Chlorhexidine gluconate 0.06% / Sodium fluoride 0.05% mouthwash sugar free

White spot lesions (WSLs) are early clinical stages of enamel demineralization, often related to orthodontic treatment or poor oral hygiene. The use of gels such as fluoride for topical application inhibits demineralization and promotes remineralization of dental tissues through various mechanisms. A variety of therapeutic approaches are available; however, recent research indicates that combined treatment strategies may yield superior clinical outcomes compared to monotherapy. The aim of this study was to critically compare the efficacy of combining multiple treatment techniques for WSLs compared to using these techniques alone. A systematic search was conducted in PubMed, Scopus, and Cochrane databases according to PRISMA guidelines. The PICO strategy was used to formulate the research question: Which clinical approaches combined or isolated (C) influence the treatment and prevention effectiveness (O) of white spot lesions (I) in humans (P) in the last ten years (T)? Inclusion criteria focused on clinical studies from the last ten years evaluating the combined use of at least two treatment techniques for WSL, resulting in a total of 8 randomized controlled trials selected from an initial pool of 1185 articles. Our results suggest that combined treatment strategies, including resin infiltration with fluoride varnish and ozone therapy combined with fluoride application, demonstrated enhanced efficacy in lesion masking and remineralization compared to single-treatment approaches. CPP-ACP and hydroxyapatite-based creams improved aesthetics, particularly when used alongside fluoride varnish. Our study concluded that the combination of remineralization agents like fluoride gel, infiltrative resins, and antimicrobial treatments offers superior outcomes on white spot lesion treatment than using these techniques alone. However, long-term clinical studies are needed to standardize treatment protocols and confirm durability.

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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.

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IntroductionFluoride varnishes are widely used in caries prevention, but the rate and duration of fluoride ion release differ depending on material composition and environmental factors.ObjectivesThis systematic review synthesized evidence from in vitro studies on human teeth to identify key factors influencing fluoride release.MethodsA systematic literature search was conducted in July 2025 in PubMed, Scopus, Web of Science, Embase, and the Cochrane Library using the terms "fluoride release" AND "varnish" in titles and abstracts. Study selection followed PRISMA 2020 guidelines, predefined eligibility criteria, and was structured according to the PICO framework. Of 484 retrieved records, 15 studies met the inclusion criteria and were analyzed qualitatively.ResultsThe primary outcome was the magnitude and duration of fluoride release from varnishes. Most studies reported peak release within the first 24 h, followed by a marked decline, although some formulations (e.g., Clinpro XT and Duraphat) maintained more stable long-term release. Substantial methodological heterogeneity was observed across studies, including differences in sample type, storage medium, pH, temperature, and measurement protocols, which influenced fluoride release dynamics. Reported secondary outcomes included enamel remineralization, changes in surface properties, and antibacterial activity, with bioactive additives such as CPP-ACP and TCP enhancing preventive effects. Acidic conditions consistently increased fluoride release.ConclusionsThe magnitude and persistence of fluoride release from varnishes depend on both intrinsic material properties and external environmental conditions. Bioactive additives may prolong fluoride availability and provide additional preventive benefits.

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Background and aimsAntiseptics have been widely used in periodontology and implantology as an adjunct to mechanical plaque control. The main objective of this review was to summarize the best evidence for the use of antiseptics in the prevention and treatment of periodontal and peri-implant diseases.MethodsA comprehensive literature search was conducted across multiple databases, including Scopus, PubMed/Medline, Web of Science, and ScienceDirect. Keywords such as (Antiseptics OR mouthwashes) AND (gingivitis OR periodontitis OR peri-implantitis OR mucositis) were used. Inclusion criteria included narrative or systematic reviews with or without meta-analysis and clinical studies. In vitro, animal studies, and case reports were excluded.ResultsAntiseptics, including chlorhexidine, essential oils, and povidone-iodine, proved effective in reducing gingival inflammation and improving the plaque index. Other molecules, such as octenidine dihydrochloride, showed some effectiveness, although further studies are needed to expand their use.ConclusionAntiseptics play a crucial role in improving periodontal health. Prescriptions should be tailored to therapeutic goals to ensure appropriate dosage and duration, while avoiding excessive use.

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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.

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IntroductionThe increasing prevalence of dental implants has brought greater attention to the prevention and management of peri-implant diseases, which can compromise long-term implant success. This systematic review evaluated the current evidence on oral self-care practices for maintaining peri-implant health in healthy, non-smoking adults.MethodsThis systematic review was reported in accordance with the PRISMA 2020 statement and registered in the PROSPERO database (CRD420251028140). PICO methods and guidelines for the Center for Evidence-Based Medicine were used to develop the focus question, "What are the best practices for oral self-care for the prevention and management of peri-implant conditions and diseases?" Risk of bias was determined by applying the ROBIS Tool to assess risk of bias in systematic reviews and the revised Cochrane risk of bias tool for randomized trials (RoB2).ResultsAcross 12 studies, interventions were categorized into five domains: toothbrushes, interdental aids, toothpaste, mouth rinses/topicals, and multi-modal self-care strategies. Powered toothbrushes, particularly oscillating-rotating models, demonstrated superior plaque and inflammation reduction compared to manual options. Triclosan-containing toothpastes consistently outperformed fluoride-only formulations in decreasing plaque, bleeding on probing, and pathogenic bacteria. Interdental aids such as interproximal brushes and oral irrigators were more effective than floss in reducing inflammatory markers. Stannous fluoride-based rinses showed potential anti-inflammatory benefits, while prolonged chlorhexidine use may elevate inflammatory cytokines.DiscussionA multimodal approach combining mechanical and chemical adjuncts was most effective for peri-implant disease prevention. These findings emphasize the importance of individualized, evidence-based home care protocols in preserving implant longevity and reducing peri-implant disease burden.Systematic review registrationhttps://www.crd.york.ac.uk/PROSPERO/view/CRD420251028140, PROSPERO CRD420251028140.

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Background and aimWhite spot lesions (WSLs) are the most common lesions in orthodontic treatment. Preventing WSLs during and after orthodontic treatment is a major challenge in modern dentistry. Introducing nanotechnology-based materials with antimicrobial, anticariogenic, and remineralizing potential is the emerging trend to prevent WSL. This systematic review was conducted to find the effectiveness of nanoparticle-based oral rinses in preventing WSL in orthodontic treatments.Materials and methodsThe systematic review included human trials published in English between January 2010 and September 2024. The search strategy involved exploring electronic databases such as PubMed Central, SCOPUS, Web of Science, and Cochrane. The reviewers individually assessed the risk of bias in the included studies using the recommended assessment of the risk of bias approach in the included studies.ResultsOne study that met the inclusion criteria was included in this systematic review. The overall incidence of WSLs per tooth after six months was 9.52% for the nanosilver (NS) mouthwash, compared to 24.4% for both the fluoride and chlorhexidine (CHX) mouthwashes. The right maxillary lateral incisor had the highest incidence (38.09%). Gingival margins of maxillary teeth had a higher incidence of WSLs compared to mandibular teeth, as the formation of biofilm is high in maxillary teeth.ConclusionNanosilver mouthwash reduces the incidence of WSLs by over 80% compared to chlorhexidine and fluoride mouthwash in fixed orthodontic treatment. Furthermore, better-conducted trials with various nanoparticle-based mouthwashes are necessary for their clinical use in orthodontic patients.

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