Cetylpyridinium chloride 0.025% gel

AimTo evaluate the effectiveness of cetylpyridinium chloride (CPC) and chlorhexidine (CHX) mouthwashes (MW) on plaque and gingivitis scores for patients with gingivitis, in brushing as well as non-brushing situations.MethodsA comprehensive search of MEDLINE-PubMed and Cochrane-CENTRAL was conducted to identify clinical and randomised controlled trials comparing CPC and CHX mouthwashes on plaque and gingivitis scores. The staining index was evaluated as a secondary outcome. In addition, the risk of bias was assessed. The data was summarised using a descriptive approach, and whenever possible, a meta-analysis was conducted. The results for brushing and non-brushing studies were presented separately. Grading was applied using the GRADE approach to rate the certainty of evidence.ResultsThe search resulted in 424 unique papers, from which 14 full-text papers providing 18 comparisons were selected. Different concentrations of CPC-MW (0.1%, 0.075%, 0.05%) and CHX-MW (0.2%, 0.12%) were used. The risk of bias was estimated to be low, moderate or high for each study. A meta-analysis for non-brushing models showed a significant favour for CHX-MW in plaque index scores (0.55 [95% CI: 0.19; 0.91], p = 0.003). For brushing, no significant differences were found between CPC-MW and CHX-MW. The descriptive analysis supports these findings. CHX-MW tends to stain more than CPC-MW.ConclusionThere is moderate certainty for a small statistically significant favourable effect of CHX-MW over CPC-MW for plaque control in non-brushing situations, but no difference between them for plaque and gingivitis prevention in brushing situations.

Abstract licence: CC BY

Background and aimEffective oral hygiene using different mechanical means is mainly dependent on the patient. Mouthwashes containing antimicrobial agents have been developed to be used as an adjunct to mechanical supragingival plaque control. The aim of this umbrella review is to evaluate and compare the long-term efficacy of commonly used, commercially available daily mouthwashes in plaque control and gingival inflammation.MethodsThe current umbrella review was conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions using the PICOS format. The search was conducted in four databases: PubMed, Scopus, Cochrane and Web of Science. Nine systematic reviews/meta-analyses (SRs/MAs) on the long-term efficacy of commercially available mouthwashes (low-concentration chlorhexidine [CHX], cetylpyridinium chloride [CPC], mouthwashes with essential oils [EOs], fluoride and oxygen-releasing mouthwashes) were included.ResultsThe results revealed that in all SRs/MAs, the prolonged daily use of mouthwashes helped in reducing plaque and gingival inflammation indices but not always with statistical significance.ConclusionsResults of the present study indicate that the long-term use of mouthwashes containing EOs seems to give the best results in both reducing plaque levels and improving gingivitis indices among all tested formulations.Trial registrationPROSPERO Registration Number CRD 42024618552.

Abstract licence: CC BY-NC-ND

ObjectivesThe established effect of cetylpyridinium chloride (CPC) mouthwash on SARS-CoV-2 viral titers is unclear. No clinical trial has examined the impact of on-demand aqueous chlorine dioxide mouthwash on SARS-CoV-2 viral titer.MethodsIn this multicenter, 3-armed, randomized, open-label, placebo-controlled clinical trial involving mildly symptomatic COVID-19 patients, we randomly assigned them to receive 20 mL of 0.05% CPC, 10 mL of 0.01% on-demand aqueous chlorine dioxide, or 20 mL of purified water as a placebo mouthwash in a 1:1:1 ratio. The primary measurement was the SARS-CoV-2 viral titer in saliva, evaluated by a mixed-effects linear regression model.Results49 patients received CPC mouthwash (n=16), on-demand aqueous chlorine dioxide mouthwash (n=16), and placebo (n=17) between January 14, 2024, and February 20, 2024. 0.05% CPC mouthwash significantly reduced salivary viral titer at 10 minutes postuse (-0.97 log10 PFU/mL; 95% CI, -1.64 to -0.30; P = .004), while no such effect was observed at 30 minutes (difference vs placebo, -0.26 log10 PFU/mL; 95% CI, -0.92 to 0.40; P = .435) or 60 minutes (difference vs. placebo, -0.05 log10 PFU/mL; 95% CI, -0.68 to 0.58; P = .877). 0.01% on-demand chlorine dioxide mouthwash did not reduce salivary viral titer at 10 minutes, 30 minutes, or 60 minutes compared to placebo.Conclusions10 minutes after using a 0.05% CPC mouthwash, the salivary viral titer of SARS-CoV-2 decreased compared to placebo. 0.01% on-demand aqueous chlorine dioxide mouthwash and placebo had no significant difference in SARS-CoV-2 viral titers.Trial registrationJapan Registry of Clinical Trials (jRCT): jRCTs031230566.

Abstract licence: CC BY