Giovanna Giuliana

In vitro activities of antimicrobial agents against Candida species

OBJECTIVE Antimicrobial mouthrinses may represent a valid alternative to topical antifungal agents. However, the action of antimicrobials could be affected by the different ingredients incorporated into mouthrinse products. The purpose of the present study was to investigate the in vitro antifungal and fungicidal activities of antimicrobials alone. STUDY DESIGN A broth macrodilution method was used to determine the minimum inhibitory concentration of 4 antimicrobial agents against Candida species. Minimum fungicidal concentration was also determined. RESULTS All antimicrobials showed antifungal activity against all tested organisms, but cetylpyridinium chloride received significantly lower minimum inhibitory concentrations (P < .005). Cetylpyridinium chloride also showed a greater fungicidal activity than chlorhexidine digluconate and hexetidine (P< .005), whereas sanguinarine chloride appeared to be less fungicidal against most of the isolates tested. CONCLUSIONS These findings suggest that cetylpyridinium chloride may be used as a topical antifungal agent. Clinical trials are now required to assess its value in the management of oral candidosis.

Effect of antimicrobial mouthrinses on the in vitro adhesion of Candida albicans to human buccal epithelial cells

Abstract Adhesion to epithelial cells is a critical step in successful oral colonization and infection by Candida albicans. Therefore, three mouthrinse products, containing chlorhexidine 0.2% (CHX), cetylpyridinium chloride 0.05% (CPC) or triclosan 0.045% (TRN), were compared for their effects on the in vitro adhesion of C. albicans to human buccal epithelial cells (BEC). Candidal adhesion appeared to be significantly reduced by oral rinsing with the CHX-containing mouthrinse (P<0.0001). In vivo exposure of BEC to the CPC mouthrinse also inhibited adhesion of C. albicans (P<0.0001). Both CHX and CPC products suppressed adhesion to the same extent (P>0.01). On the other hand, the TRN mouthrinse did not significantly affect epithelial adhesion of C. albicans (P>0.01). These findings suggest that mouthrinses containing CHX or CPC could be of value in the control of candidal colonization and infection. Clinical trials are warranted on the effectiveness of these products in reducing oral Candida carriage.

Effect of hormone replacement therapy (HRT) on periodontal status of postmenopausal women

Summary Background The risks/benefits balance of hormone replacement therapy (HRT) is controversial. The aim of this study was to assess the periodontal status of a postmenopausal women group receiving HRT and to determine the effects of HRT on clinical measures of periodontal disease. Material/Methods Ninety-one postmenopausal women, 52 taking HRT (HRT+) and 39 not taking HRT (HRT−), completed the study. Clinical parameters measured included visible supragingival plaque, probing pocket depth (PD) and clinical attachment level (CAL). Gingival status was recorded as gingival bleeding on probing (BOP). Previous oral contraceptive use and current and past smoking status were also assessed. Results Data indicated that PD and CAL were not significantly different between HRT+ patients and HRT− patients (P=0.8067 and P=0.1627, respectively). The HRT+ group exhibited significantly lower visible plaque levels compared to the control group (P<0.0001). The percentage of gingival sites with positive BOP was significantly lower in the HRT+ group compared to the HRT− group (34.85% vs. 65.15%; P=0.0007). Plaque accumulation was also tested in ANCOVA as a possible explanatory variable for the differences observed in gingival bleeding. The ANCOVA showed no significant differences in gingival bleeding between HRT+ and HRT− women (P=0.4677). No significant differences in past smoking status and oral contraceptive use were detected between HRT+ and HRT− women (P=0.9999 and P=0.0845, respectively). Conclusions These findings indicated that long-term HRT was not associated with relevant effects on periodontal status and clinical measures of periodontal disease, thus suggesting that HRT may not confer protection against periodontitis in postmenopausal women.

Topical Fluoride for Preventing Dental Caries in Children and Adolescents

The use of topically applied fluoride has been widely researched as a means to reduce the risk of dental caries in conjunction with other treatment modalities (mechanical oral hygiene, dietary control, antimicrobial intervention, pit and fissure sealants). There is overwhelming evidence that reports not only the significance and importance of the use of fluoride as a caries-preventive agent, but also how safe fluoride application is when used appropriately, particularly in higher risk individuals and populations. This paper reviews the caries-protective benefits of topical fluoride application in children and adolescents, with an emphasis on the clinical efficacy and safety of the vehicles by which fluoride is topically delivered. Fluoride toothpaste represents today the most cost-effective fluoride-delivery system in the oral cavity and its use should be the centerpiece in all caries-preventive strategies. On the other hand, mouthrinses, gels and varnishes currently represent adjuncts to toothpaste use and should be targeted towards individuals and groups at high risk of caries.