHI score at the interdental papillae compared with control group (p < 0.01). CHX + ADS + HA group presented improved healing across all time points in terms of EHI, plaque containment, and gingival inflammation when compared to control group (p < 0.01).
CONCLUSIONS
The usage of CHX-ADS following periodontal surgery improved early wound healing, reduced plaque accumulation and gingival inflammation. During the early post-operative period the adjunct of HA further improved soft tissue closure.
CLINICAL RELEVANCE
This study aims at evaluating the response of gingival tissues to mouth rinsing with chlorhexidine and anti-discoloration system (CHX + ADS) or CHX + ADS + hyaluronic acid (CHX + ADS + HA) versus no rinse in terms of healing of the periodontal surgical wound. CHX + ADS mouth rinses enhanced early soft tissue closure after periodontal surgery and contributed to the reduction in plaque accumulation and gingival inflammation. The adjunct of HA may be beneficial especially in the early post-operative period. CHX + ADS administration following periodontal surgery may improve soft tissue healing in the first two post-operative weeks.
Topics: Humans; Chlorhexidine; Wound Healing; Female; Male; Mouthwashes; Middle Aged; Hyaluronic Acid; Treatment Outcome; Anti-Infective Agents, Local; Adult; Periodontitis; Periodontal Index; Dental Plaque Index
PubMed: 38833009
DOI: 10.1007/s00784-024-05643-0 -
Journal of Oral Biology and... 2024Numerous studies on Triphala and Curcumin mouthwashes were analyzed individually and no study has compared the efficacy of Triphala mouthwash to Curcumin mouthwash in...
BACKGROUND
Numerous studies on Triphala and Curcumin mouthwashes were analyzed individually and no study has compared the efficacy of Triphala mouthwash to Curcumin mouthwash in the management of gingivitis. Although various mouthwashes have shown reduction of plaque and gingivitis the search is still on for an ideal mouthwash with minimum side effects and better patient acceptance.
OBJECTIVES
To access the efficacy of all the mouthwashes in the management of gingivitis.
METHODS
By purposive sampling, 81 patients of both sexes with gingivitis were randomized by lottery method into 3 groups - A, B and C. Group A received scaling and Triphala mouthwash, Group B received scaling and Curcumin mouthwash and Group C underwent scaling and received Chlorhexidine mouthwash. Oral hygiene was assessed using Plaque, Gingival and Bleeding indices at baseline,7th day and 14th day. The inter-group comparisons were analysed using One-way analysis of variance (ANOVA) and multiple comparisons using Tukey's Honest significant difference test (α = 0.05) and the intra-group comparisons for the indices across various time periods within each group were analysed using Repeated-measures ANOVA and Bonferroni-adjusted pairwise comparisons post hoc test (α = 0.05). The statistical significance was set at p ≤ 0.05.
RESULTS
The study has shown that herbal mouthwashes are as effective as chlorhexidine in treating gingivitis although curcumin mouthwash showed a greater potential in reducing gingival inflammation.
CONCLUSION
Both Triphala and Curcumin mouthwashes were proven to be equally effective in reducing plaque, gingival and bleeding scores, although curcumin was better in reducing gingival inflammation. Hence herbal mouthwashes such as Triphala and Curcumin with no side effects can be considered as an alternative mouthwash to chlorhexidine.
PubMed: 38832298
DOI: 10.1016/j.jobcr.2024.05.002 -
Cureus May 2024Dental caries has become a substantial global health burden, and many techniques have been used in dentistry to protect the tooth from decay. is a green cruciferous...
INTRODUCTION
Dental caries has become a substantial global health burden, and many techniques have been used in dentistry to protect the tooth from decay. is a green cruciferous vegetable with a good source of vitamins C, K and E, which are also effective antibiotics and antioxidants. These characteristics will shield the oral cavity from pathogenic onslaught and can be considered during the formulation of antimicrobial mouthwash, toothpaste, or dental sealants.
MATERIALS AND METHODS
extract was prepared by heating and condensing the red and green cabbage. Both extracts were assessed for antimicrobial activity (antibacterial and antifungal activities) and cytotoxicity. After incubation, the zone of inhibition was calculated for antibacterial activity and the number of live nauplii for cytotoxicity. Results: The extract from red cabbage was found to have more effective antibacterial properties than that from green cabbage. The red extract formed the highest zone of inhibition against (20 mm), followed by (15 mm) and (9 mm). In contrast, the green cabbage extract formed the highest inhibition against (12 mm). The cytotoxicity increases with increased concentration, with the highest toxicity at 20 µL for both extracts. Conclusion: The properties of can be utilized in dental products such as toothpaste, mouthwash, and dental sealants due to their antibacterial effects. By incorporating extracts into these products, oral health professionals may soon have additional tools to promote oral hygiene and prevent oral infections, offering a natural and effective alternative to traditional oral care ingredients.
PubMed: 38832175
DOI: 10.7759/cureus.59613 -
International Medical Case Reports... 2024Erythema multiforme is a hypersensitivity reaction caused by various factors, such as viruses, chemicals, and drugs. Electronic cigarettes (e-cigarettes) or vape is a...
INTRODUCTION
Erythema multiforme is a hypersensitivity reaction caused by various factors, such as viruses, chemicals, and drugs. Electronic cigarettes (e-cigarettes) or vape is a battery-powered nicotine delivery device that substitutes for traditional cigarettes. The chemical components of vaping, including propylene glycol and nicotine, can cause hypersensitivity reactions.
OBJECTIVE
To report a case of oral erythema multiforme in an e-cigarettes user, treatment, and review the literature regarding the impact of these devices on oral health.
CLINICAL CASE
A 22-year-old woman came to the Oral Medicine Department with complaints of stomatitis causing pain, eating, and drinking difficulty, which started with fever and pimple-like on the lips. She was an active vape user for one year. Extraoral examination revealed no lesions on other body parts. The serosanguinolent crusts on the lips, an erosive area on the labial commissures and tended to bleed. Intraoral examination revealed white ulcers with yellowish edges and irregular, varying sizes in several parts of the oral mucosa. The anti-HSV-1 IgG laboratory results showed non-reactive, leading to a diagnosis of oral erythema multiforme. Management of oral conditions using 0.9% NaCl compress, dexamethasone mouthwash, and hyaluronic acid, applying 2% miconazole cream on labial commissures and vaseline album cream on the dry lips, and stopping vaping. Oral condition improved in a week of therapy.
CONCLUSION
Erythema multiforme restricted to the mouth is rare, especially associated with electronic cigarettes. Early identification of oral ulcerative disorders is crucial for accurate diagnosis and treatment, where clinicians should consider oral erythema multiforme as a possible diagnosis.
PubMed: 38828364
DOI: 10.2147/IMCRJ.S455640 -
PeerJ 2024Carbonic anhydrase VI (CA VI) is crucial in regulating oral pH and predicting susceptibility to dental caries. The hypothesis posits that caries activity may alter the...
BACKGROUND
Carbonic anhydrase VI (CA VI) is crucial in regulating oral pH and predicting susceptibility to dental caries. The hypothesis posits that caries activity may alter the CA VI function, diminishing its capacity to regulate pH effectively and potentially exacerbating cariogenic challenges. This 1-year cohort study sought to investigate the enzymatic activity of salivary CA VI and buffering capacity following a 20% sucrose rinse in 4 to 6.5-year-old children.
METHOD
This research involved 46 volunteers categorized into three groups based on their caries status after follow-up: caries-free (C), arrested caries (C), and caries active (C). Children underwent visible biofilm examination and saliva collection for salivary flow rate, buffering capacity, and CA VI analyses before and after a 20% sucrose rinse.
RESULTS
A reduction in the buffering capacity was observed after sucrose rinse in all groups. The CA VI activity decreased significantly in C and C groups after sucrose rinse, although it did not change in the C group. An improvement in the buffering capacity and salivary flow rate was found at follow-up when compared with the baseline. After 1-year follow-up, buffering capacity and salivary flow rate increased in all groups, whilst the CA VI activity reduced only in C and C children.
CONCLUSION
Sucrose rinse universally reduces the salivary buffering capacity, while caries activity may disrupt CA VI activity response during a cariogenic challenge. After a year, increased salivary flow enhances buffering capacity but not CA VI activity in caries-active children.
Topics: Humans; Saliva; Sucrose; Child; Carbonic Anhydrases; Dental Caries; Male; Female; Longitudinal Studies; Child, Preschool; Buffers; Hydrogen-Ion Concentration; Mouthwashes
PubMed: 38827285
DOI: 10.7717/peerj.17429 -
Medical Science Monitor : International... Jun 2024BACKGROUND Dentin contamination with hemostatic agents before bonding indirect restorations negatively affects the bond strength. However, the consensus on which...
BACKGROUND Dentin contamination with hemostatic agents before bonding indirect restorations negatively affects the bond strength. However, the consensus on which materials could be used to clean contamination of hemostatic agents has not been explored. The aim of this study was to assess the effect of Katana Cleaner applied on the surface of dentin contaminated with hemostatic agents on the shear bond strength (SBS) of self-adhesive resin cement by comparing it with three other surface cleaners. MATERIAL AND METHODS Ninety dentin specimens were divided into a no contamination group (control) (n=10), 4 groups contaminated with 25% aluminum chloride (Viscostat Clear) (n=40), and 4 groups contaminated with 20% ferric sulfate (Viscostat) (n=40). Subsequently, 4 different cleaners were used for each contamination group (water rinse, phosphoric acid, chlorhexidine, and Katana Cleaner). Then, self-adhesive resin cement was directly bonded to the treated surfaces. All specimens were subjected to 5000 thermal cycles of artificial aging. The shear bond strength was measured using a universal testing machine. RESULTS Two-way analysis of variance showed that the contaminant type as the main factor was statistically non-significant (p=0.655), cleaner type as the main factor was highly significant (p<0.001), and interaction between the contaminant and cleaner was non-significant (p=0.51). The cleaner type was the main factor influencing the bond strength. Phosphoric acid and chlorhexidine showed better performance than Katana Cleaner. CONCLUSIONS Cleaning dentin surface contamination with phosphoric acid and chlorhexidine had better performance than with Katana Cleaner.
Topics: Humans; Resin Cements; Dentin; Hemostatics; Shear Strength; Dental Bonding; Chlorhexidine; Materials Testing; Surface Properties; Dentin-Bonding Agents; Ferric Compounds
PubMed: 38825814
DOI: 10.12659/MSM.943353