Search

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. [ABSTRACT FROM AUTHOR]

Background: Antiseptic mouthwashes are useful adjuncts to daily brushing and flossing for the control of dental plaque and gingivitis. The objective of the present study was to compare the effect of three mouthwashes: chlorhexidine, essential oils and cetylpyridinium chloride on oral health‐related quality of life, gingival health, tongue coating and also to compare their potential side effects after 2‐week consumption. Methods: Sixty participants were enrolled in this study and were divided into four groups (three mouthwash groups plus no mouthwash group). At the beginning, scaling and cleaning were performed and the following parameters were recorded: oral health impact profile (OHIP‐5) questionnaire, tongue coating index, modified gingival index, calculus surface index, modified Lobene stain index and a questionnaire for side effects. Each group has followed up in 2 weeks. Data were analysed using paired t‐test, ANOVA, Fisher's exact test and Pearson chi‐square. Results: At the end of second week, all three mouthwashes significantly improved OHIP‐5 score and reduced modified gingival index whereas essential oils and cetylpyridinium chloride significantly reduced tongue coating index when compared to control group (p < 0.05). The differences between four groups were significant for calculus formation, dental staining and reported burning sensation and changes of taste sensation and perception (p < 0.05). Conclusion: The use of all three mouthwashes has been effective in controlling and reducing gingivitis and tongue coating; however, it appeared that essential oils has the minimum and Chlorhexidine has the maximum side effects. Moreover, the use of all three mouthwashes has been examined to improve the quality of life. Overall, essential oils mouthwash has the best performance among these three mouthwashes. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Currently, new functional materials are being created with a strong emphasis on their ecological aspect. Materials and devices based on DNA biopolymers, being environmentally friendly, are therefore very interesting from the point of view of applications. In this paper, we present the results of research on complexes in the powder form based on plasmid DNA (pDNA) and three surfactants with aliphatic chains containing 16 carbon atoms (cetyltrimethylammonium chloride, benzyldimethylhexadecylammonium chloride and hexadecylpyridinium chloride). The X-ray diffraction results indicate a local hexagonal packing of DNA helices in plasmid DNA complexes, resembling the packing for corresponding complexes based on linear DNA. Based on the Fourier-transform infrared spectroscopy results, the DNA conformation in all three complexes was determined as predominantly of A-type. The two relaxation processes revealed by dielectric spectroscopy for all the studied complexes are connected with two different contributions to total conductivity (crystallite part and grain boundaries). The crystallite part (grain interior) was interpreted as an oscillation of the polar surfactant head groups and is dependent on the conformation of the surfactant chain. The influence of the DNA type on the properties of the complexes is discussed, taking into account our previous results for complexes based on linear DNA. We showed that the type of DNA has an impact on the properties of the complexes, which has not been demonstrated so far. It was also found that the layer of pDNA–surfactant complexes can be used as a layer with variable specific electric conductivity by selecting the frequency, which is interesting from an application point of view. [ABSTRACT FROM AUTHOR]

Introduction: Oral healthcare professionals play a crucial role in guiding patients toward evidence-based choices among the many available oral rinses. In this study, we explored how specific oral rinse formulations affect the viability and modulate critical virulence traits of the opportunistic fungal pathogen Candida albicans.Materials and Methods: We assessed the effects of these oral rinses on the production of germ tube, production of phospholipase and hemolysin, as well as biofilm formation. Results: We found that oral rinses containing cetylpyridinium chloride (CPC) and chlorhexidine (CHX) showed the greatest fungicidal activity with the lowest minimum fungicidal concentrations (0.38% and 0.78%, respectively). Oral rinses based on zinc chloride and sodium fluoride with Miswak bark extract (MIS) or essential oils (EO) had much lower fungicidal activity (8–16 times lower) compared to CHX and CPC. However, they had a significantly greater impact on the virulence traits of C. albicans. They reduced germ tube production by 86–89% (vs. 42% for CHX and 29% for CPC), completely inhibited phospholipase and hemolysin production, and together with the CPC-based oral rinse, exerted the greatest reductions in biofilm formation across all tested concentrations. This was in contrast to both the controls and CHX, which had a minimal effect on biofilm formation. Conclusion: By inhibiting the virulence factors, the oral rinse can have a crippling effect on C. albicans, weakening this opportunistic pathogen and hindering its potential to cause infection. Highlights of the Study: Oral rinses with cetylpyridinium chloride and chlorhexidine showed the most potent fungicidal activity. Zinc chloride and sodium fluoride-based rinses with Miswak bark extract or essential oils significantly affected the virulence traits of C. albicans. Chlorhexidine-based oral rinse had only a minimal effect on biofilm formation, in contrast to the other formulations which exerted high anti-biofilm activity. [ABSTRACT FROM AUTHOR]

Background: Regular brushing is the most popular oral hygiene technique and using additional interdental cleaning tools like dental floss and oral rinse (OR) is advised. The objective of this study was to examine the efficacy of ORs containing 0.045% cetylpyridinium chloride (CPC) on oral health-related parameters in a 4-week-long double-blinded and randomized clinical trial. Methods: Seventy-four subjects were assigned to four groups: two control groups that used non-CPC-containing ORs (C1 [n = 20], C2 [n = 19]) and two groups that used CPC-containing ORs (immediate-use CPC [IUC] [n = 16], concentrated-use CPC [CUC] [n = 19]). The subjects were instructed to gargle with 20 mL of the ORs for 30 s after brushing their teeth thrice a day for 4 weeks. There was a substantial decrease in the levels of volatile sulfur compounds after the use of the ORs. Results: The Turesky modification of the Quigley–Hein Plaque Index and Löe and Silness Gingival Index showed a decreasing trend after the intervention, but not at a significant level. The Tongue Coating Index also showed a decrease in the intervention groups, but not in the control groups. Surprisingly, in both formulations, the inclusion of CPC in OR dramatically decreased the growth of aerobic bacteria in the mouth by expressed CFU/mL in both treatment groups. Conclusion: CPC-containing ORs can be recommended as an adjunct to the standard home care routine in promoting oral health. Clinical trial registration: NCT05644236. [ABSTRACT FROM AUTHOR]

Abstract Background Recent randomized clinical trials suggest that the effect of using cetylpyridinium chloride (CPC) mouthwashes on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load in COVID-19 patients has been inconsistent. Additionally, no clinical study has investigated the effectiveness of on-demand aqueous chlorine dioxide mouthwash against COVID-19. Methods We performed a randomized, placebo-controlled, open-label clinical trial to assess for any effects of using mouthwash on the salivary SARS-CoV-2 viral load among asymptomatic to mildly symptomatic adult COVID-19-positive patients. Patients were randomized to receive either 20 mL of 0.05% CPC, 10 mL of 0.01% on-demand aqueous chlorine dioxide, or 20 mL of placebo mouthwash (purified water) in a 1:1:1 ratio. The primary endpoint was the cycle threshold (Ct) values employed for SARS-CoV-2 salivary viral load estimation. We used linear mixed-effects models to assess for any effect of the mouthwashes on SARS-CoV-2 salivary viral load. Results Of a total of 96 eligible participants enrolled from November 7, 2022, to January 19, 2023, 90 were accepted for the primary analysis. The use of 0.05% CPC mouthwash was not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.640; 95% confidence interval [CI], -1.425 to 2.706; P = 0.543); 2 h (difference vs. placebo, 1.158; 95% CI, -0.797 to 3.112; P = 0.246); 4 h (difference vs. placebo, 1.283; 95% CI, -0.719 to 3.285; P = 0.209); 10 h (difference vs. placebo, 0.304; 95% CI, -1.777 to 2.385; P = 0.775); or 24 h (difference vs. placebo, 0.782; 95% CI, -1.195 to 2.759; P = 0.438). The use of 0.01% on-demand aqueous chlorine dioxide mouthwash was also not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.905; 95% CI, -1.079 to 2.888; P = 0.371); 2 h (difference vs. placebo, 0.709; 95% CI, -1.275 to 2.693; P = 0.483); 4 h (difference vs. placebo, 0.220; 95% CI, -1.787 to 2.226; P = 0.830); 10 h (difference vs. placebo, 0.198; 95% CI, -1.901 to 2.296; P = 0.854); or 24 h (difference vs. placebo, 0.784; 95% CI, -1.236 to 2.804; P = 0.447). Conclusions In asymptomatic to mildly symptomatic adults with COVID-19, compared to placebo, the use of 0.05% CPC and 0.01% on-demand aqueous chlorine dioxide mouthwash did not lead to a significant reduction in SARS-CoV-2 salivary viral load. Future studies of the efficacy of CPC and on-demand aqueous chlorine dioxide mouthwash on the viral viability of SARS-CoV-2 should be conducted using different specimen types and in multiple populations and settings.

Background: It was evidenced that cetylpyridinium‐chloride (CPC) mouthwash could inhibit SARS‐COV‐2 activity and reduce salivary viral load, thus reducing SARS‐CoV‐2 transmission. However, due to insufficient residence time in the oral cavity, CPC‐containing mouthwashes have no prolonged antiviral effect. The duration of action of the CPC buccal tablet is expected to be longer than that of the mouthwash. However, there are currently no reports on the salivary drug concentration of CPC buccal tablets. Objective: The study aimed to investigate the salivary drug concentration of CPC buccal tablets and the antiviral effect of CPC on SARS‐CoV‐2 in vitro. Trial design: This is a single‐dose, single‐arm clinical trial, involving 10 Chinese healthy subjects who received 2‐mg CPC buccal tablet to collect saliva samples and to detect saliva concentration at different timepoints within 2 h (Clinical Trial Registration Number: NCT05802628, Registration Date: April 6, 2023). Materials and methods: CPC concentration in saliva was detected by liquid chromatography tandem mass spectrometry (LC–MS/MS), and pharmacokinetic parameters were calculated based on the non‐compartmental model. With an in vitro antiviral experiment, the activity of CPC buccal tablets against SARS‐CoV‐2 and its cellular toxicity was tested. Results: Drug concentrations in saliva at 15 min, 30 min, 1 h, 1.5 h, and 2 h after administration were 8008.33 (1042.25, 41081.11), 2093.34 (373.15, 5759.83), 1016.58 (378.66, 3480.68), 891.77 (375.66, 6322.07), and 717.43 (197.87, 2152.71) ng/mL. PK parameters of saliva concentration: Cmax = 8008.33 (1042.25, 41081.11) ng/mL, AUC0‐t = 4172.37 (904.42, 13912.61) ng/mL * h, AUC0‐∞ = 6712.85 (1856.77, 19971.12) ng/mL * h, T1/2 = 1.22 (0.59, 2.83) h, Tmax = 0.25 (0.25, 0.25) h. As determined in in vitro experiment, CPC was active on SARS‐CoV‐2 with cytotoxic and inhibitory activity of CC50 = 35.75 μM (≈12155 ng/mL) and EC50 = 7.39 μM (≈2512.6 ng/mL). Conclusions: The comparison between the salivary CPC concentration and EC50/CC50 values from in vitro antiviral experiments suggests that CPC buccal tablets may inhibit SARS‐CoV‐2 activity, and the inhibition may last for approximately 30 min without cytotoxicity. [ABSTRACT FROM AUTHOR]

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 FROM AUTHOR]

Cationic surfactant (CS) is one of the alarming emerging contaminants often found in municipal and industrial wastewater. Various research articles have already reported about the toxicity of CS. In the current research work, sustainable and green alginate (Ag) and alginate composite beads with xanthan gum (AgX) are explored for the adsorptive elimination of model CS, cetylpyridinium chloride (CPC) and cetyltrimethylammonium bromide (CTAB), from wastewater. The composite (AgX) beads showed relatively better performance than Ag beads in terms of mechanical strength and equilibrium time. Studies on FTIR spectra, SEM analysis, size distribution, pHzpc measurement, and elemental analyses were conducted in order to characterize the adsorbent and to get an insight into the adsorption phenomenon. At the end of 8 days' equilibrium time, the maximum adsorptive retention capacity of the AgX beads was obtained as ~ 310 mg/g with an initial CPC concentration of 600 mg/L, using an adsorbent dose of 1.5 g/L. A layered isotherm with varying slopes was obtained, indicating different stages of CPC adsorption. CPC uptake by hydrogel beads was associated with significant shrinkage of the beads. Removal of CPC from real wastewater was possible with good efficiency. The effect of pH and interfering ions on CPC removal was examined. The results showed that the pH range of 5.5–6 was the optimum, and there was no interference from Co(II), Ni(II), and Mg(II) ions. The results showed good reproducibility with a relative standard deviation (RSD) < ± 10%. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of COVID-19 preventive mouthwashes on the surface hardness, surface roughness (Ra), and color change (ΔE) of three different polymer-based composite CAD/CAM materials (Vita Enamic (ENA), Grandio Block (GB), Lava Ultimate (LU)). Methods: A total of 100 rectangular-shaped specimens with dimensions of 2 mm × 7 mm × 12 mm were obtained by sectioning three different CAD/CAM blocks and randomly divided into five subgroups according to the 30 days of mouthwash immersion protocol as follows: Control: artificial saliva, PVP-I: 1% povidone-iodine, HP: 1.5% hydrogen peroxide, CPC: mouthwash containing 0.075% cetylpyridinium chloride, EO: mouthwash containing essential oils. Microhardness, Ra, and ΔE values were measured at baseline and after 30 days of immersion protocols. Data were analyzed using the Wald Chi-square, two-way ANOVA, and post hoc Tukey tests. Results: The independent factors (materials and solutions) significantly influenced the microhardness and color (p < 0.001). Ra of the materials was not affected by any of the mouthwashes (p > 0.05). The microhardness and color of each material varied significantly after immersion in PvP-I and HP (p < 0.05). The highest percentage change in microhardness, Ra, and ΔE was found in LU immersed in PvP-I and HP mouthwashes, while the lowest change was found in ENA groups (p < 0.05). Conclusion: Within the limitations of this study, it was found that the surface hardness and color of tested polymer-based composite CAD/CAM materials are susceptible to degradation and change after 30 days of immersion in 1% PvP-I and 1.5% HP mouthwashes. [ABSTRACT FROM AUTHOR]

Background: Recent randomized clinical trials suggest that the effect of using cetylpyridinium chloride (CPC) mouthwashes on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load in COVID-19 patients has been inconsistent. Additionally, no clinical study has investigated the effectiveness of on-demand aqueous chlorine dioxide mouthwash against COVID-19. Methods: We performed a randomized, placebo-controlled, open-label clinical trial to assess for any effects of using mouthwash on the salivary SARS-CoV-2 viral load among asymptomatic to mildly symptomatic adult COVID-19-positive patients. Patients were randomized to receive either 20 mL of 0.05% CPC, 10 mL of 0.01% on-demand aqueous chlorine dioxide, or 20 mL of placebo mouthwash (purified water) in a 1:1:1 ratio. The primary endpoint was the cycle threshold (Ct) values employed for SARS-CoV-2 salivary viral load estimation. We used linear mixed-effects models to assess for any effect of the mouthwashes on SARS-CoV-2 salivary viral load. Results: Of a total of 96 eligible participants enrolled from November 7, 2022, to January 19, 2023, 90 were accepted for the primary analysis. The use of 0.05% CPC mouthwash was not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.640; 95% confidence interval [CI], -1.425 to 2.706; P = 0.543); 2 h (difference vs. placebo, 1.158; 95% CI, -0.797 to 3.112; P = 0.246); 4 h (difference vs. placebo, 1.283; 95% CI, -0.719 to 3.285; P = 0.209); 10 h (difference vs. placebo, 0.304; 95% CI, -1.777 to 2.385; P = 0.775); or 24 h (difference vs. placebo, 0.782; 95% CI, -1.195 to 2.759; P = 0.438). The use of 0.01% on-demand aqueous chlorine dioxide mouthwash was also not shown to be superior to placebo in change from baseline salivary Ct value at 30 min (difference vs. placebo, 0.905; 95% CI, -1.079 to 2.888; P = 0.371); 2 h (difference vs. placebo, 0.709; 95% CI, -1.275 to 2.693; P = 0.483); 4 h (difference vs. placebo, 0.220; 95% CI, -1.787 to 2.226; P = 0.830); 10 h (difference vs. placebo, 0.198; 95% CI, -1.901 to 2.296; P = 0.854); or 24 h (difference vs. placebo, 0.784; 95% CI, -1.236 to 2.804; P = 0.447). Conclusions: In asymptomatic to mildly symptomatic adults with COVID-19, compared to placebo, the use of 0.05% CPC and 0.01% on-demand aqueous chlorine dioxide mouthwash did not lead to a significant reduction in SARS-CoV-2 salivary viral load. Future studies of the efficacy of CPC and on-demand aqueous chlorine dioxide mouthwash on the viral viability of SARS-CoV-2 should be conducted using different specimen types and in multiple populations and settings. [ABSTRACT FROM AUTHOR]

Two new surfactant sensors were developed by synthesizing Pt-doped acid-activated multi-walled carbon nanotubes (Pt@MWCNTs). Two different ionophores using Pt@MWCNTs, a new plasticizer, and (a) cationic surfactant 1,3-dihexadecyl-1H-benzo[d]imidazol-3-ium-DHBI (Pt@MWCNT-DHBI ionophore) and (b) anionic surfactant dodecylbenzenesulfonate-DBS (Pt@MWCNT-DBS ionophore) composites were successfully synthesized and characterized. Both surfactant sensors showed a response to anionic surfactants (dodecylsulfate (SDS) and DBS) and cationic surfactants (cetylpyridinium chloride (CPC) and hexadecyltrimethylammonium bromide (CTAB)). The Pt@MWCNT-DBS sensor showed lower sensitivity than expected with the sub-Nernstian response of ≈23 mV/decade of activity for CPC and CTAB and ≈33 mV/decade of activity for SDS and DBS. The Pt@MWCNT-DHBI surfactant sensor had superior response properties, including a Nernstian response to SDS (59.1 mV/decade) and a near-Nernstian response to DBS (57.5 mV/decade), with linear response regions for both anionic surfactants down to ≈2 × 10−6 M. The Pt@MWCNT-DHBI was also useful in critical micellar concentration (CMC) detection. Common anions showed very low interferences with the sensor. The sensor was successfully employed for the potentiometric titration of a technical grade cationic surfactant with good recoveries. The content of cationic surfactants was measured in six samples of complex commercial detergents. The Pt@MWCNT-DHBI surfactant sensor showed good agreement with the ISE surfactant sensor and classical two-phase titration and could be used as an analytical tool in quality control. [ABSTRACT FROM AUTHOR]

The primary treatment method for eradicating Helicobacter pylori (H. pylori) infection involves the use of antibiotic-based therapies. Due to the growing antibiotic resistance of H. pylori, there has been a surge of interest in exploring alternative therapies. Cetylpyridinium chloride (CPC) is a water-soluble and nonvolatile quaternary ammonium compound with exceptional broad-spectrum antibacterial properties. To date, there is no documented or described specific antibacterial action of CPC against H. pylori. Therefore, this study aimed to explore the in vitro activity of CPC against H. pylori and its potential antibacterial mechanism. CPC exhibited significant in vitro activity against H. pylori, with MICs ranging from 0.16 to 0.62 μg/mL and MBCs ranging from 0.31 to 1.24 μg/mL. CPC could result in morphological and physiological modifications in H. pylori, leading to the suppression of virulence and adherence genes expression, including flaA, flaB, babB, alpA, alpB, ureE, and ureF, and inhibition of urease activity. CPC has demonstrated in vitro activity against H. pylori by inhibiting its growth, inducing damage to the bacterial structure, reducing virulence and adherence factors expression, and inhibiting urease activity. [ABSTRACT FROM AUTHOR]

Background. Endodontic irrigants are essential for disinfecting the root canal system. None of the currently available irrigants perfume sufficiently. However, most products contain surfactants, which enhance the antimicrobial properties of the irrigants. Objectives. To evaluate the effect of cetylpyridinium chloride (CPC) surfactant on the antimicrobial activity of chlorhexidine and compare it with that of chlorhexidine (CHX) and Biopure MTAD against Enterococcus faecalis, Staphylococcus aureus, and Candida albicans. Materials and Methods. In this in vitro study, three microorganisms were used (E. faecalis, S. aureus, and C. albicans), and each organism was treated with three different irrigants: 2% CHX, 2% CHX + 0.2% CPC, and 100% Biopure MTAD. The antimicrobial activity was evaluated by direct contact assay for 5 min of contact time. The colony-forming unit per mL was calculated after antimicrobial treatment and 24 hr of incubation at 37°C. The data were statistically analyzed using Statistical Package for Social Science (SPSS) version 22. The Kruskal–Wallis and the multiple Wilcoxon sum rank tests were used. The level of significance was set at 0.05. Results. The result showed a nonsignificant difference between the different irrigants against E. faecalis. Among S. aureus subgroups, 2% CHX was statistically significant and more efficient than MTAD. Among C. albicans subgroups, 2% CHX and combined irrigant (2% CHX + 0.2% CPC) were statistically more efficient than MTAD. The 2% CHX and combined irrigants were equally effective against all the tested microorganisms. Conclusions. All the used irrigants have comparable effects against E. faecalis after 5 min. CHX have a comparable effects to that of the combined irrigant and more efficient against S. aureus than MTAD. CHX and the combined irrigant have potent antimicrobial activity against C. albicans superior to MTAD. CPC surfactant can be used with CHX to overcome its clinical drawbacks or limitations without altering or reducing its antimicrobial activity. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Glass ionomer cements (GICs), the most frequently used restorative materials in pediatric dentistry, may be used as medium for slow release of other active anti-microbial components apart from fluoride. OBJECTIVES: The objectives of this study were to determine the level of released chloride ions and anti-microbial compounds by incorporating 2% anti-microbial agents into conventional and experimental GICs. MATERIAL AND METHODS: The study was carried out using a conventional glass ionomer cements ChemFlex and Fuji IX as well as experimental glass ionomer cement MP4 and anti-microbial compounds, such as cetylpyridinium chloride and benzalkonium chloride. A total of 36 specimens (4 mm x 6 mm) were prepared, including 6 specimens of each GIC integrated with 2% of anti-microbial agents, and other six samples of the same cement without any anti-microbial agents used as a control group. Amounts of released Cl-- ions were determined with the use of an ion-selective electrode, and amounts of anti-microbial agents were determined by UV/VIS spectrophotometer. Measurements were performed at 9 successive time intervals starting from fifteenth minute and finishing after seven days. RESULTS: The results obtained show a continual release of both chloride ions and anti-microbial compounds from analyzed GICs that increased over time. CONCLUSIONS: In comparison with conventional GICs, MP4 GIC produces a significantly higher release both of chloride ions and anti-microbial compounds. [ABSTRACT FROM AUTHOR]

Background: Although the role of chlorhexidine and other mouthwashes in periodontal therapy has been elucidated, little information is available on their use as routine preoperative mouth rinses before surgery, especially in periodontal procedures such as dental implant surgery. Objective: This study aimed to compare the efficacy of preoperative chlorhexidine, essential oil, and cetylpyridinium chloride mouthwashes in reducing bacterial contamination at the time of implant placement. Materials and Methods: Eligible patients who underwent dental implant surgery were randomly divided into four groups based on the mouthwash used: (1) 0.12 % chlorhexidine, (2) essential oil, (3) cetylpyridinium chloride, and (4) saline (served as the control group). All the patients of each group rinsed preoperatively with 15 mL of the respective mouthwash for 60 s. Saliva samples before (pre) and immediately after rinsing with the mouthwash (post) and after suturing the flap (end) were collected on the day of the implant placement. Real-time quantitative polymerase chain reaction (qPCR) was performed to analyze the samples and quantify the targeted periodontal pathogens using a propidium monoazide (PMA) dye. Results: Forty patients were included in the study. Real-time qPCR demonstrated a significant reduction in the number of pathogens in the saliva samples of the mouthwash groups compared to that of the control group. A statistically significant difference was observed between the groups for the pre–post and pre–end samples (p

Objective: To evaluate the antitumor and antimicrobial properties of an alginate-based membrane (ABM) loaded with bismuth lipophilic nanoparticles (BisBAL NPs) and cetylpyridinium chloride (CPC) on clinically isolated bacteria and a pancreatic cancer cell line. Material and methods: The BisBAL NP-CPC ABM was characterized using optical and scanning electron microscopy (SEM). The antimicrobial potential was measured using the disk-diffusion assay, and antibiofilm activity was determined through the live/dead assay and fluorescence microscopy. The antitumor activity was analyzed on the pancreatic cell line (Panc 03.27) using the MTT assay and live/dead assay with fluorescence microscopy. Results: After a 24-h exposure (37°C, aerobic conditions), 5 µM BisBAL NP reduced the growth of K. pneumoniae by 77.9%, while 2.5 µM BisBAL NP inhibited the growth of Salmonella, E. faecalis and E. faecium by 82.9%, 82.6%, and 78%, respectively (p < 0.0001). The BisBAL NPs-CPC ABM (at a ratio of 10:1; 500 and 50 µM, respectively) inhibited the growth of all isolated bacteria, producing inhibition halos of 9.5, 11.2, 7, and 10.3 mm for K. pneumoniae, Salmonella, E. faecalis, and E. faecium, respectively, in contrast to the 6.5, 9.5, 8.5, and 9.8 mm obtained with 100 µM ceftriaxone (p < 0.0001). The BisBAL NPs-CPC ABM also reduced bacterial biofilms, with 81.4%, 74.5%, 97.1%, and 79.5% inhibition for K. pneumoniae, E. faecium, E. faecalis, and Salmonella, respectively. Furthermore, the BisBAL NPs-CPC ABM decreased Panc 03.27 cell growth by 76%, compared to 18% for drug-free ABM. GEM-ABM reduced tumoral growth by 73%. The live/dead assay confirmed that BisBAL NPs-CPC-ABM and GEM-ABM were cytotoxic for the turmoral Panc 03.27 cells. Conclusion: An alginate-based membrane loaded with BisBAL NP and CPC exhibits dual antimicrobial and antitumoral efficacy. Therefore, it could be applied in cancer treatment and to diminish the occurrence of surgical site infections. [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. [ABSTRACT FROM AUTHOR]

Although the role of chlorhexidine and other mouthwashes in periodontal therapy has been elucidated, little information is available on their use as routine preoperative mouth rinses before surgery, especially in periodontal procedures such as dental implant surgery. This study aimed to compare the efficacy of preoperative chlorhexidine, essential oil, and cetylpyridinium chloride mouthwashes in reducing bacterial contamination at the time of implant placement. Eligible patients who underwent dental implant surgery were randomly divided into four groups based on the mouthwash used: (1) 0.12 % chlorhexidine, (2) essential oil, (3) cetylpyridinium chloride, and (4) saline (served as the control group). All the patients of each group rinsed preoperatively with 15 mL of the respective mouthwash for 60 s. Saliva samples before (pre) and immediately after rinsing with the mouthwash (post) and after suturing the flap (end) were collected on the day of the implant placement. Real-time quantitative polymerase chain reaction (qPCR) was performed to analyze the samples and quantify the targeted periodontal pathogens using a propidium monoazide (PMA) dye. Forty patients were included in the study. Real-time qPCR demonstrated a significant reduction in the number of pathogens in the saliva samples of the mouthwash groups compared to that of the control group. A statistically significant difference was observed between the groups for the pre–post and pre–end samples (p < 0.001) but not for the post–end samples (p = 0.203). A statistically significant difference was observed between the chlorhexidine, essential oil, and cetylpyridinium chloride mouthwash groups and the saline group (P < 0.001). The bacterial counts significantly differed with and without the use of the PMA dye. Preoperative chlorhexidine, essential oil, and cetylpyridinium chloride mouthwashes can reduce the bacterial load at the time of implant placement, thereby reducing the incidence of implant-related complications. [ABSTRACT FROM AUTHOR]

Perfluoroalkyl and polyfluoroalkyl substances (PFASs) are environmentally persistent, bioaccumulating, and toxic compounds that have attracted global attention. It is challenging to reduce the residual concentrations of these compounds to safe discharge limits. In this study, batch experiments were performed to evaluate natural clinoptilolite and clinoptilolites modified (MC) with cetylpyridinium chloride (CPC-MC), didodecyldimethylammonium bromide (DDAB-MC), hexadecyltrimethylammonium bromide (HDTMA-MC), and tetramethylammonium chloride (TMA-MC) as cost-effective aqueous PFAS adsorbents. The removal capacities of the adsorbents for the majority of the PFASs decreased in the following order: DDAB-MC > CPC-MC ≫ modified natural clinoptilolite with hexadecyltrimethyl ammonium bromide (HDTMA-MC) ≫ modified natural clinoptilolite with tetramethylammonium chloride (TMA-MC) ≈ natural clinoptilolite modified with NaCl (NC). In particular, CPC-MC and DDAB-MC reduced PFASs concentration in 50 μg/L by up to 98% for perfluorooctane sulphonate. Within 30 min, CPC-MC (30.5 μg/L) and DDAB-MC (32.1 μg/L) met the PFOS water quality criterion of 36 μg/L in inland surface waters. Both adsorbents met this criterion at the highest solution volume (40 mL) and 0.125 g/L (solid-to-liquid ratio of 1:8). PFASs with short hydrocarbon chains competed more for adsorption. PFASs with sulphonate functional groups were also adsorbed more than carboxyl groups in single- and multi-PFAS solutions. The modified surfaces of clinoptilolites controlled PFAS adsorption through hydrophobic and electrostatic interactions. PFAS removal with surfactant-modified clinoptilolites is cost-effective and protects aquatic environments by using surplus natural materials. [ABSTRACT FROM AUTHOR]

Background: The oral cavity is the site of entry and replication for many respiratory viruses. Furthermore, it is the source of droplets and aerosols that facilitate viral transmission. It is thought that appropriate oral hygiene that alters viral infectivity might reduce the spread of respiratory viruses and contribute to infection control. Materials and methods: Here, we analyzed the antiviral activity of cetylpyridinium chloride (CPC), chlorhexidine (CHX), and three commercial CPC and CHX-containing mouthwash preparations against the Influenza A virus and the Respiratory syncytial virus. To do so the aforementioned compounds and preparations were incubated with the Influenza A virus or with the Respiratory syncytial virus. Next, we analyzed the viability of the treated viral particles. Results: Our results indicate that CPC and CHX decrease the infectivity of both the Influenza A virus and the Respiratory Syncytial virus in vitro between 90 and 99.9% depending on the concentration. Likewise, CPC and CHX-containing mouthwash preparations were up to 99.99% effective in decreasing the viral viability of both the Influenza A virus and the Respiratory syncytial virus in vitro. Conclusion: The use of a mouthwash containing CPC or CHX alone or in combination might represent a cost-effective measure to limit infection and spread of enveloped respiratory viruses infecting the oral cavity, aiding in reducing viral transmission. Our findings may stimulate future clinical studies to evaluate the effects of CPC and CHX in reducing viral respiratory transmissions. [ABSTRACT FROM AUTHOR]

The synthesis of bis-quaternary ammonium compounds based on a polyhydric alcohol, 2,3-bis(hydroxymethyl)butane-1,4-diol, and pyridine was accomplished. The bacteriostatic and bactericidal activity of the products against ESKAPE pathogens and Candida albicans yeast-like fungus both in planktonic and biofilm forms was studied. The activity of the bis-pyridinium salts was compared with the activities of known antiseptic agents, octenidine dihydrochloride and cetylpyridinium chloride. It was found that the compound containing ten carbon atoms in the alkyl group is effective against various strains of Staphylococcus aureus, Escherichia coli, Klebsiella pneumoniae, and C. albicans. [ABSTRACT FROM AUTHOR]

Candida albicans is the most critical fungus causing oral mycosis. Many mouthwashes contain antimicrobial substances, including antifungal agents. This study aimed to investigate the in vitro activity of 15 commercial mouthwashes against 12 strains of C. albicans. The minimal inhibitory concentrations (MICs), minimal fungicidal concentrations (MFCs), and anti-biofilm activity were studied. MICs were determined by the micro-dilution method using 96-well plates, and MFCs were determined by culturing MIC suspensions on Sabouraud dextrose agar. Anti-biofilm activity was evaluated using the crystal violet method. The mouthwashes containing octenidine dihydrochloride (OCT; mean MICs 0.09–0.1%), chlorhexidine digluconate (CHX; MIC 0.12%), and CHX with cetylpyridinium chloride (CPC; MIC 0.13%) exhibited the best activity against C. albicans. The active compound antifungal concentrations were 0.5–0.9 µg/mL for OCT products and 1.1–2.4 µg/mL for CHX rinses. For mouthwashes with CHX + CPC, concentrations were 1.56 µg/mL and 0.65 µg/mL, respectively. Products with polyaminopropyl biguanide (polyhexanide, PHMB; MIC 1.89%) or benzalkonium chloride (BAC; MIC 6.38%) also showed good anti-Candida action. In biofilm reduction studies, mouthwashes with OCT demonstrated the most substantial effect (47–51.1%). Products with CHX (32.1–41.7%), PHMB (38.6%), BAC (35.7%), Scutellaria extract (35.6%), and fluorides + essential oils (33.2%) exhibited moderate antibiofilm activity. The paper also provides an overview of the side effects of CHX, CPC, and OCT. Considering the in vitro activity against Candida albicans, it can be inferred that, clinically, mouthwashes containing OCT are likely to offer the highest effectiveness. Meanwhile, products containing CHX, PHMB, or BAC can be considered as promising alternatives. [ABSTRACT FROM AUTHOR]

This study focuses on the properties of the nonionic surfactant Genapol and the cationic surfactant cetylpyridinium chloride (CPC) to develop a composite detergent with bactericidal activity. Research includes studying the properties of CPC and Genapol solutions, creating composite mixtures with different concentration ratios and assessing the bactericidal effectiveness of the resulting detergents. The main foaming agents CPC and Genapol were used without purification, which emphasizes their high biodegradability. Various tests, including surface tension measurements, contact angle evaluation and pH measurements, were carried out at room temperature to evaluate the properties of surfactants and surfactant mixtures. The results show that CPC exhibits foaming, emulsifying and bactericidal properties due to its high surface activity and adsorption capacity. Genapol has the advantages of high surface activity at different pH levels, excellent foaming and emulsifying properties. The combination of these surfactants in a complex detergent creates a universal cleaner with antibacterial properties independent of pH and environmental harshness. The bactericidal effect of solutions of CPCGenapol mixtures was also determined. The results show that the composite solution exhibits a noticeable bactericidal effect with zones of growth inhibition ranging from 13.5±0.5 mm to 17±0.1 mm. The greatest antibacterial activity was observed against Micobacterium citreum and Bacillus subtilis. Sarcina flava and Staphylococcus aureus showed similar growth inhibition results. [ABSTRACT FROM AUTHOR]

The primary objective was to assess the safety of a new toothpaste formulation containing cetylpyridinium chloride (CPC) and cymenol as active agents. In addition, clinical efficacy and patient perception were evaluated. A 6-week randomized clinical trial was designed and patients were randomly allocated to use a test or control dentifrice. Adverse effects were assessed at 3- and 6-week follow-up visits, together with the following clinical parameters: Turesky plaque index (PlI), bleeding on marginal probing (BOMP), bleeding on probing (BOP) and Gründemann modification of the stain index (GMSI). Patient-reported outcome measures (PROMs) were also evaluated. A total of 60 patients were randomized and 55 were finally included in the analysis (test, 29; control, 26). Both toothpastes were safe and well tolerated by the patients. Statistically significant differences between test and control groups were observed for BOP changes between baseline week 6 (p = 0.031) and lower levels of plaque were registered in the test group at the 3- and 6-week visits (p < 0.05). No differences were observed for staining or PROMs. The use of a toothpaste containing CPC and cymenol was safe and not associated with any adverse effects. Significantly better clinical results were observed for the test group in terms of PlI levels and BOP reductions. [ABSTRACT FROM AUTHOR]

We report an unusual case of anaphylaxis induced by the lysozyme-containing over-the-counter-drug Lysopaine®, which contains 20 mg lysozyme hydrochloride and 1.5 mg cetylpyridinium chloride, in a 9-year-old child with allergy to hen's egg as well as multiple IgE-mediated food allergies. The involvement of lysozyme was confirmed by positive skin prick tests for Lysopaine® and the presence of specific IgE against lysozyme. Our case highlights the importance of properly educating allergic patients to recognize allergens, even minor ones. Despite the presence of lysozyme in various food and drug products, it is not necessarily perceived as an allergenic protein by patients with egg allergy, and the labeling may be misleading, thereby exposing patients to potentially severe reactions. [ABSTRACT FROM AUTHOR]

Abstract Objectives Maxillomandibular fixation requires the jawbones to remain static. Mechanical cleaning is also carried out by brushing or with a water flosser to maintain the oral cavity in a hygienic state, but this cannot be considered sufficient. Mouthwashes are used as a substitute for mechanical cleaning or in a supplementary role after such cleaning. The aim is to evaluate the effectiveness of HABITPRO mouthwash, which contains cetylpyridinium chloride, dipotassium glycyrrhizinate, and tranexamic acid in the specific environment created by maxillomandibular fixation used as an adjunct to mechanical cleaning. Material and Methods A total of 55 patients who had undergone maxillomandibular fixation were randomly allocated to either a HABITPRO group (n = 29) or a placebo group (n = 26). To investigate their oral hygiene status, their plaque control record (PCR) was reviewed, and the caries‐related bacterial counts, pH, acid buffering capacity, white blood cell count, and ammonia in saliva were measured immediately before maxillomandibular fixation, on Day 10 of fixation, and immediately after fixation was released. Results After approximately 2–3 weeks of mouthwash use, the PCR index also increased significantly in the placebo group compared with baseline, whereas it remained almost steady in the HABITPRO group. Additionally, salivary ammonia levels decreased significantly in the HABITPRO group compared to that of the placebo group. Conclusions Even with maxillomandibular fixation, continued gargling with HABITPRO mouthwash in the perioperative period as an adjunct to mechanical cleaning can help maintain better oral hygiene and reduce bacterial counts.

Abstract Objectives This study explored the changes in bacterial flora composition and total bacterial count in the saliva and tongue coating, along with the change in the tongue coating index (TCI) following an intervention with 0.3% cetylpyridinium chloride (CPC) mouth spray after professional oral care. Materials and Methods Fifty‐two adult volunteers aged 30–60 years were equally divided into CPC spray (n = 26) and control (n = 26) groups. All subjects underwent scaling and polishing. The CPC spray group was administered four puffs of CPC spray to the tongue dorsum four times a day for 3 weeks. The control group performed only routine daily oral care (brushing) and did not use any other spray. Bacteriological evaluation of saliva and tongue coating was performed using 16S ribosomal RNA gene sequencing and quantitative polymerase chain reaction. The tongue coating was evaluated to calculate the TCI. A per‐protocol analysis was conducted for 44 subjects (CPC spray group, n = 23; control group, n = 21). Results At 1 and 3 weeks after CPC spray use, the flora of the saliva and tongue coating changed; the genus Haemophilus was dominant in the CPC spray group, whereas the genus Saccharibacteria was dominant in the control group. The sampling time differed among individual participants, which may have affected the bacterial counts. There was no significant intragroup change in TCI in either group. Conclusions CPC spray affected the bacterial flora in the saliva and tongue coating, particularly with respect to an increase in the abundance of Haemophilus. However, CPC spray did not change the TCI. These results suggest that it may be optimal to combine CPC spray with a physical cleaning method such as using a tongue brush or scraper. Clinical Trial Registration: University Hospital Medical Information Network UMIN000041140.

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.

To provide the poultry industry with effective mitigation strategies, the effects of cetylpyridinium chloride (CPC) on the reduction of Salmonella Infantis, hilA expression, and chicken skin microbiota were evaluated. Chicken breast skins (4×4 cm; N = 100, n = 10, k = 5) were inoculated with Salmonella (Typhimurium or Infantis) at 4°C (30min) to obtain 108 CFU/g attachment. Skins were shaken (30s), with remaining bacteria being considered firmly attached. Treatments were applied as 30s dips in 50 mL: no inocula-no-treatment control (NINTC), no treatment control (NTC), tap water (TW), TW+600 ppm PAA (PAA), or TW+0.5% CPC (CPC). Excess fluid was shaken off (30s). Samples were homogenized in nBPW (1 min). Samples were discarded. Salmonella was enumerated and Log10 transformed. Reverse transcriptase-qPCR (rt-qPCR) was performed targeting hilA gene and normalized using the 2-ΔΔCt method. Data were analyzed using one-way ANOVA in RStudio with means separated by Tukey's HSD (P≤0.05). Genomic DNA of rinsates was extracted, 16S rRNA gene (V4) was sequenced (MiSeq), and data analyzed in QIIME2 (P≤0.05 and Q≤0.05). CPC and PAA affected Salmonella levels differently with CPC being effective against S. Infantis compared to TW (P<0.05). Treatment with CPC on S. Infantis-infected skin altered the hilA expression compared to TW (P<0.05). When inoculated with S. Typhimurium, there was no difference between the microbiota diversity of skins treated with PAA and CPC; however, when inoculated with S. Infantis, there was a difference in the Shannon's Entropy and Jaccard Dissimilarity between the two treatments (P<0.05). Using ANCOM at the genus level, Brochothrix was significant (W = 118) among skin inoculated with S. Typhimurium. Among S. Infantis inoculated, Yersiniaceae, Enterobacterales, Lachnospiraceae CHKCI001, Clostridia vadinBB60 group, Leuconostoc, Campylobacter, and bacteria were significant (408). CPC and PAA-treated skins had lowest relative abundance of the genera. In conclusion, CPC mitigated Salmonella Infantis, altered hilA expression, and influenced the chicken skin microbiota. [ABSTRACT FROM AUTHOR]

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). [ABSTRACT FROM AUTHOR]

To evaluate the effectiveness of antiseptic mouthwashes in reducing SARS-CoV-2 load clinically and in vitro. A systematic electronic search (MEDLINE/Scopus/Cochrane) was conducted to identify prospective clinical and in vitro studies published between 2019 included and 16 June 2023 assessing the effectiveness of mouthwashes in reducing SARS-CoV-2 load in saliva or surrogates. Data were summarized in tables and a network meta-analysis was performed for clinical trials. Thirty-five studies (14 RCTs, 21 in vitro) fulfilled the inclusion criteria. The risk of bias was judged to be high for 2 clinical and 7 in vitro studies. The most commonly test product was chlorhexidine alone or in combination with other active ingredients, followed by povidone-iodine, hydrogen peroxide and cetylpyridinium chloride. Overall, the descriptive analysis revealed the effectiveness of the mouthwashes in decreasing the salivary viral load both clinically and in vitro. Network meta-analysis demonstrated a high degree of heterogeneity. Among these studies, only chlorhexidine 0.20% was associated to a significant Ct increase in the saliva 5 min after rinsing compared to non-active control (p = 0.027). Data from clinical and in vitro studies suggested the antiviral efficacy of commonly used mouthwashes. Large well-balanced trials are needed to identify the best rinsing protocols. [ABSTRACT FROM AUTHOR]

Background. Symptomatic patients with COVID-19 typically have a high SARS-CoV-2 viral load in their saliva. Procedures to reduce the viral load in their oral cavity are important for mitigating the viral transmission. Methods. This randomized clinical trial investigated the impact of two mouthwashes (0.075% cetylpyridinium chloride plus 0.28% zinc lactate (CPC+Zn) (n = 32), and 0.075% cetylpyridinium chloride (CPC) (n = 31)) on the viral load of SARS-CoV-2 in saliva when compared to the distilled water negative control (n = 32). Saliva was collected before (T0) and after (5 min, T1; 30 min, T2; and 60 min, T3) the intervention. Viral load in saliva was measured by qRT-PCR assays. The data in both groups was normalized for T0 and Negative Control, resulting in fold change values. Results. CPC+Zn oral solution reduced the viral load in saliva by 6.34-fold at T1, 3.6-fold at T2 and 1.9-fold at T3. Rinsing with the CPC mouthwash reduced the viral load in saliva by 2.5-fold at T1, 1.9-fold at T2 and 2.0-fold at T3. Conclusion. CPC+Zn mouthwash or with the CPC mouthwash reduced the viral load in saliva of COVID-19 patients immediately after rinsing. These reductions extended up to 60 min. [ABSTRACT FROM AUTHOR]

Herein, a new strategy is proposed for achieving dynamic chiral controls in self-assembly systems of plasmonic nanorods based on temperature-modulation. Via enlarging Au{100} side facets of Au nanorod (AuNR) building block and changing surface ligand from often-used cetyltrimethylammonium bromide (CTAB) to cetylpyridinium chloride (CPC), inversion of chiroptical signal in side-by-side (SS) oligomers is realized. Under the guide of chiral cysteine (Cys), Au{100} side facet-linked SS rods twist in the opposite direction compared with Au{110} side facet-linked counterparts. At high CPC concentration, by controlling the incubation temperature of chiral Cys, the dominant twist mode can be regulated. Finite-difference time-domain (FDTD) simulations indicate the key role of the twisting dihedral angle of the oligomers in driving chiral signal inversion. At low CPC concentration, a temperature-sensitive chiral switching is observed owing to the conformation change of the CPC ligand layer. The temperature-modulated chiral responses are based on the interactions of chiral molecules, achiral surface ligands, and exposed facets of the building block. The rich dynamic tunability of chiroptical responses of plasmonic assemblies may find applications in stimulus-responsive nanodevices. [ABSTRACT FROM AUTHOR]

Objectives: Maxillomandibular fixation requires the jawbones to remain static. Mechanical cleaning is also carried out by brushing or with a water flosser to maintain the oral cavity in a hygienic state, but this cannot be considered sufficient. Mouthwashes are used as a substitute for mechanical cleaning or in a supplementary role after such cleaning. The aim is to evaluate the effectiveness of HABITPRO mouthwash, which contains cetylpyridinium chloride, dipotassium glycyrrhizinate, and tranexamic acid in the specific environment created by maxillomandibular fixation used as an adjunct to mechanical cleaning. Material and Methods: A total of 55 patients who had undergone maxillomandibular fixation were randomly allocated to either a HABITPRO group (n = 29) or a placebo group (n = 26). To investigate their oral hygiene status, their plaque control record (PCR) was reviewed, and the caries‐related bacterial counts, pH, acid buffering capacity, white blood cell count, and ammonia in saliva were measured immediately before maxillomandibular fixation, on Day 10 of fixation, and immediately after fixation was released. Results: After approximately 2–3 weeks of mouthwash use, the PCR index also increased significantly in the placebo group compared with baseline, whereas it remained almost steady in the HABITPRO group. Additionally, salivary ammonia levels decreased significantly in the HABITPRO group compared to that of the placebo group. Conclusions: Even with maxillomandibular fixation, continued gargling with HABITPRO mouthwash in the perioperative period as an adjunct to mechanical cleaning can help maintain better oral hygiene and reduce bacterial counts. [ABSTRACT FROM AUTHOR]

Objectives: This study explored the changes in bacterial flora composition and total bacterial count in the saliva and tongue coating, along with the change in the tongue coating index (TCI) following an intervention with 0.3% cetylpyridinium chloride (CPC) mouth spray after professional oral care. Materials and Methods: Fifty‐two adult volunteers aged 30–60 years were equally divided into CPC spray (n = 26) and control (n = 26) groups. All subjects underwent scaling and polishing. The CPC spray group was administered four puffs of CPC spray to the tongue dorsum four times a day for 3 weeks. The control group performed only routine daily oral care (brushing) and did not use any other spray. Bacteriological evaluation of saliva and tongue coating was performed using 16S ribosomal RNA gene sequencing and quantitative polymerase chain reaction. The tongue coating was evaluated to calculate the TCI. A per‐protocol analysis was conducted for 44 subjects (CPC spray group, n = 23; control group, n = 21). Results: At 1 and 3 weeks after CPC spray use, the flora of the saliva and tongue coating changed; the genus Haemophilus was dominant in the CPC spray group, whereas the genus Saccharibacteria was dominant in the control group. The sampling time differed among individual participants, which may have affected the bacterial counts. There was no significant intragroup change in TCI in either group. Conclusions: CPC spray affected the bacterial flora in the saliva and tongue coating, particularly with respect to an increase in the abundance of Haemophilus. However, CPC spray did not change the TCI. These results suggest that it may be optimal to combine CPC spray with a physical cleaning method such as using a tongue brush or scraper. Clinical Trial Registration: University Hospital Medical Information Network UMIN000041140. [ABSTRACT FROM AUTHOR]

In this study, we examined the cytotoxic effects of six commercial children's mouthrinses (designated as #1, #2, #3, #4, #5, and #6) and four commercial children's toothpastes (designated as #1, #2, #3, and #4) on primary human neonatal melanocytes that were used as a representative model for oral melanocytes. Mouthrinses diluted directly with culture medium (1:2, 1:5, 1:10, 1:100, and 1:1000) were added to monolayers of melanocytes for 2 min, followed by 24 h recovery, after which MTS cytotoxicity assay was conducted. The extracts of each toothpaste were prepared (50% w/v), diluted in culture medium (1:2, 1:5, 1:10, 1:50, 1:100, and 1:1000), and added to cell monolayers for 2 min (standard brushing time), followed by an analysis of cell viability after 24 h. Results showed that all mouthrinses except mouthrinse #4 showed significantly greater loss of cell viability, ascribed to cetylpyridinium chloride (CPC) that induced significant cytotoxicity to melanocytes (IC50 = 54.33 µM). In the case of toothpastes, the examination of cellular morphology showed that a 2 min exposure to all toothpaste extracts induced a concentration-dependent decline in cell viability, pronounced in toothpaste containing sodium lauryl sulfate (SLS) detergent. Further results suggested SLS to be the critical driver of cytotoxicity (IC50 = 317.73 µM). It is noteworthy that toothpaste #1 exhibited much lower levels of cytotoxicity compared to the other three toothpastes containing SLS. Taken together, these findings suggest that the melanocytotoxicity of children's mouthrinse (#4) and toothpaste (#1) is comparatively low. To the best of our knowledge, this is the first study to examine the impact of children's toothpastes and mouthrinses on neonatal primary human melanocytes. Future studies to investigate these findings in a realistic scenario replicating oral cavity conditions of the presence of microbiota, pellicle layer and saliva, and other cell types are warranted. [ABSTRACT FROM AUTHOR]

In this work, after cationic pretreatment of cotton fabric with cetylpyridinium chloride (CPC), the compound of citric acid (CA) and succinic acid (SUA) were used as crosslinking agents to dye cotton fabrics with natural madder dye to improve the dyeing and antibacterial properties and realise the multifunctional finishing of cotton fabric. The effects of mordant dyeing, CA + SUA crosslinked dyeing, and CPC/CA + SUA crosslinked dyeing on the microstructure and properties of cotton fabrics were compared. The dyeing by the three processes occurred primarily in the amorphous zone of the fibres, and all kept the original crystalline form of the cotton. CA + SUA crosslinked dyeing and CPC/CA + SUA crosslinked dyeing increased the thermal stability of the cotton fabric. CPC/CA + SUA crosslinked dyed cotton obtained excellent dyeing results with the colour depth value (K/S) of 12.3 and rubbing fastness and washing fastness of levels 4–5, and the levelness and dye permeability were acceptable. Furthermore, the antibacterial rate against Escherichia coli and Staphylococcus aureus reached 99.99%, and the ultraviolet protection factor (UPF) reached 50+. Moreover, the wrinkle recovery angle (WRA) increased by 55% compared with raw cotton. This showed that CPC/CA + SUA crosslinked dyed cotton had excellent antibacterial, anti‐ultraviolet, and anti‐wrinkle performances. [ABSTRACT FROM AUTHOR]

The efficiency of decontamination of blister and nerve agents was studied using the example of nucleophilic decomposition of paraoxone (O,O-diethyl-O-4-nitrophenyl phosphate) and oxidation of methylphenyl sulfide. Hydrogen peroxide solutions in an oil-in-water microemulsion containing synthetic nanoclay Laponite EP and polyvinylpyrrolidone polymer were studied as reactive decontamination systems. The base of the microemulsion consisted of an aqueous phase, a codetergent (isopropanol), oil (hexane), with a variation of detergent (cetylpyridinium chloride, sodium dodecyl sulfate, and Triton X-100). It was shown that the solubility of paraoxone and methylphenyl sulfide in the studied microemulsions increases by an average of 100 times or more compared to the solubility in water, and the substrate binding constants are 2-3 times higher than the binding constants in similar microemulsion media. It was found that the presence of nanoclay in the microemulsion provides a catalytic effect, i.e. an increase in the rate of decomposition of paraoxone and methylphenyl sulfide by at least 2 times. In addition, nanoclay thickens the microemulsion and, together with the polymer, increases the viscosity of the reaction medium. The determined kinetic parameters of decontamination and solubility of substrates allow us to conclude that the use of the investigated microemulsion system provides an acceleration of nucleophilic substitution and oxidation reactions by 150-350 times compared to the reaction rate in water. [ABSTRACT FROM AUTHOR]

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]

Objectives: Evaluate the strength degradation of polymeric ligature chains after their immersion in cetylpyridinium chloride-based mouthwashes. Methods: 240 elastomeric samples from four different manufacturers (Rocky Mountain®, Ormco®, Morelli® and Dentaurum®) in two types of configurations (with and without intermodular links) and divided in 3 groups (distilled water, Vitis CPC Protect® and PERIO·AID® 0.05%) at 5 follow-up periods (0–24 h, 7–14 -21 days) were immersed twice a day for 60 s, following the manufacturers' protocols. A universal traction machine was used to perform the measurements and a post hoc multiple comparisons were based on the Bonferroni test and extended to a 3-way ANOVA test (α = 0.05). Results: There was a drop in strength up to 35.9% at 24 h. After a week, the short chains (52%) degraded less than the long ones (57.3%) with significant differences (p

ABSTRACTManagement of urinary tract infection (UTI) in postmenopausal women can be challenging. The recent rise in resistance to most of the available oral antibiotic options together with high recurrence rate in postmenopausal women has further complicated treatment of UTI. As such, intravesical instillations of antibiotics like gentamicin are being investigated as an alternative to oral antibiotic therapies. This study evaluates the efficacy of the candidate intravesical therapeutic VesiX, a solution containing the cationic detergent Cetylpyridinium chloride, against a broad range of uropathogenic bacterial species clinically isolated from postmenopausal women with recurrent UTI (rUTI). We also evaluate the cytotoxicity of VesiX against cultured bladder epithelial cells and find that low concentrations of 0.0063% and 0.0125% provide significant bactericidal effect toward diverse bacterial species including uropathogenic Escherichia coli (UPEC), Klebsiella pneumoniae, Enterococcus faecalis, Pseudomonas aeruginosa, and Proteus mirabilis while minimizing cytotoxic effects against cultured 5637 bladder epithelial cells. Lastly, to begin to evaluate the potential utility of using VesiX in combination therapy with existing intravesical therapies for rUTI, we investigate the combined effects of VesiX and the intravesical antibiotic gentamicin. We find that VesiX and gentamicin are not antagonistic and are able to reduce levels of intracellular UPEC in cultured bladder epithelial cells.IMPORTANCEWhen urinary tract infections (UTIs), which affect over 50% of women, become resistant to available antibiotic therapies dangerous complications like kidney infection and lethal sepsis can occur. New therapeutic paradigms are needed to expand our arsenal against these difficult to manage infections. Our study investigates VesiX, a Cetylpyridinium chloride (CPC)-based therapeutic, as a candidate broad-spectrum antimicrobial agent for use in bladder instillation therapy for antibiotic-resistant UTI. CPC is a cationic surfactant that is FDA-approved for use in mouthwashes and is used as a food additive but has not been extensively evaluated as a UTI therapeutic. Our study is the first to investigate its rapid bactericidal kinetics against diverse uropathogenic bacterial species isolated from postmenopausal women with recurrent UTI and host cytotoxicity. We also report that together with the FDA-approved bladder-instillation agent gentamicin, VesiX was able to significantly reduce intracellular populations of uropathogenic bacteria in cultured bladder epithelial cells.

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.

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.