Olivia Aherne^1,2, Roberto Ortiz² , Magnus M. Fazli^3,4 and Julia R. Davies^1*

Abstract

Background: Caries and periodontitis are amongst the most prevalent diseases worldwide, leading to pain and loss of oral function for those affected. Prevention relies heavily on mechanical removal of dental plaque biofilms but for populations where this is not achievable, alternative plaque control methods are required. With concerns over unde-sirable side-effects and potential bacterial resistance due to the use of chlorhexidine gluconate (CHX), new antimicrobial substances for oral use are greatly needed. Here we have investigated the antimicrobial effect of hypochlorous acid (HOCl), stabilized with acetic acid (HAc), on oral biofilms and compared it to that of CHX. Possible adverse effects of stabilized HOCl on hydroxyapatite surfaces were also examined.

Methods: Single- and mixed-species biofilms of six common oral bacteria (Streptococcus mutans, Streptococcus gordonii, Actinomyces odontolyticus, Veillonella parvula, Parvimonas micra and Porphyromonas gingivalis) within a flow-cell model were exposed to HOCl stabilized with 0.14% or 2% HAc, pH 4.6, as well as HOCl or HAc alone. Biofilm viability was assessed in situ using confocal laser scanning microscopy following LIVE/DEAD® BacLight™ staining. In-situ quartz crystal microbalance with dissipation (QCM-D) was used to study erosion of hydroxyapatite (HA) surfaces by stabilized HOCl.

Results: Low concentrations of HOCl (5 ppm), stabilized with 0.14% or 2% HAc, significantly reduced viability in multi-species biofilms representing supra- and sub-gingival oral communities, after 5 min, without causing erosion of HA surfaces. No equivalent antimicrobial effect was seen for CHX. Gram-positive and Gram-negative bacteria showed no significant differential suceptibility to stabilized HOCl.

Conclusions: At low concentrations and with exposure times which could be achieved through oral rinsing, HOCl stabilized with HAc had a robust antimicrobial activity on oral biofilms, without causing erosion of HA surfaces or affecting viability of oral keratinocytes. This substance thus appears to offer potential for prevention and/or treatment of oral biofilm-mediated diseases.

Keywords: Biofilm control, Oral disease, Caries, Periodontitis, Oral infection

Julio Cesar Plata ^1,2, David Díaz-Báez ³ , Nathaly Andrea Delgadillo ³ , Diana Marcela Castillo ³ , Yormaris Castillo ³ , Claudia Patricia Hurtado ² , Yineth Neuta ³ , Justo Leonardo Calderón ³ and Gloria Inés Lafaurie ^3,*

1 Master’s Program in Dental Sciences, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

2 School of Dentistry, Universidad Cooperativa de Colombia, Bucaramanga P.O. Box 680001, Colombia; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

3 Unit of Oral Basic Investigation-UIBO, School of Dentistry, Universidad El Bosque, Bogotá P.O. Box 110121, Colombia; 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (D.D.-B.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (N.A.D.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (D.M.C.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (Y.C.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (Y.N.); 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。 (J.L.C.)

* Correspondence: 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。

Abstract: Background: Hypochlorous acid (HOCl) is an antimicrobial agent with high affinity to Gram-negative bacteria of the subgingival biofilm. It could have an equivalent or no inferiority effect to chlorhexidine (CHX) to avoid recolonization of these microorganisms after the post-surgical period. Objective: The objective is to compare the reduction of plaque index (PI), gingival index (GI), pocket depth (PD), gain of clinical attachment level (CAL), and bacterial recolonization of periodontopathic microorganisms in subgingival biofilm at 7, 21, and 90 days after Open Flap Debridement (OFD) under two antimicrobial protocols: (A) HOCl 0.05% followed by HOCl 0.025% and (B) CHX 0.2%/CHX 0.12% used per 21 days without regular oral hygiene during the post-surgical period. Material and methods: A no-inferiority randomized controlled trial was carried out. Thirty-two patients were randomly divided to receive each antiplaque protocol after OFD in patients with periodontitis. Clinical indexes and bacterial recolonization were assessed using qPCR for up to 90 days. Data were analyzed using repeated measures ANOVA, mixed effects models adjusted for treatment, time, and the Chi-squared/Fisher test. A no-inferiority analysis was also performed using the Hodges–Lehmann hypothesis test for non-inferiority. Results: HOCl was not inferior to CHX in reducing PI. Both groups showed a comparable reduction of recolonization for Porphyromonas gingivalis, Tannerella forsythia, and Eubacterium nodatum. However, the HOCl protocol was non-inferior to the CHX protocol for Treponema denticola and Aggregatibacter actinomicetemcomitans. Conclusions: HOCl improved periodontal healing. HOCl showed an impact in reducing the recolonization of periodontopathic bacteria in the postoperative period.

Keywords: chlorhexidine; antiplaque; bacterial recolonization; hypochlorous acid

Diah R Hadiati¹, Mohammad Hakimi¹, Detty S Nurdiati ², Yuko Masuzawa³, Katharina da Silva Lopes ⁴, Erika Ota⁵

¹Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia. ²Department of Obstetrics and Gynaecology, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia. ³Department of Health Informatics, Graduate

School of Medicine/School of Public Health, Kyoto University, Kyoto, Japan. ⁴Graduate School of Public Health, St. Luke's International University, Tokyo, Japan. ⁵Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan

Contact: Diah R Hadiati, 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。.

Editorial group: Cochrane Pregnancy and Childbirth Group.

Publication status and date: New search for studies and content updated (no change to conclusions), published in Issue 6, 2020.

Citation: Hadiati DR, Hakimi M, Nurdiati DS, Masuzawa Y, da Silva Lopes K, Ota E. Skin preparation for preventing infection following caesarean section. Cochrane Database of Systematic Reviews 2020, Issue 6. Art. No.: CD007462. DOI: 10.1002/14651858.CD007462.pub5. Copyright © 2020 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

Clare F Heal ^1,2, Jennifer L Banks ³, Phoebe D Lepper ³, Evangelos Kontopantelis ⁴, Mieke L van Driel ⁵

¹General Practice and Rural Medicine, James Cook University, Mackay, Australia. ²Anton Breinl Research Centre for Health Systems Strengthening, Townsville, Australia. ³School of Medicine and Dentistry, James Cook University, Mackay, Australia. ⁴Centre for Health Informatics, Institute of Population Health, The University of Manchester, Manchester, UK. ⁵Discipline of General Practice, School of Medicine, The University of Queensland, Brisbane, Australia

Contact: Clare F Heal, General Practice and Rural Medicine, James Cook University, Mackay Base Hospital, Bridge Road, Mackay, Queensland, 4740, Australia. 该Email地址已收到反垃圾邮件插件保护。要显示它您需要在浏览器中启用JavaScript。.

Editorial group: Cochrane Wounds Group.

Publication status and date: New, published in Issue 11, 2016.

Citation: Heal CF, Banks JL, Lepper PD, Kontopantelis E, van Driel ML. Topical antibiotics for preventing surgical site infection in wounds healing by primary intention. Cochrane Database of Systematic Reviews 2016, Issue 11. Art. No.: CD011426. DOI: 10.1002/14651858.CD011426.pub2.

Copyright © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.