Antimicrobial efficacy of 0·05% cetylpyridinium chloride mouthrinses

Abstract

Significance and Impact of the Study: These in vitro and ex-vivo studies provide a biological rationale for previous clinical studies demonstrating the efficacy of CPC mouthrinses in reducing supragingival plaque and plaque-associated gingivitis.Keywords antimicrobial susceptibility, cetylpyridinium chloride, chlorhexidine, dental plaque, mouthrinse, oral microbiology. AbstractThis study evaluated the antimicrobial activity of two commercially available 0Á05% cetylpyridinium chloride (CPC) mouthrinses with or without alcohol and examined its antimicrobial activity on oral bacterial species including fresh clinical isolates compared to a chlorhexidine mouthrinse and a control fluoride mouthrinse without CPC. Two different approaches were used to evaluate antimicrobial activity. First, the minimum inhibitory concentration (MIC) was determined for each mouthrinse against a panel of 25 micro-organisms including species associated with dental caries, gingivitis and periodontitis. Second, supragingival dental plaque obtained from 15 adults was incubated with the four mouthrinses to evaluate antimicrobial activity on micro-organisms in oral biofilms. Both CPC mouthrinses exhibited lower MIC's, that is, greater antimicrobial activity, against oral Gram-negative bacteria especially periodontal pathogens and species implicated in halitosis such as Aggregatibacter actinomycemcomitans, Campylobacter rectus, Eikenella corrodens, Porphyromonas gingivalis, Prevotella intermedia and Solobacterium moorei than the control mouthrinse. Ex-vivo tests on supragingival plaque micro-organisms demonstrated significantly greater antimicrobial activity by the CPC mouthrinses (>90% killing, P < 0Á001) and the chlorhexidine rinse (>98% killing, P < 0Á05) compared to the control fluoride mouthrinse. Whilst the chlorhexidine mouthrinse was most effective, mouthrinses containing 0Á05% CPC formulated with or without alcohol demonstrated broadspectrum antimicrobial activity against both laboratory strains and supragingival plaque bacteria compared to a control mouthrinse without CPC.

Commercial antimicrobials mouthrinses on caries and periodontitis-related biofilm control: a review of literature

“…This ex vivo model showed no difference between CPC rinses formulated with alcohol or without alcohol. Both CPC (> 90% killing) and CHX (98% killing) showed higher antimicrobial activity compared to F [22].…”

Efficacy of Mouth Rinse Formulation Based on Cetylpyridinium Chloride 0.1% in the Control of Dental Calculus Buildup

“…The selection of an oral rinse is influenced by many factors, including product formulation and patient preference for esthetics. The majority of therapeutic rinses contain alcohol, which may not be desired for certain patient populations, including children, patients of certain religious faiths, patients with xerostomia, recovering alcoholics, and others [14]. High levels of alcohol also can produce a burning sensation during use and is a product attribute that may be unpleasant for some patients.…”

“…Oral health treatment has shifted from treating the existing disease to preventing future disease. The CPC-containing mouth rinse, designed for the broad population, may be particularly appealing to those patient groups seeking an anticalculus, antiplaque, and antigingivitis rinse without alcohol or the burn of alcohol [14].…”

“…Clinical efficacy for these agents typically has been assessed as the reduction in tartar area coverage on the teeth between dental cleanings [13]. Research shows that topically applied mineralization inhibitors also can influence adhesion and hardness of calculus deposits on the tooth surface, facilitating removal [14,15].…”

Cetylpyridinium Chloride

“…However, it is also an antiseptic that kills bacteria and other microorganisms. 2 Therefore, it is effective in preventing dental plaque and in reducing gingivitis. 3 CPC is widely used in industrial and commercial formulations, including disinfectants, cosmetics, and pharmaceuticals.…”