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Bismuth lipophilic nanoparticles (BisBAL NPs) and cetylpyridinium chloride (CPC) are antineoplastic and antimicrobial in vitro. As a next pre-clinical step, a clinically viable dosage form for vaginal application was developed. Compendial pharmacopeial tests (mass uniformity, disintegration, and compressive mechanics) and inductively coupled plasma optical emission spectroscopy were conducted on in-house developed glycerinated gelatin (60:15 v/w) vaginal ovules containing BisBAL NP-CPC. The antimycotic activity of BisBAL NP-CPC vaginal ovules was analyzed using disk diffusion and cell viability XTT assays. The antitumor properties of BisBAL NP-CPC vaginal ovules were assessed by cell viability MTT tests. BisBAL NP-CPC and drug-free vaginal ovules deposited into ex vivo porcine vaginas disaggregated without signs of adverse cytotoxicity within the timespan of clinical efficacy. BisBAL NP-CPC vaginal ovules demonstrated antifungal efficacy comparable to miconazole: C. albicans growth inhibition haloes in diffusion tests were 23 ± 0.968 mm (n = 3) for BisBAL NP-CPC and 20.35 ± 0.899 mm (n = 3) for miconazole. Likewise, BisBAL NP-CPC vaginal ovules reduced HeLa cell growth by 81%, outperforming the clinical reference of 500 μM 5-fluouracil, which induced a 70% growth inhibition. BisBAL NP-CPC incorporated into glycerinated gelatin vaginal ovules constitute an innovative drug delivery system for topical antimycotic and anti-cervical carcinoma treatments.

Oral candidiasis is an opportunistic infection caused by fungi of the genus Candida. Nystatin, fluconazole, and miconazole are the most widely used antifungal drugs in dentistry, but in recent years, they have been shown to be less effective due to the increase in the resistance to antifungal drugs. The growing challenge of antifungal resistance emphasizes the importance of exploring not only alternative strategies in the fight against Candida spp. infections but also supportive treatment for pharmacological treatment for oral candidiasis. This review aims to evaluate and compare the in vitro reports on antifungal efficacy against Candida spp. exhibited by mouthwashes distributed on the European market. The research question was elaborated through the PEO framework recommended by PRISMA 2020. A bibliographic search strategy was developed for the scientific online databases Pubmed and ScienceDirect. According to the eligibility criteria, 21 papers were included in this study over a 27-year period. Mouthwashes containing chlorhexidine digluconate, cetylpyridinium chloride, hexetidine, and fluorine compounds among others, and natural antimicrobials, such as menthol, thymol, eucalyptol, and Glycyrrhiza glabra extracts, have demonstrated antifungal effectiveness. Nonetheless, the methodological variance introduces ambiguity concerning the comparative efficacy of distinct molecules or mouthwash formulations and complicates the evaluation and the comparison of results between studies. Some mouthwashes commercially available in Europe have the potential to be used in anti-Candida therapy and prevention since they have shown antifungal effect.

Dental caries is a global health problem that requires better prevention measures. One of the goals is to reduce the prevalence of the cariogenic Gram-positive bacterium Streptococcus mutans. We have recently shown that naturally occurring arachidonic acid (AA) has both anti-bacterial and anti-biofilm activities against this bacterium. An important question is how these activities are affected by other anti-bacterial compounds commonly used in mouthwashes. Here, we studied the combined treatment of AA with chlorhexidine (CHX), cetylpyridinium chloride (CPC), triclosan, and fluoride. Checkerboard microtiter assays were performed to determine the effects on bacterial growth and viability. Biofilms were quantified using the MTT metabolic assay, crystal violet (CV) staining, and live/dead staining with SYTO 9/propidium iodide (PI) visualized by spinning disk confocal microscopy (SDCM). The bacterial morphology and the topography of the biofilms were visualized by high-resolution scanning electron microscopy (HR-SEM). The effect of selected drug combinations on cell viability and membrane potential was investigated by flow cytometry using SYTO 9/PI staining and the potentiometric dye DiOC2(3), respectively. We found that CHX and CPC had an antagonistic effect on AA at certain concentrations, while an additive effect was observed with triclosan and fluoride. This prompted us to investigate the triple treatment of AA, triclosan, and fluoride, which was more effective than either compound alone or the double treatment. We observed an increase in the percentage of PI-positive bacteria, indicating increased bacterial cell death. Only AA caused significant membrane hyperpolarization, which was not significantly enhanced by either triclosan or fluoride. In conclusion, our data suggest that AA can be used together with triclosan and fluoride to improve the efficacy of oral health care.

Abstract Colloidal systems have been used to encapsulate, protect and release essential oils in mouthwashes. In this study, we investigated the effect of cetylpyridinium chloride (CPC) on the physicochemical properties and antimicrobial activity of oil-in-water colloidal systems containing tea tree oil (TTO) and the nonionic surfactant polysorbate 80. Our main aim was to evaluate whether CPC could improve the antimicrobial activity of TTO, since this activity is impaired when this essential oil is encapsulated with polysorbate 80. These systems were prepared with different amounts of TTO (0-0.5% w/w) and CPC (0-0.5% w/w), at a final concentration of 2% (w/w) polysorbate 80. Dynamic light scattering (DLS) results revealed the formation of oil-swollen micelles and oil droplets as a function of TTO concentration. Increases in CPC concentrations led to a reduction of around 88% in the mean diameter of oil-swollen micelles. Although this variation was of only 20% for the oil droplets, the samples appearance changed from turbid to transparent. The surface charge of colloidal structures was also markedly affected by the CPC as demonstrated by the transition in zeta potential from slightly negative to highly positive values. Electron paramagnetic resonance (EPR) studies showed that this transition is followed by significant increases in the fluidity of surfactant monolayer of both colloidal structures. The antimicrobial activity of colloidal systems was tested against a Gram-negative (Escherichia coli) and Gram-positive (Staphylococcus aureaus) bacteria. Our results revealed that the inhibition of bacterial growth is observed for the same CPC concentration (0.05% w/w for E. coli and 0.3% w/w for S. aureus) regardless of TTO content. These findings suggest that TTO may not act as an active ingredient in polysorbate 80 containing mouthwashes.

This work studied the denaturation process of whey protein isolate (WPI) with the addition of cetylpyridinium chloride (CPC) surfactant and its combination with the plasticizer polyethylene glycol (PEG). Samples were prepared by dilution in water with different concentrations of CPC, with and without PEG, and were analyzed for miscibility and viscosity. Samples that proved to be miscible at this stage were subjected to thermal treatment for denaturing, dried, lyophilized, and ground. The effect of the process was evaluated by characterizing the samples by Fourier Transform Infrared Spectrophotometry, Differential Scanning Calorimetry, Thermogravimetry, and parallel plate rheometry. The results showed that there was an interaction between CPC and WPI, as well as between PEG and WPI in different ways and that there was a synergy between PEG and CPC in the interaction with WPI. The results showed that the CPC may have acted in such a way as to change part of the α-helix structure to the β-sheet structure and the PEG acted in the protein's intramolecular interactions, but without changing the original structure. The rheological behavior, which means to evaluate the plastification of the material, showed the predominance of the elastic component (G′) concerning the viscous one (G″) for all samples. The use of CPC concentrations between 100 and 75 phr were the ones that resulted in a better ratio between G′ and G″and a reduction in complex viscosity. The processing applied in the modification of the WPI influenced the interactions between the components. [ABSTRACT FROM AUTHOR]

A new virus has been discovered, SARS-CoV-2 (severe acute respiratory syndrome coronavirus). SARS-CoV-2 is transmitted through aerosols or salivary droplets. Therefore, this may be a potential high-risk for viral infection and transmission in a dental clinic. After the pandemic we know that an oral viral load reduction could reduce the risk of transmission via saliva. Oral antiseptics seem to be one of useful methods in preventing viral transmission. The aim of this review was to evaluate the available evidence on the effectiveness of mouthwashes in dental care facilities. Methods: An electronic search was conducted using MEDLINE, Pubmed and Scopus databases, using systematic review method and review final information. After those we summarized results, discussed, and recommended for using proper mouthwash in dental field. A total of 308 articles were found. Six in vitro and six in vivo articles were selected, assessing the effectiveness of oral antiseptic mouthwashes. Conclusion: All documents clear evidence to support the use of antiseptics to potentially reduce the viral load of SARS-CoV-2. It is highly recommended that dental practitioners use oral antiseptics before dental procedures to protect against the transmission of Coronavirus virus and routine using in the future. [ABSTRACT FROM AUTHOR]

The fact that bacteria are one of the most important contributors to the genesis of dental disease raises the question of how to eradicate or decrease them to acceptable levels. There are several medications and procedures for preserving oral health. New scientific and technological advancements in the field of prevention equip us with a plethora of new items to improve oral health and care. Some of them are intended for use at home, while others are intended for professional use. Modern mechanical and chemotherapeutical oral hygiene treatments seek to change the oral microbiota and contribute to healthy dental and periodontal tissue. The literature has several categories of anti-microbial agents. One of these is the grouping into groups based on chemical properties, and it is this classification that this study will adhere to. This categorization divides anti-microbial agents into cationic, anionic, non-ionic agents, enzymes, and sugar alcohols. The purpose of this research is to provide a full and comprehensive assessment of antimicrobial agents for oral hygiene, their mode of action on the bacterial cell, and the relevance and value of their use in oral prevention. [ABSTRACT FROM AUTHOR]

Cetylpyridinium chloride (CPC) is a chemical compound used widely in industry, having been adopted in pharmaceutical and cosmetic formulations as a preservative, antimicrobial, and antiseptic agent. In pharmaceutical development, thermal analysis and Infrared Spectrum (FTIR) are widely used on preformulation studies. Thus, in this work we performed the thermal characterization of CPC through DSC and TG/DTA techniques, and evaluated it by FTIR to understand the thermal events that characterize CPC. In addition, its binary combinations with possible adjuvants: sugar alcohols (sorbitol and xylitol) and flavoring agents (menthol and thymol), were evaluated. Statistical analysis using Pearson's correlation allowed us to define clearly the extent of these interactions. The DSC study showed endothermic peaks at 84.09 °C and 233.84 °C for CPC. TG analysis indicated mass loss of 92.91% at a temperature of 239.57 °C. DTA evaluation showed endothermic peaks at 83.68 °C and 240.12 °C. In the FTIR analysis, bands of characteristic spectra for CPC were presented. The evaluation of binary combinations with the components studied allowed for the identification of interactions of CPC with menthol and thymol, with alterations of melting point and eutectic mixtures formation, even at room temperature, with thymol. The spectral constancy of CPC and mixtures with different components were evaluated through linear correlation, with no significant chemical interactions evidenced. This was due to the Pearson's correlation values being greater than 0.8, which represents an absence of chemical interactions between the components tested. [ABSTRACT FROM AUTHOR]

The present research work is concerned with the systematic account of the catalytic behaviour of binary surfactant solutions during the oxidation of 2-butanol by the diperiodatocuprate(III) copper(III)–periodate complex (DPC) in an aqueous solvent. The work primarily deals with the kinetics of the mixed micelle diperiodatocuprate(III) copper(III)–periodate complex (DPC)-catalysed oxidation of 2-butanol by maintaining pseudo-first-order reaction conditions. The cetylpyridinium chloride (CPC)/Triton X-100 (TX-100) mixed micelle serves as a nano-reactor for the oxidation reaction offering a micro-heterogeneous system in an aqueous media. A strong and pronounced catalytic effect has been exhibited by a mixture of CPC and TX-100 surfactants in 1:7 molar ratio compared to any of the single surfactant. The binary surfactant system cooperatively accelerated the oxidation rate of 2-butanol by reducing the reaction completion time up to 40 times. The cetyltrimethylammonium bromide (CTAB) micelle in the reaction system substantially decreased the oxidation rate compared to the reaction in aqueous media only. Proton NMR spectra are conducted to characterize the oxidation product 2-butanone. NMR data precisely correlate the interaction behaviour of CPC and TX-100 in association with the formation of mixed micellar aggregates in the reaction system. The calculated kinetic parameters such as rate constant (kobs), half-life (t1/2) and effective rate constant (keff) values for the oxidation of 2-butanol by DPC in binary surfactant system are correlated with micellar pseudo-phase model and proton NMR analysis of mixed micelles. The blended micellar catalyst has been recovered and recycled for the next reaction as soon as the oxidation of 2-butanol is finished up. [ABSTRACT FROM AUTHOR]

Perioperative oral management (POM) reduces the risk of postoperative pneumonia. Povidone iodine (PVP-I) is used in the self-care aspect of POM in Japan; however, its bactericidal capability may be reduced by dilution or saliva. Thus, we conducted a randomized parallel controlled feasibility study to evaluate the effects of 0.05% cetylpyridinium chloride (CPC) mouthwash compared to PVP-I gargle on the oral flora as perioperative self-care, in addition to brushing. A total of 100 patients scheduled for surgery, except in the head and neck region, under general anesthesia were randomly assigned into the CPC (n = 51) or PVP-I (n = 49) groups. Patients underwent clinical assessment and professional oral care (POC) before surgery, then brushed and used CPC or PVP-I products. Buccal mucosa, tongue coating, and saliva samples were collected six times in perioperative period. All samples were analyzed using 16 S rRNA gene sequencing and quantitative polymerase chain reaction. Clinical indicators and samples from 83 participants (42 and 41 in the CPC and PVP-I groups, respectively) were analyzed. Reduced dental plaque adhesion and gingival bleeding and improved total bacterial counts were observed in both groups one week after surgery. In the CPC group, Streptococcus was suppressed until one week after surgery compared with that in the PVP-I group. Our study supports the feasibility of a full-scale randomized controlled trial to determine the effects of CPC mouthwash and PVP-I gargle on the oral flora. A CPC mouthwash may maintain the antibiotic effect longer than a PVP-I gargle. [ABSTRACT FROM AUTHOR]

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Abstract Background Enterococcus faecalis (E. faecalis) is frequently isolated from root canals with failed root canal treatments. Due to the strong ability of E. faecalis to resist many often-used antimicrobials, coping with E. faecalis infections remains a challenge. The aim of this study was to investigate the synergistic antibacterial effect of low-dose cetylpyridinium chloride (CPC) and silver ions (Ag+) against E. faecalis in vitro. Methods The minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and the fractional inhibitory concentration index (FICI) were used to confirm the existence of the synergic antibacterial activity between low-dose CPC and Ag+. Colony-forming unit (CFU) counting, time-killing curve and dynamic growth curve were used to evaluate the antimicrobial effects of CPC and Ag+ combinations against planktonic E. faecalis. Four weeks biofilms were treated with drug-contained gels to determine the antimicrobial effect on biofilm-resident E.faecalis, and the integrity of E.faecalis and its biofilms were observed by FE-SEM. CCK-8 assays was used to test the cytotoxicity of CPC and Ag+ combinations on MC3T3-E1 cells. Results The results confirmed the synergistic antibacterial effect of low-dose CPC and Ag+ against both planktonic and 4-week biofilm E. faecalis. After the addition of CPC, the sensitivity of both planktonic and biofilm-resident E. faecalis to Ag+ improved, and the combination showed good biocompatibility on MC3T3-E1 cells. Conclusions Low-dose CPC enhanced the antibacterial ability of Ag+ against both planktonic and biofilm E.faecalis with good biocompatibility. It may be developed into a novel and potent antibacterial agent against E.faecalis, with low toxicity for root canal disinfection or other related medical applications.

Purpose: The effects of three preoperative mouthwashes on salivary bacterial levels were evaluated and compared between subjects with differing periodontal status.Materials and Methods: Based on periodontal parameters, periodontally healthy individuals (n = 60) and those with gingivitis (n = 60) and periodontitis (n = 60) were randomly assigned to a single preoperative dose of chlorhexidine (CHX), essential oils (EO), cetylpyridinium chloride (CPC) or negative control mouthwashes. Saliva samples were collected between 8:00 and 11:00 a.m., before and after a single-dose rinse with the respective mouthwash. Total bacterial load and levels of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola and Streptococcus oralis were determined by qPCR. Data were statistically analysed using paired t- and Student's t-tests (p < 0.05).Results: CHX, EO and CPC showed greater antimicrobial efficacy than did the negative control. CHX [1226445.53] and EO [1743639.38] provided greater reductions in comparison to both CPC [106302.96] and negative control [37852.46]). CHX provided greater reductions of simultaneous levels of Pg [106326.00], Td [3335841] and Tf [61557.47] in the healthy group, as did EO in the diseased groups. CPC provided the greatest reduction [3775319.36] in the periodontitis group.Conclusion: Periodontal status influenced the antimicrobial efficacy of preoperative mouthwashes. Therefore, periodontal status should be taken into consideration by clinicians. The antimicrobial efficacy differed among the agents tested. CHX and EO showed the greatest efficacy. The recognition of periodontal condition by clinicians is mandatory to select the most effective preoperative mouthwash. [ABSTRACT FROM AUTHOR]

Purpose: The use of a mouthwash as an adjunct to mechanical plaque removal may be useful to improve oral hygiene. In this study, cetylpyridinium chloride (CPC)-based mouthwashes containing sodium fluoride and xylitol (X-PUR Opti-Rinse 0.05% NaF and X-PUR Opti-Rinse 0.2% NaF) were evaluated for their antimicrobial activity against important oral pathogens associated with dental caries, periodontal disease, and candidiasis. Moreover, their biocompatibility and anti-inflammatory properties were assessed.Materials and Methods: Antimicrobial activity was determined using a disk-diffusion assay, a microplate dilution assay, and the European standard protocols for antiseptics. Microbicidal properties were assessed against both planktonic and biofilm cultures. An oral epithelial cell model was used to evaluate the biocompatibility of mouthwashes and their ability to attenuate cytokine secretion.Results: Using three different antimicrobial assays, the CPC-based mouthwashes were found to be highly active against the tested microorganisms. More specifically, the mouthwashes met the European Standard NF EN 1040 and NF EN 1275 defined as a log10 reduction ≥ 5 (≥ 99.999% killing) for bacteria and log10 reduction ≥ 4 (≥ 99.99% killing) for fungi, respectively. The CPC-based mouthwashes were also bactericidal against biofilms of S. mutans, S. sobrinus, and P. gingivalis. Using an oral epithelial cell model, the CPC-based mouthwashes were found to be less cytotoxic than a chlorhexidine-containing mouthwash used as control. Lastly, the CPC-based mouthwashes decreased the secretion of interleukin-6 and interleukin-8 by lipopolysaccharide-stimulated oral epithelial cells. Conclusion: The CPC-based mouthwashes supplemented with sodium fluoride (0.05% or 0.2%) and xylitol (10%) were highly active against important oral pathogens. Moreover, using an oral epithelial cell model, these mouthwashes were found to be biocompatible and to exhibit anti-inflammatory activity. [ABSTRACT FROM AUTHOR]

Controlling Salmonella in poultry processing continues to be important to processors and consumers. Cetylpyridinium chloride (CPC) has proven to be effective in vitro in controlling Salmonella. This study evaluated the recovery of Salmonella after overnight storage in 4°C filter‐sterilized carcass rinsate containing CPC from 0.44 to 909 ppm (μg/mL). Ten Salmonella serotypes (18 strains), of which 6 serotypes are commonly isolated from poultry products, were grown in Bacto‐Tryptic Soy Broth overnight at 37°C. Serial dilutions of a CPC/propylene glycol solution were prepared in 24‐well tissue culture plates containing filter‐sterilized carcass rinsate. Approximately 107 cfu/mL of each Salmonella serotype was added to the appropriate wells. Inoculated plates were stored overnight at 4°C. After storage, triplicate plates of brilliant green agar with sulfapyridine (BGS) were surface inoculated with 10 μL of the contents for each well, streaked for isolation, and incubated at 37°C for 24 h. Three replications were conducted. The presence of typical colonies on BGS plates was recorded as growth and verified through biochemical and serological testing. Of the serotypes chosen, Salmonella Kentucky, Dublin, and Enteritidis were the least resistant to CPC with a median minimum inhibitory concentration (MIC) of 14.22 μg/mL (range from 3.55 to 56.88 μg/mL); S. Typhimurium demonstrated a median MIC of 114.00 μg/mL (range from 28.44 to 114.00 μg/mL). Residual CPC potentially remaining attached to a carcass or in the weep after processing could potentially alter which Salmonella serotype is recovered from a carcass rinse due to different growth patterns during regulatory testing, with a potential for more virulent strains not to be recovered. [ABSTRACT FROM AUTHOR]

The aim of this brief overview is to give clinicians a background for assessing publications presenting in vivo human clinical trials regarding the effect of common dental mouthwashes on SARS‐CoV‐2 virus. It explains how the effects of oral mouthwashes on oro‐nasally transmitted infectious virus was assessed in the early phase of the Covid‐19 pandemic. The method of virus quantification including effect measures and factors, trial design that may cause flaws in the effect estimates presented in publications are explained. The status of in vivo human clinical trials regarding the anti‐virucidal effect of sodium lauryl sulfate, povidone‐iodine, chlorhexidine, hydrogen peroxide and cetylpyridinium chloride is presented from the few systematic reviews available at this time. [ABSTRACT FROM AUTHOR]

Mixed micelles, an emerging strategy with the potential to perform an organic reaction in aqueous phase, have been employed in the oxidation of benzyl alcohol by diperiodatoargentate(III) in alkaline media. Herein, two commonly available surfactants, cationic CPC (cetylpyridinium chloride) and nonionic Brij-35 (polyoxyethylene (23) lauryl ether), are used to fabricate the micellar assembly, which have shown a huge catalytic activity for the aforementioned oxidation process, since the reaction time reduces from 1 day to 5 min. In order to evaluate the synergistic effect of the CPC/Brij-35 binary mixture in the oxidation process, the favourable micellization, greater solubilisation of benzyl alcohol, and the significant electrostatic attraction between the negatively charged Ag(III) metal centre and the mixed micellar microenvironment have been corroborated. Dynamic light scattering, zeta potential, and 1H NMR measurements supported the kinetic profile of the oxidation while CMCs for all compositions have been determined from conductometric and fluorometric measurements. On the basis of all these results, we have suggested a possible pathway and reaction zone in mixed micellar media. [ABSTRACT FROM AUTHOR]

Introduction: Povidone-iodine 1% and cetylpyridinium chloride 0.05% mouthwashes have been used to remove microbial plaque and reduce gingivitis and the dysfunction of COVID-19. The present research was conducted to determine these two types of mouthwash effects on the shear bond strength of orthodontic brackets in laboratory conditions. Method: In this experimental-laboratory research, healthy human premolar teeth were selected and preserved in 1% thymol. The samples were divided into three groups, including control and 0.05% cetylpyridinium chloride and 1% povidone-iodine mouthwashes. The shear bond strength values of the brackets were measured with a UTM device and with a blade speed of 1 mm/min After keeping each group in mouthwash and applying thermal cycles. The Adhesive Remnant Index (ARI) observed the amount of residual adhesive using a stereomicroscope at ten magnifications. The bond strength of brackets was investigated by one-way Analysis of Variance (ANOVA) in three groups, and pairwise comparisons were performed with Tukey's test. The chi-square test also analyzed the remaining adhesive degrees in the groups. Results: Significant differences were observed in the shear bond strength of brackets in three groups (p=0.02). The bond strength of the brackets in the povidone-iodine mouthwash group was significantly higher than the control group (p=0.01). However, in other pairwise comparisons, no significant differences were observed between the groups. There were no significant differences in the amount of residual adhesive in the different groups. Conclusion: Immersion in mouthwashes, effective against COVID-19, had no adverse effects on metal orthodontic brackets' shear bond strength values. Therefore, these mouthwashes can establish oral and dental hygiene and destroy COVID-19's function in orthodontic patients. [ABSTRACT FROM AUTHOR]

Introduction: COVID‐19 is a transmissible respiratory and multisystem disease caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). Viral transmission occurs mainly through the spread of salivary droplets or aerosol from an infected subject. Studies suggest that salivary viral load is correlated with disease severity and probability of transmission. Cetylpyridinium chloride mouthwash has been found to be effective in reducing salivary viral load. The aim of this systematic review of randomized controlled trials is to evaluate the efficacy of the mouthwash ingredient cetylpyridinium chloride on salivary viral load in SARS‐CoV‐2 infection. Methods: Randomized controlled trials comparing cetylpyridinium chloride mouthwash with placebo and other mouthwash ingredients in SARS‐CoV‐2 positive individuals were identified and evaluated. Results: Six studies with a total of 301 patients that met the inclusion criteria were included. The studies reported the efficacy of cetylpyridinium chloride mouthwashes in reduction on SARS‐CoV‐2 salivary viral load compared to placebo and other mouthwash ingredients. Conclusion: Mouthwashes containing cetylpyridinium chloride are effective against salivary viral load of SARS‐CoV‐2 in vivo. There is also the possibility that the use of mouthwash containing cetylpyridinium chloride in SARS‐CoV‐2 positive subjects could reduce transmissibility and severity of COVID‐19. [ABSTRACT FROM AUTHOR]

Objectives: Aerosols and splatter are routinely generated in dental practice and can be contaminated by potentially harmful bacteria or viruses such as SARS-CoV-2. Therefore, preprocedural mouthwashes containing antiseptic agents have been proposed as a potential measure for infection control in dental practice. This review article aims to summarize the clinical (and, if insufficient, preclinical) evidence on preprocedural mouthwashes containing antiseptic agents and to draw conclusions for dental practitioners. Methods: Literature on preprocedural mouthwashes for reduction of bacterial or viral load in dental aerosols was searched and summarized. Results: Preprocedural mouthwashes, particularly those containing chlorhexidine digluconate (CHX), cetylpyridinium chloride (CPC), or essential oils (EO), can significantly reduce the bacterial load in dental aerosols. With respect to viruses such as HSV-1, there are too little clinical data to draw any clear recommendations. On the other hand, clinical data is consolidating that CPC-containing mouthwashes can temporarily reduce the intraoral viral load and infectivity in SARS-CoV-2 positive individuals. Nevertheless, potential risks and side effects due to regular antiseptic use such as ecological effects or adaptation of bacteria need to be considered. Conclusions: The use of preprocedural mouthwashes containing antiseptics can be recommended according to currently available data, but further studies are needed, particularly on the effects on other viruses besides SARS-CoV-2. When selecting a specific antiseptic, the biggest data basis currently exists for CHX, CPC, EO, or combinations thereof. Clinical relevance: Preprocedural mouthwashes containing antiseptics can serve as part of a bundle of measures for protection of dental personnel despite some remaining ambiguities and in view of potential risks and side effects. [ABSTRACT FROM AUTHOR]

Soon after the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, preprocedural mouthwashes were recommended for temporarily reducing intraoral viral load and infectivity of individuals potentially infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in order to protect medical personnel. Particularly, the antiseptic cetylpyridinium chloride (CPC) has shown virucidal effects against SARS-CoV-2 in vitro. Therefore, the aim of this randomized controlled clinical trial was to investigate the efficacy of a commercially available mouthwash containing CPC and chlorhexidine digluconate (CHX) at 0.05% each in SARS-CoV-2–positive patients as compared to a placebo mouthwash. Sixty-one patients who tested positive for SARS-CoV-2 with onset of symptoms within the last 72 h were included in this study. Oropharyngeal specimens were taken at baseline, whereupon patients had to gargle mouth and throat with 20 mL test or placebo (0.9% NaCl) mouthwash for 60 s. After 30 min, further oropharyngeal specimens were collected. Viral load was analyzed by quantitative reverse transcriptase polymerase chain reaction, and infectivity of oropharyngeal specimens was analyzed by virus rescue in cell culture and quantified via determination of tissue culture infectious doses 50% (TCID50). Data were analyzed nonparametrically (α = 0.05). Viral load slightly but significantly decreased upon gargling in the test group (P = 0.0435) but not in the placebo group. Viral infectivity as measured by TCID50 also significantly decreased in the test group (P = 0.0313), whereas there was no significant effect but a trend in the placebo group. Furthermore, it was found that the specimens from patients with a vaccine booster exhibited significantly lower infectivity at baseline as compared to those without vaccine booster (P = 0.0231). This study indicates that a preprocedural mouthwash containing CPC and CHX could slightly but significantly reduce the viral load and infectivity in SARS-CoV-2–positive patients. Further studies are needed to corroborate these results and investigate whether the observed reductions in viral load and infectivity could translate into clinically useful effects in reducing COVID-19 transmission (German Clinical Trials Register DRKS00027812). [ABSTRACT FROM AUTHOR]

Abstract Background The efficacy of mouth-rinses strongly depends upon their substantivity. The use of natural and non-toxic products that avoid secondary effects is gaining interest in preventive dentistry. The purpose of this study was to evaluate the substantivity of two formulations of mouth-washing solutions based on cetylpyridinium (CPC) and O-cymen-5-ol. Methods This was a randomized, double-blind, crossover trial conducted at the Faculty of Medicine and Health Sciences of the University of Barcelona. Bacterial re-colonization was followed by live/dead (SYTOTM9 + propidium iodide) bacterial staining and measured by confocal laser scanning microscopy and fluorometry. Unstimulated saliva samples were collected from 16 healthy individuals at baseline saliva and then, at 15 min, 30 min and 1, 2, 3, and 4 h after the following mouth-rinses: (i) a single, 1-min mouth-rinse with 15 ml of placebo (negative control); (ii) a single, 1-min mouth-rinse with 15 ml of CPC (0.05%) ; (iii) a single, 1-min mouth-rinse with 15 ml of O-cymen-5-ol (0.09%); (iv) a single, 1-min mouth-rinse with 15 ml of CPC (0.05%) + O-cymen-5-ol (0.09%). Results Proportion of dead bacteria was significantly higher for all mouthrinses during the first 15 min compared to baseline (CPC = 48.0 ± 13.9; 95% CI 40.98–56.99; p

Abstract Oral health is a window to a patient’s general well-being. Balance in oral microbiome functions is crucial for health maintenance. A state of oral dysbiosis may lead to a variety of local and systemic pathological conditions. The presence of dental plaque is related to the majority of oral infections. Proper oral hygiene is crucial and the most economic practice contributing to oral health prophylaxis. Aside from prophylactic treatments provided by dental practitioners, mouth rinses, containing antimicrobial agents, are one of the possible tools used for oral care. Our study was to determine whether available mouth rinses and selected products dedicated for professional use are efficient to eradicate biofilm formed by reference and clinical strains of Streptococcus mutans, Streptococcus sanguinis, Streptococcus oralis, Streptococcus mitis, Staphylococcus aureus, Enterococcus faecalis, Lactobacillus rhamnosus and Candida albicans on the surface of hydroxyapatite – major mineral component of a tooth. Therefore, such antimicrobials as chlorhexidine, cetylpyridine chloride, polyhexanide, silver nanoparticles, sulphonated phenolics, and natural antiplaque essential oils and coconut oil were analyzed. Applied experimental settings in in vitro models were designed to reflect accurately the recommended use of the tested substances, therefore four types of eradication procedure were conducted. Sialorrhea simulation was also performed to evaluate antibiofilm potential of diluted mouth rinses. Biofilm was investigated with quantitative method where absorbance values were measured. Statistical differences were assessed using the Kruskal–Wallis test with a post-hoc Dunnett’s analysis. Results have shown that biofilms displayed a diversified sensitivity to the tested antimicrobials. The highest antibiofilm activity was detected for cetylpyridine chloride while the lowest for chlorhexidine. However the differences in E. faecalis biofilm reduction observed after the use of these two compounds were not statistically significant (p > 0.05), whereas all observed differences in S. aureus survival after exposure to the examined antimicrobial agents were statistically significant (p

Concern about microbial tolerance and resistance to established antimicrobials drives research into alternatives for local antiseptic wound treatment. Precise efficacy profiles are thereby important in the evaluation of potential alternative antimicrobials, and protein interference (“protein error”) is a key factor. Here, the antimicrobial efficacy of cetylpyridinium chloride (CPC) and miramistin (MST) was compared to the established antimicrobials octenidine (OCT), povidon-iodine (PVP-I), polyhexamethylene-biguanide (PHMB) and chlorhexidine (CHX). Efficacy was evaluated after 0.5, 1, 3, 5 and 10 min against Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, Enterococcus faecium and Candida albicans using an in vitro quantitative suspension method (based on DIN EN 13727). To investigate protein interference, 0.3% or 3% bovine albumin was used as the challenge. OCT and PVP-I demonstrated a significant efficacy within 0.5 min, regardless of the microbial organism and protein challenge (p < 0.01). CPC and MST showed no inferiority in efficacy, with only MST needing up to 3 min to achieve the same microbial reduction. PHMB and CHX also achieved significant reduction rates over the tested time-course, yet demonstrated a necessity for prolonged exposure (up to 10 min) for comparable reduction. A protein interference was predominantly observed for PHMB against S. aureus, but without statistically significant differences in antimicrobial efficacy between the 0.3% and 3% protein challenges. All other tested agents showed no relevant interference with the presence of protein. CPC and MST proved to be non-inferior to established wound antiseptics agents in vitro. In fact, CPC showed a more efficient reduction than PHMB and CHX despite there being an introduced protein challenge. Both agents demonstrated no significant “protein error” under challenging conditions (3% albumin), posing them as valid potential candidates for alternative antimicrobials in wound management.

Cetylpyridinium chloride (CPC) is effective against respiratory viruses, including influenza. Septolete Total, lozenges containing CPC and benzydamine, demonstrated virucidal activity against influenza A virus, higher than CPC alone.

Natural products are well-known due to their antimicrobial properties. This study aimed to evaluate the antimicrobial effect of Desplac® product (composed of Aloe Vera, Propolis Extract, Green Tea, Cranberry, and Calendula) on the subgingival biofilm. Two different protocols were used to treat the 33-species biofilms: (A) 2×/day (12/12 h) for 1 min with Desplac® or Noplak Toothpaste (Chlorhexidine + Cetylpyridinium Chloride) or Oral B ProGengiva (stannous Fluoride) or a placebo gel; (B) a 12-h use of the Desplac® product or 0.12% chlorhexidine gel or a placebo gel. After 7 days of biofilm formation, the metabolic activity (MA) and biofilm profile were determined by 2,3,5-triphenyltetrazolium chloride and Checker-board DNA-DNA hybridization, respectively. Statistical analysis used the Kruskal-Wallis test followed by Dunn's post-hoc. In protocol A, all treatments presented reduced MA compared to the placebo (p = 0.05). The Desplac®-treated biofilm showed a similar microbial profile to other antimicrobials, although with higher bacterial total counts. In protocol B, MA of Desplac®-treated biofilms was lower than the placebo's MA but higher than chlorhexidine-treated biofilms (p = 0.05). Pathogen levels in Desplac®-treated biofilms were lower than in placebo-treated biofilms and elevated compared to the chlorhexidine-treated biofilms (p = 0.05). Desplac® inhibited the biofilm development and disrupted the mature subgingival biofilm, highlighting its effect on Tannerella forsythia counts. [ABSTRACT FROM AUTHOR]

Background: Enterococcus faecalis (E. faecalis) is frequently isolated from root canals with failed root canal treatments. Due to the strong ability of E. faecalis to resist many often-used antimicrobials, coping with E. faecalis infections remains a challenge. The aim of this study was to investigate the synergistic antibacterial effect of low-dose cetylpyridinium chloride (CPC) and silver ions (Ag+) against E. faecalis in vitro. Methods: The minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) and the fractional inhibitory concentration index (FICI) were used to confirm the existence of the synergic antibacterial activity between low-dose CPC and Ag+. Colony-forming unit (CFU) counting, time-killing curve and dynamic growth curve were used to evaluate the antimicrobial effects of CPC and Ag+ combinations against planktonic E. faecalis. Four weeks biofilms were treated with drug-contained gels to determine the antimicrobial effect on biofilm-resident E.faecalis, and the integrity of E.faecalis and its biofilms were observed by FE-SEM. CCK-8 assays was used to test the cytotoxicity of CPC and Ag+ combinations on MC3T3-E1 cells. Results: The results confirmed the synergistic antibacterial effect of low-dose CPC and Ag+ against both planktonic and 4-week biofilm E. faecalis. After the addition of CPC, the sensitivity of both planktonic and biofilm-resident E. faecalis to Ag+ improved, and the combination showed good biocompatibility on MC3T3-E1 cells. Conclusions: Low-dose CPC enhanced the antibacterial ability of Ag+ against both planktonic and biofilm E.faecalis with good biocompatibility. It may be developed into a novel and potent antibacterial agent against E.faecalis, with low toxicity for root canal disinfection or other related medical applications. [ABSTRACT FROM AUTHOR]

Owing to their surface active properties, surfactants have numerous applications in different fields of life. In the present research work, the solubilization of reactive red 2 (RR2) has been studied in single and mixed micellar systems (MMS) using UV-visible spectroscopy and electrical conductivity measurements. The interaction of RR2 with ionic micelles of cetylpyridinium chloride (CPC) was investigated. In order to probe the interaction of RR2 in MMS, mixtures of CPC and TX-114 (Triton X-114, a nonionic surfactant) were used. UV-visible spectroscopy has been used to obtain the degree of solubilization of RR2 in terms of the partition coefficient (Kc) and Gibbs free energy of partitioning (ΔG°p). Electrical conductivity data have been employed to detect the critical micelle concentration (CMC) of the surfactant systems in the presence of RR2 and, accordingly, to calculate the thermodynamic parameters of the micellization. From the obtained data, it is concluded that the micellization is spontaneous at all studied temperatures. Moreover, the micellization was observed to be driven by both enthalpy and entropy. The results also indicated that MMS have better solubilizing power than single micellar solutions. [ABSTRACT FROM AUTHOR]

Despite being able to adhesively restore teeth, adhesives and cement do not possess any anticariogenic protection potential, by which caries recurrence may still occur and reduce the clinical lifetime of adhesive restorations. Several antibacterial agents have been incorporated into dental adhesives and cement to render them anticariogenic. Due to an additional therapeutic effect, such materials are classified as 'dental combination products' with more strict market regulations. We incorporated cetylpyridinium chloride (CPC), often used for oral hygiene applications, into montmorillonite (CPC-Mont), the latter to serve as a carrier for controlled CPC release. CPC-Mont incorporated into tissue conditioner has been approved by the Pharmaceuticals and Medical Devices Agency (PmontMDA) in Japan. To produce a clinically effective dental cement with the antibacterial potential to prevent secondary caries, we incorporated CPC-Mont into PMMA resin cement. We measured the flexural strength, shear bond strength onto dentin, CPC release, and the biofilm-inhibition potential of the experimental CPC-Mont-containing PMMA cement. An 8 and 10 wt% CPC-Mont concentration revealed the antibacterial potential without reducing the mechanical properties of the PMMA cement. [ABSTRACT FROM AUTHOR]

The spectrophotometric and fluorescent characteristics of the surfactant-modified molybdenum (VI) - bromopyrogallol red reagent system were studied. The hydrophobic modification was achieved by adding cationic, nonionic surfactants, or, accordingly, mixtures of surfactant modifiers into the metal reagent system. Modification of the metal reagent system with a nonionic surfactant leads to a decrease in the limit of detection of the hydrophobic organic cation in the molybdenum (VI) - bromopyrogallol red system by the fluorescence method and an increase in the contrast of the spectrophotometric reaction. The colloid-chemical state of molybdenum (VI) - bromopyrogallol red solutions in the presence of cationic surfactant, nonionic surfactant, and their mixture was also investigated. An increase in the turbidity of the investigated solutions is registered under the conditions of a decrease in the scattering factor, which, in turn, increases the limit of detection of the spectrophotometric determination of decamethoxine in the surfactant-modified molybdenum (VI) - bromopyrogallol red system. Based on the obtained results, the conditions for controlled modification of the metal reagent system with surfactants for the determination of hydrophobic organic cations by molecular spectroscopy methods were proposed. Fluorescence and spectrophotometric detection of decamethoxine content in medicines was carried out in optimized surfactant-modified molybdenum (VI) - bromopyrogallol red systems. [ABSTRACT FROM AUTHOR]

Purpose This study aimed to assess the effectiveness of ultrasonic denture hygiene interventions in improving denture cleanliness among elderly individuals. Materials and Methods Sixty-six participants who had received upper metal framework removable partial dentures within the past 5 years were randomly allocated into three denture hygiene intervention groups: group 1 (mechanical cleaning with a toothbrush and ultrasonic cleaning with cetylpyridinium chloride), group 2 (mechanical cleaning with a toothbrush and ultrasonic cleaning with distilled water), and control (mechanical cleaning with a toothbrush only). Denture cleanliness was assessed at baseline and 1-month using: i) Denture Cleanliness Index (DCI) scores; ii) plaque coverage percentage; and (iii) microbiological samples for bacterial and yeast detection. Differences between groups were assessed with one-way analysis of variance and Chi-squared tests. Results Mean DCI scores and mean percentages of plaque coverage area were significantly reduced in group 1 and group 2, compared to the control group for both cobalt chromium (CoCr) and acrylic fitting surfaces (p<0.001). No significant differences were found between groups 1 and 2 with regard to the prevalence and viable counts of yeasts or total microbial viable counts. No significant differences in the investigated clinical and microbiological parameters were observed between CoCr and acrylic surfaces following the intervention period. Conclusion The ultrasonic cleaner was significantly more effective than mechanical cleaning in the reduction of biofilm coverage on metal framework removable partial dentures over a 1-month intervention period. Nevertheless, the adjunctive use of cetylpyridinium chloride with ultrasonic cleaning did not yield additional benefits. [ABSTRACT FROM AUTHOR]

Purpose: Existing options for attaching facial and somato prostheses, such as skin adhesives, are problematic because of microbial colonization and skin irritation. This study aims to evaluate the suitability of adhesive polyurethane gel sheets containing cetylpyridinium chloride (CPC)-montmorillonite (Mont) for prosthesis fastening. Methods: Adhesive gel sheets were fabricated as mixtures of base resin (99.6 wt% polyol) and hardening agent at a ratio of 3:1 with 0 (control), 2, 5, 10, or 15 wt% CPC-Mont. The controlled release of CPC, antimicrobial activity, in vitro skin irritation, and adhesive force against silicone and human skin at different blending ratios were determined. Statistical analyses of the data were performed using one-way analysis of variance (ANOVA), analysis of covariance (ANCOVA), Tukey's test, or single regression analysis, as appropriate. Results: The amount of CPC released increased with the CPC-Mont blending ratio and was linearly proportional to the surface occupation area ratio of CPC-Mont. The samples with >5 wt% CPC-Mont exhibited antimicrobial activity against Staphylococcus aureus at an exposure time of 0 d, and samples with >2 wt% CPC-Mont exhibited antimicrobial activity against Candida albicans at an exposure time of 1 d. All samples were classified as non-irritant based on an in vitro skin irritation test. The adhesive force on the silicone material and human skin decreased with increasing CPC-Mont blending ratio. Conclusions: Samples with 5 wt% CPC-Mont are potential candidates as antimicrobial adhesive polyurethane gel sheets for fastening facial and somato prostheses. [ABSTRACT FROM AUTHOR]

Combination therapies appear to be beneficial for preventing bacterial resistance to antibacterial approaches. The aim of this study was to define and determine an optimal effective concentration combination (OPECC) for binary application of antibacterial compounds. The antiseptics chlorhexidine (CHX), benzalkonium chloride (BAC), and cetylpyridinium chloride (CPC), as well as the antibiotic ciprofloxacin (CIP), were tested against planktonic Escherichia coli in binary combinations by applying a checkerboard assay, and then evaluated according to the established synergism principles. Extending the checkerboard method, the optical density (OD) of the wells was measured photometrically. On the borderline between effective (OD = 0) and non-effective (OD > 0) eradication of the bacterial cultures, the OPECC was determined. Binary combinations of CPC or CHX with BAC were assessed as either synergistic or indifferent, respectively, while there was no OPECC to calculate. For all other binary combinations, an OPECC was derivable, and these were assessed as either synergistic or indifferent. In conclusion, the evaluation of the binary combination application of antibacterial compounds based on the checkerboard method was refined to such an extent that it was possible to determine at least one concentration pair that could be defined and considered as an OPECC, independently of the evaluation of the system according to the different synergy principles. In general, the method presented herein for determining an OPECC can be applied to any conceivable method or system aimed at the eradication of a pathogen. [ABSTRACT FROM AUTHOR]

This work aimed to evaluate and compare the antimicrobial actions and effects over time of eight types of mouthwash, based on the impact of chlorhexidine on the main microorganisms that are responsible for oral diseases: Enterococcus faecalis, Pseudomonas aeruginosa, and Candida albicans. The mouthwashes' antimicrobial action was determined in terms of their minimum inhibitory concentration (MIC), minimum bactericidal/fungicidal concentration (MBC/MFC), and time-kill curves at different contact times (10 s, 30 s, 60 s, 5 min, 15 min, 30 min, and 60 min), against selected oral microorganisms. All the mouthwashes showed a notable effect against C. albicans (MICs ranging from 0.02% to 0.09%), and higher MIC values were recorded with P. aeruginosa (1.56% to >50%). In general, the mouthwashes showed similar antimicrobial effects at reduced contact times (10, 30, and 60 s) against all the tested microorganisms, except with P. aeruginosa, for which the most significant effect was observed with a long time (15, 30, and 60 min). The results demonstrate significant differences in the antimicrobial actions of the tested mouthwashes, although all contained chlorhexidine and most of them also contained cetylpyridinium chloride. The relevant antimicrobial effects of all the tested mouthwashes, and those with the best higher antimicrobial action, were recorded by A—GUM® PAROEX®A and B—GUM® PAROEX®, considering their effects against the resistant microorganisms and their MIC values. [ABSTRACT FROM AUTHOR]

Objective: To determine the combined antitumor effect of bismuth lipophilic nanoparticles (BisBAL NP) and cetylpyridinium chloride (CPC) on human lung tumor cells. Material and methods: The human lung tumor cells A549 were exposed to 1–100 µM BisBAL NP or CPC, either separately or in a 1:1 combination. Cell viability was measured with the PrestoBlue assay, the LIVE/DEAD assay, and fluorescence microscopy. The integrity and morphology of cellular microtubules were analyzed by immunofluorescence. Results: A 24-h exposure to 1 µM solutions reduced A549 growth with 21.5% for BisBAL NP, 70.5% for CPC, and 92.4% for the combination (p < 0.0001), while a 50 µM BisBAL NP/CPC mixture inhibited cell growth with 99% (p < 0.0001). BisBAL NP-curcumin conjugates were internalized within 30 min of exposure and could be traced within the nucleus of tumor cells within 2 h. BisBAL NP, but not CPC, interfered with microtubule organization, thus interrupting cell replication, similar to the action mechanism of docetaxel. Conclusion: The growth inhibition of A549 human tumor cells by BisBAL NP and CPC was cumulative as of 1 µM. The BisBAL NP/CPC combination may constitute an innovative and cost-effective alternative for treating human lung cancer. [ABSTRACT FROM AUTHOR]

This investigation reports the synthesis of ZnO nanoparticles from various sources of zinc salts via a microwave-assisted method. Furthermore, the synthesized ZnO nanoparticles were capped with different capping agents such as sodium hexametaphosphate (SHMP), polyvinylpyrrolidone (PVP), and cetylpyridinium chloride (CPC) to examine the stability and characteristics of ZnO nanoparticles. The synthesized ZnO nanoparticles were characterized with sophisticated analytical techniques such as XRD, FTIR, SEM, UV–vis DRS, Raman, and PL to understand their properties. From these studies, the XRD depicts the decrease in crystallinity of ZnO nanoparticles with the addition of different capping agents, and the morphology of the ZnO nanoparticles was influenced by capping agents as evidenced by SEM. The band gap of the synthesized ZnO nanoparticles is found to decrease with different capping agents confirmed by UV–Vis DRS studies. Furthermore, the photocatalytic degradation performance of the prepared samples is assessed by the degradation of methylene blue under visible light irradiation. The ZnO nanoparticles synthesized from the Zinc nitrate source with SHMP capping agent show a greater extent of photocatalytic degradation efficiency than other Zinc sources. After 60 min of light, MB was observed to have degraded by about 80%, and hence, zinc nitrate is a suitable source to synthesize ZnO. [ABSTRACT FROM AUTHOR]

The use of environmentally benign nanoreactors in water is crucial for sustainable organic synthesis. Herein, we report that nanomicelles formulated by two surfactants (cationic cetylpyridinium chloride (CPC) and nonionic polyoxyethylene (23) lauryl ether (Brij-35)) in water produce efficient catalysis of diperiodatoargentate(III) directed oxidation of unsaturated alcohol, isoprenol. Interestingly, the maximum speed of reaction was observed when CPC and Brij-35 existed together in a 1 : 1 mole ratio. The kinetic outcome was elucidated with the help of 1H NMR analysis and favourable micellization of the binary surfactant system. The various mixed micellar microenvironment influences the reaction rate following the confinement of reactants at close proximity to the micellar pseudophase. The reaction, performed through this green envelope of mixed micellar media, reduces the time of reaction effectively. [ABSTRACT FROM AUTHOR]

Aim: Aerosols released from the oral cavity help spread the SARS‐CoV‐2 virus. The use of a mouthwash formulated with an antiviral agent could reduce the viral load in saliva, helping to lower the spread of the virus. The aim of this study was to assess the efficacy of a mouthwash with 0.07% cetylpyridinium chloride (CPC) to reduce the viral load in the saliva of Coronavirus disease 2019 (COVID‐19) patients. Materials and Methods: In this multi‐centre, single‐blind, randomized, parallel group clinical trial, 80 COVID‐19 patients were enrolled and randomized to two groups, namely test (n = 40) and placebo (n = 40). Saliva samples were collected at baseline and 2 h after rinsing. The samples were analysed by reverse transcription‐quantitative polymerase chain reaction (RT‐qPCR) and an enzyme‐linked immunosorbent assay test specific for the nucleocapsid (N) protein of SARS‐CoV‐2. Results: With RT‐qPCR, no significant differences were observed between the placebo group and the test group. However, 2 h after a single rinse, N protein concentration in saliva was significantly higher in the test group, indicating an increase in lysed virus. Conclusions: The use of 0.07% CPC mouthwash induced a significant increase in N protein detection in the saliva of COVID‐19 patients. Lysis of the virus in the mouth could help reduce the transmission of SARS‐CoV‐2. However, more studies are required to prove this. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the effect of cetylpyridinium chloride (CPC) addition on the antibacterial and surface hardness characteristics of two commercial resin-based dental composites (RBDCs). A total of two hundred and seventy (n = 270) specimens from Filtek Z250 Universal and Filtek Z350 XT flowable RBDCs were fabricated with the addition of CPC at 2 %wt and 4 %wt concentrations to assess their antibacterial activity using the agar diffusion test and direct contact inhibition test, and their surface hardness using the Vickers microhardness test after 1 day, 30 days, and 90 days of aging. A surface morphology analysis of the specimens was performed using a scanning electron microscope (SEM). The RBDCs that contained 2 %wt and 4 %wt CPC demonstrated significant antibacterial activity against Streptococcus mutans up to 90 days, with the highest activity observed for the 4 %wt concentration. Nevertheless, there was a reduction in antibacterial effectiveness over time. Moreover, compared to the control (0 %wt) and 2 %wt CPC groups, the universal RBDCs containing 4 %wt CPC exhibited a notable decrease in surface hardness, while all groups showed a decline in hardness over time. In conclusion, the satisfactory combination of the antibacterial effect and surface hardness property of RBDCs was revealed with the addition of a 2 %wt CPC concentration.

Mouthwashes containing cetylpyridinium chloride (CPC) or on-demand aqueous chlorine dioxide (ACD) have potential to reduce the salivary severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) load in individuals with SARS-CoV-2 infection. This study will evaluate the effect of CPC and on-demand ACD mouthwashes on salivary SARS-CoV-2 levels in individuals with acute asymptomatic or mild SARS-CoV-2 infection (COVID-19) staying in a residential recuperation facility in Osaka, Japan. This randomized, open-label clinical trial will include three equal-sized groups (CPC mouthwash, on-demand ACD mouthwash, and placebo), with 30 participants per group. A stratified replacement block method will be used to ensure balanced allocation based on symptom presence and days since symptom onset. Participants will use mouthwash at set times for 7 days or until the end of recuperation. Saliva samples will be collected at multiple time points and tested for SARS-CoV-2 using quantitative reverse transcription polymerase chain reaction. The primary outcome will be changes in salivary SARS-CoV-2 viral load 2 h after the first mouthwash use compared with the pre-mouthwash level. Secondary outcomes will include changes in salivary viral load and clinical parameters at different time points. This study was registered with the Japan Registry of Clinical Trials on 18 October 2022 (jRCTs051220107).

Purpose: To evaluate the efficacy of SmartMouth Clinical DDS compared with 0.12% chlorhexidine and placebo mouthrinses.Materials and Methods: Seventy-six subjects with gingivitis or chronic periodontitis were enrolled in a double-blind, placebo-controlled, clinical study. Examinations included Gingival Index (GI), Bleeding Score (BS), Plaque Index (PI), Tooth Stain Index (TSI), and Calculus Index (CI). Subjects were given a prophylaxis and oral hygiene instructions at the time of enrolment. Subjects were assigned to one of three groups: SmartMouth Clinical DDS (SM), 0.12% chlorhexidine (CHX), or placebo (PL). Subjects were examined at 3 and 6 weeks. Data were evaluated as differences from baseline for each group. Analysis of variance (ANOVA), t tests or non-parametric alternatives were used to analyse data.Results: The GI, BS and PI decreases from baseline were statistically significant at both 3 and 6 weeks for all three groups (p ≤ 0.025). Differences between groups were not statistically significant, except that the PI decrease for CHX was significantly greater than PL at 6 weeks (p = 0.048). At 6 weeks there was a statistically significant increase in TSI for CHX (p ≤ 0.001). CI decreased significantly for all groups at 3 weeks (p ≤ 0.004) and for PL at 6 weeks (p ˂ 0.001). At 3 weeks and 6 weeks, the percentages for compliance were significantly higher for SM and PL than for CHX (p ˂ 0.001). SM had less taste alteration reported than CHX (p = 0.003).Conclusion: While all three groups were shown to improve GI, BS and PI scores; non-prescription SM resulted in less taste alteration, less tooth stain and better compliance than CHX. [ABSTRACT FROM AUTHOR]

الملخص: أهداف البحث: تقييم الفعالية المضادة للبكتيريا والترسبات لغسول الفم المتاح تجاريًا المحتوي على الصبار وبيروكسيد الهيدروجين وكلوريد سيتيل بيريدينيوم من خلال دراسة إعادة نمو الترسبات لمدة 4 أيام. طرق البحث: تم تقييم درجة الترسبات والعينات اللعابية (اليوم 0 واليوم 4) لعدد 96 مشاركا في تجربة عشوائية منضبطة متوازية الذراع لمدة 4 أيام. تم تقسيم المشاركين إلى خمس مجموعات امتنعت عن تدابير نظافة الفم المعتادة خلال فترة الدراسة واستخدموا غسول الفم المتاح تجاريا والذي يحتوي على الصبار أو بيروكسيد الهيدروجين أو كلوريد سيتيل بيريدينيوم كمنتجات اختبار مع الماء المقطر كعنصر تحكم سلبي وغسول الفم الكلورهيكسيدين كعنصر تحكم إيجابي. تم التعبير عن العد البكتيري اللعابي كوحدات تشكيل مستعمرة (طريقة الاستزراع). النتائج: كان هناك فرق كبير في درجة الترسبات و العد البكتيري اللعابي بين غسولات الفم في اليوم الرابع من الدراسة. كانت درجة الترسبات و العد البكتيري اللعابي لغسول الفم المحتوي على الصبار أقل بكثير من الماء المقطر وأعلى بكثير من غسول الفم الكلورهيكسيدين. كانت درجة الترسبات لغسول الفم المحتوي على بيروكسيد الهيدروجين أعلى بكثير من غسول الفم المحتوي على الصبار وغسول الفم المحتوي على كلوريد سيتيل بيريدينيوم . لم يلاحظ أي فرق بين غسول الفم المحتوي على الصبار و كلوريد سيتيل بيريدينيوم . أيضًا ، العد البكتيري اللعابي لبيروكسيد الهيدروجين كان أعلى من كلوريد سيتيل بيريدينيوم. لم يكن هناك فرق إحصائي بين العد البكتيري اللعابي لغسول الفم المحتوي على الصبار وبيروكسيد الهيدروجين أو الصبار وكلوريد سيتيل بيريدينيوم لم يلاحظ أي فرق للحد من الترسبات و العد البكتيري اللعابي بين غسول الفم المتاح تجاريا المحتوي على الصبار وبيروكسيد الهيدروجين وكلوريد سيتيل بيريدينيوم. الاستنتاجات: كانت الفعالية المضادة للبلاك والمضادة للبكتيريا لغسول الفم المتاح تجاريا المحتوي على الصبار مماثلة لـغسول الفم المحتوي على كلوريد سيتيل بيريدينيوم وأفضل بكثير من غسول الفم المحتوي على بيروكسيد الهيدروجين ومن الممكن أن تكون بديلا طبيعيا لغسول الفم المصنوع كيميائيا. Abstract: Objectives: To evaluate the antiplaque and antibacterial efficacy of commercially available mouthwashes containing aloe vera (AV), hydrogen peroxide (HP), and cetylpyridinium chloride (CPC) in a 4-day plaque regrowth study. Methods: Plaque score and salivary samples were assessed (Day-0 and Day-4) in 96 participants in a randomised, double-blind prospective parallel-arm 4-day plaque regrowth study. Participants were divided into five groups who refrained from engaging in regular oral hygiene measures during the study period and used commercially available mouthwashes containing AV, HP, and CPC as test products with distilled water (DW) and chlorhexidine (CHX) mouthwash as negative and positive controls, respectively. Salivary bacterial count was expressed as colony-forming units (CFU) (culture method). Results: There was a significant difference both in plaque score (p

Aim: Dentinal tubules serve as disease‐causing channels for infiltration and penetration of bacteria and their by‐products; which are regarded as the major driver of pathogenesis in pulpal inflammation and infection. In this study, we aimed to evaluate the transdentinal potential of nanoscale cetylpyridinium chloride/cholesterol (CPC/Chol) sterosomes, which are a recently developed type of cationic non‐phospholipid liposomal nanocarrier; as well as their intrinsic and universal antibacterial activity. Methodology: Cetylpyridinium chloride/cholesterol sterosomes were formulated, with a hydrodynamic diameter of 134 ± 4 nm, a low polydisperse index of 0.161 ± 0.007, and a positive zeta potential of 41 ± 3 mV at pH 7.4. Transdentinal diffusion ability of sterosomes was evaluated using human dentine blocks in vitro, and Wistar rat molar teeth in vivo. The intrinsic antibacterial activities of CPC/Chol sterosomes against Enterococcus faecalis, Streptococcus mutans, Fusobacterium nucleatum, and Porphyromonas gingivalis were further examined. Results: Cetylpyridinium chloride/cholesterol sterosomes successfully penetrated through the dentinal tubules, and diffused into the pulp, which could be internalized by dental pulp cells with a high efficiency. In addition, they exhibited substantial levels of intrinsic antibacterial activity against these Gram‐positive and Gram‐negative endodontic bacteria and their biofilms. Conclusions: Given its high penetration and diffusion ability through the dentine and pulp, great potential for multi‐drug delivery, and distinct intrinsic antibacterial activity; sterosome‐based nanocarriers might serve as a promising therapeutic strategy aimed at targeting various specific pathways associated with pulpal diseases. This will help determine and characterize the most appropriate prophylactic and therapeutic targets for early intervention in our future dentistry practice. [ABSTRACT FROM AUTHOR]

Quaternary ammonium compounds, including benzalkonium chloride (BAC) and cetylpyridinium chloride (CPC), are widely used as disinfectants. Increased use of inhalable products containing BAC or CPC has raised concerns for lung toxicity. This study sought to elucidate the microstructure of plasma membrane damage caused by BAC and CPC and the subsequent mechanism by which the damage is mediated, as assessed using two human pulmonary epithelial cell lines (A549 and BEAS-2B). Scanning electron microscopic observation showed that exposure to BAC or CPC for 3 hr reduced the length and density of microvilli on the plasma membrane in A549 cells. Analysis of cell cycle distribution following plasma membrane damage revealed that BAC and CPC promote G0/G1 cell cycle arrest in both cell lines. The protein levels of Cdc6, an essential regulator of DNA replication during G1/S transition, are decreased significantly and dose dependently by BAC or CPC exposure. CPC and BAC decreased the Cdc6 levels that had been increased by a PI3K agonist in A549 cells, and levels of phosphorylated AKT were reduced in response to BAC or CPC. Conversely, exposure to equivalent concentrations of pyridinium chloride (lacking a hydrocarbon tail) induce no changes. These results suggest that plasma membrane damage triggered by BAC or CPC causes Cdc6-dependent G0/G1 cell cycle arrest in pulmonary cells. These effects are attributable to the long alkyl chains of BAC and CPC. The reduction of Cdc6 following plasma membrane damage may be caused, at least in part, by diminished signaling via the PI3K/AKT pathway. [ABSTRACT FROM AUTHOR]

Although autopolymerizing resin offers numerous applications in orthodontic treatment, plaque tends to accumulate between the appliance and the mucosa, which increases the number of microorganisms present. In this study, we added cetylpyridinium chloride (CPC) loaded montmorillonite (Mont) and nanoporous silica (NPS) to autopolymerizing resin (resin-Mont, resin-NPS) and evaluated their drug release capacity, antimicrobial capacity, drug reuptake capacity, mechanical strength, and color tone for the devolvement of autopolymerizing resin with antimicrobial properties. As observed, resin-Mont and resin-NPS were capable of the sustained release of CPC for 14 d, and a higher amount of CPC was released compared to that of resin-CPC. Additionally, resin-Mont and resin-NPS could reuptake CPC. Moreover, the antimicrobial studies demonstrated that resin-Mont and resin-NPS could release effective amounts of CPC against Streptococcus mutans for 14 d and 7 d after reuptake, respectively. Compared to resin-CPC, resin-Mont exhibited a higher sustained release of CPC in all periods, both in the initial sustained release and after reuptake. However, the mechanical strength decreased with the addition of Mont and NPS, with a 36% reduction observed in flexural strength for resin-Mont and 25% for resin-NPS. The application of these results to the resin portion of the orthodontic appliances can prevent bacterial growth on the surface, as well as on the interior, of the appliances and mitigate the inflammation of the mucosa. [ABSTRACT FROM AUTHOR]

Open fractures and internal fixation implants are often accompanied by bacterial infection, leading to osteomyelitis, characterized by intractable bone infection and sequestrum formation, and can result in lifelong disability or fatal sepsis. As common clinical treatment strategies, high-dose antibiotic application and autologous bone transplantation face the risk of recurrence and donor site injury. Herein, we designed and prepared a novel drug delivery system by rational selection of the antibacterial single-chain amphiphile (cetylpyridinium chloride, CPC) and osteoinductive sterol (20S-hydroxycholesterol, Oxy) to formulate CPC/Oxy sterosomes. We demonstrate their excellent biocompatibility and antibacterial ability through 2D and 3D settings in vitro. In addition, the osteogenic differentiation of bone marrow mesenchymal stem cells was investigated in cell monolayers and a hydrogel environment. Moreover, a rat infected critical-sized calvarial defect model was employed to illustrate the effects of antibacterial and osteogenic CPC/Oxy sterosomes in vivo. Our results showed that CPC/Oxy sterosomes not only exterminated bacterial infections, but also enhanced calvarial healing without additional antibiotics, bone formation promoters or exogenous cells. This research provides a promising and effective multifunctional sterosomal platform for the treatment of infected bone defects, with the potential to be combined with therapeutic genes, and small molecule drugs. [Display omitted] [ABSTRACT FROM AUTHOR]

Objectives: This study determined the efficacy of alcohol‐free 0.05% cetylpyridinium chloride (CPC) mouthwash as an adjunct to twice‐daily toothbrushing in comparison with 0.12% chlorhexidine gluconate (CHX) mouthwash and a placebo in reducing plaque accumulation and gingival inflammation. The side effects of the mouthwashes were also determined. Materials and Methods: A double‐blind, parallel, randomized control trial was conducted with 219 university students who were divided into three trial groups using block randomization: CPC, CHX and placebo groups. Clinical oral examinations to assess dental plaque accumulation (modified Quigley‐Hein Plaque Index), gingival health (Löe and Silness Gingival Index) and tooth staining (modified Lobene Stain Index) were performed at baseline and at 6 weeks. Results: Plaque and gingivitis scores were not significantly different among participants at baseline. After 6 weeks, plaque and gingivitis scores between the CPC and placebo groups and between the CHX and placebo groups were found to be significantly different. However, there was no significant difference between the CPC and CHX groups. The staining scores of participants in the CPC group were lower than those in the CHX group, but the difference was not significant. Taste alteration and numbness were more common among participants in the CHX group than in the CPC group. No significant difference in the perception of a burning sensation was observed. Conclusions: The 0.05% CPC mouthwash was as efficient as 0.12% CHX mouthwash in reducing dental plaque accumulation and gingival inflammation with fewer side effects, supporting its use as an adjunct to toothbrushing. [ABSTRACT FROM AUTHOR]

Aim: To analyze and compare the effectiveness of two antibacterial gels in the treatment of mucositis. Methods: After signing the informed consent, in accordance with the Helsinki Declaration of 1975, revised in 2000, 21 patients were included in the study and divided by randomization into two groups. At the baseline, the modified bleeding index (mBI) and plaque index (PI) values were measured, and an oral hygiene and implant disinfection session was carried out. The session was repeated at 7, 15, and 30 days and after 2 and 3 months from the baseline. Two products were used—a bioadhesive gel in the test group and a 1% chlorhexidine gel in the control group. Results: Due to three dropouts, the final sample was composed of 18 patients. An improvement in periodontal indices was observed, similar to mBI and PI values, in both groups. There were no complications except for the appearance of pigmentations in the control group. Conclusions: The antibacterial power and effectiveness of the two gels are comparable. Considering the small sample size of the study cohort, further studies are needed to validate the results obtained from this pilot study. [ABSTRACT FROM AUTHOR]

The occurrence of candidiasis, including superficial infections, has recently increased dramatically, especially in immunocompromised patients. Their treatment is often ineffective due to the resistance of yeasts to antimycotics. Therefore, there is a need to search for new antifungals. The aim of this study was to determine the antifungal effect of clove essential oil (CEO) and eugenol (EUG) towards both reference and clinical Candida spp. strains isolated from the oral cavity of patients with hematological malignancies, and to investigate their mode of action and the interactions in combination with the selected antimycotics. These studies were performed using the broth microdilution method, tests with sorbitol and ergosterol, and a checkerboard technique, respectively. The CEO and EUG showed activity against all Candida strains with a minimal inhibitory concentration (MIC) in the range of 0.25–2 mg/mL. It was also found that both natural products bind to ergosterol in the yeast cell membrane. Moreover, the interactions between CEO and EUG with several antimycotics—cetylpyridinium chloride, chlorhexidine, silver nitrate and triclosan—showed synergistic or additive effects in combination, except nystatin. This study confirms that the studied compounds appear to be a very promising group of phytopharmaceuticals used topically in the treatment of superficial candidiasis. However, this requires further studies in vivo. [ABSTRACT FROM AUTHOR]

The interaction between methyl red (azo dye) and cetylpyridinium chloride (cationic surfactant) in the methanol-water system were studied using a spectrophotometric technique. Variable parameters like constant dye concentration and its structure, surfactant concentration, pH, absorbance, and solvent composition were studied. Using the UV-Vis technique, critical micelle concentrations (CMCs) of cetylpyridinium chloride were measured with methyl red. The spectral data were analyzed and determined the differential absorbance, binding and partition constants, partition coefficient, the Gibbs free energy of binding and partition in mixed solvent media (0.1, 0.2, 0.3, 0.4 volume fraction (v.f.)s of methanol, respectively). [ABSTRACT FROM AUTHOR]