The effect of cetylpyridinium chloride mouthrinse as adjunct to toothbrushing compared to placebo on interproximal plaque and gingival inflammation—a systematic review with meta-analyses

Langa, Gerson Pedro José; Muniz, Francisco Wilker Mustafa Gomes; Costa, Ricardo dos Santos Araújo; Silveira, Taciane Menezes da; Rösing, Cassiano Kuchenbecker

doi:10.1007/s00784-020-03661-2

Cited by 18 publications

(18 citation statements)

References 32 publications

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“…Several reviews have been published on the efficacy of CPC mouthwash in reducing dental plaque and gingivitis. While CPC‐containing mouthwashes have been shown to be effective in reducing plaque and gingivitis when used as an adjunct to toothbrushing, the evidence is inconclusive due to the large heterogeneity between studies, particularly differences in CPC formulations 6,23–26 . CPC has been formulated in mouthwashes at concentrations ranging from 0.05% to 0.10%, and studies that tested its efficacy also reported varying durations of CPC mouthwash use from 24 h to 6 months.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of 0.05% cetylpyridinium chloride mouthwash as an adjunct to toothbrushing compared with 0.12% chlorhexidine gluconate mouthwash in reducing dental plaque and gingival inflammation: A randomized control trial

Saddki

2022

Int J Dental Hygiene

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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.

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Section: Discussionmentioning

confidence: 99%

Efficacy of 0.05% cetylpyridinium chloride mouthwash as an adjunct to toothbrushing compared with 0.12% chlorhexidine gluconate mouthwash in reducing dental plaque and gingival inflammation: A randomized control trial

Saddki

2022

Int J Dental Hygiene

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“…To date, there has been limited evidence that curcumin could be of clinical efficacy if compared with CHX 26 ; even if with encouraging results, there is insufficient evidence to recommend the use of green tea formulation as the first-choice treatment for gingivitis 27 ; limited results have also suggested that propolis-based mouthwashes could have potential but limited benefits in reducing plaque and gingival inflammation, 28 29 as well as herbal mouthwashes. 30 More promising results have been obtained with the use of cetylpyridinium chloride mouthrinse, 31 triphala mouthwash, 32 and dentifrice-containing baking soda (BS). 33 Very limited evidence described the clinical utility for gingivitis of tea-tree oil, 34 35 hyaluronic compounds, 36 37 coenzyme Q10, 38 coconut oil, 39 and Lippia sidoides gel.…”

Section: Discussionmentioning

confidence: 99%

Preliminary Evaluation of a NitrAdine-Based Brushing Solution for Patients Suffering from Gingivitis: A Prospective Clinical Case–Control Study

Perelli¹,

Abunto²,

Semenza

et al. 2021

Eur J Dent

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Objectives This article aimed to evaluate the clinical efficacy of a nonantibiotic biofilm-removal formulation based on NitrAdine (PerioTabs), combined with a regular home oral hygiene regimen, in Caucasian patients with gingivitis. Materials and Methods A sample of 60 patients were included in this clinical prospective study. All selected subjects underwent regular prophylaxis and professional oral hygiene at baseline; 30 days later, they were recalled for the measurements of the reference parameters about bleeding on probing (full-mouth bleeding upon probing score [FMBS]) and plaque index (full-mouth plaque score [FMPS]); no other clinical procedure was performed. Consequently, half of the patients (n = 30) were instructed to use PerioTabs for 10 days. The remaining patients (n = 30) were used as the negative control, only instructed to continue with their usual oral hygiene regimen. Fifteen days after, the clinical parameters of FMBS and FMPS were re-evaluated in both groups. Results Changes in the scores of clinical indices FMBS and FMPS were calculated and compared. A significant difference between pre- and post-values, for both FMBS and FMPS, was noticed in the test group; in particular, the bleeding index value demonstrated the more significant changes: 22 participants showed a clinically meaningful improvement, and 5 had a small improvement. Only three patients had no evidence of change. In addition, 50% of patients had a reduction in plaque levels. No side effects were reported. Conclusions The adjunctive use of 10-day PerioTabs treatment in the daily oral hygiene routine seemed to be efficient in reducing gingival bleeding and plaque accumulation, with absence of adverse effects. These results should be confirmed in studies with a larger number of participants following a controlled-blinded design.

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“…Its mechanism of antimicrobial activity involves the disruption of membrane function, followed by the leakage of cytoplasmic material and the collapse of the intra-cellular equilibrium [ 27 ]. Four meta-analyses reported reductions in PI scores [ 16 , 47 , 48 , 54 ], and four other meta-analyses reported reductions in GI scores [ 16 , 48 , 50 , 54 ]. CPC showed inconsistent results, especially at concentrations of less than 0.05% ( Table 2 and Table 3 ).…”

Section: Intended Effects Of Mouthwash On Biofilm Controlmentioning

confidence: 99%

“…CPC showed inconsistent results, especially at concentrations of less than 0.05% ( Table 2 and Table 3 ). The most recent meta-analysis of the effect of CPC, as an adjunct to toothbrushing, on interproximal plaque and gingival inflammation was conducted by Langa et al [ 54 ]. Studies with a minimum of 6 weeks of follow-up were included.…”

Section: Intended Effects Of Mouthwash On Biofilm Controlmentioning

confidence: 99%

Evidence on the Use of Mouthwash for the Control of Supragingival Biofilm and Its Potential Adverse Effects

et al. 2022

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Antimicrobial mouthwash improves supragingival biofilm control when used in conjunction with mechanical removal as part of an oral hygiene routine. Mouthwash is intended to suppress bacterial adhesion during biofilm formation processes and is not aimed at mature biofilms. The most common evidence-based effects of mouthwash on the subgingival biofilm include the inhibition of biofilm accumulation and its anti-gingivitis property, followed by its cariostatic activities. There has been no significant change in the strength of the evidence over the last decade. A strategy for biofilm control that relies on the elimination of bacteria may cause a variety of side effects. The exposure of mature oral biofilms to mouthwash is associated with several possible adverse reactions, such as the emergence of resistant strains, the effects of the residual structure, enhanced pathogenicity following retarded penetration, and ecological changes to the microbiota. These concerns require further elucidation. This review aims to reconfirm the intended effects of mouthwash on oral biofilm control by summarizing systematic reviews from the last decade and to discuss the limitations of mouthwash and potential adverse reactions to its use. In the future, the strategy for oral biofilm control may shift to reducing the biofilm by detaching it or modulating its quality, rather than eliminating it, to preserve the benefits of the normal resident oral microflora.

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The effect of cetylpyridinium chloride mouthrinse as adjunct to toothbrushing compared to placebo on interproximal plaque and gingival inflammation—a systematic review with meta-analyses

Cited by 18 publications

References 32 publications

Efficacy of 0.05% cetylpyridinium chloride mouthwash as an adjunct to toothbrushing compared with 0.12% chlorhexidine gluconate mouthwash in reducing dental plaque and gingival inflammation: A randomized control trial

Efficacy of 0.05% cetylpyridinium chloride mouthwash as an adjunct to toothbrushing compared with 0.12% chlorhexidine gluconate mouthwash in reducing dental plaque and gingival inflammation: A randomized control trial

Preliminary Evaluation of a NitrAdine-Based Brushing Solution for Patients Suffering from Gingivitis: A Prospective Clinical Case–Control Study

Evidence on the Use of Mouthwash for the Control of Supragingival Biofilm and Its Potential Adverse Effects

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