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Hypochlorous acid (HOCl) in a non-antibiotic antimicrobial agent used in clinical medicine. Nevertheless, its antiplaque oral effect has not been evaluated. Chlorhexidine (CHX) is the gold standard as an antiplaque agent for its high substantivity in plaque and saliva. There are no published studies evaluating the substantivity of hypochlorous acid compared to CHX. Objective: To evaluate the efficacy of mouthwashes of HOCl in substantivity evaluated by reduction of bacterial viability in saliva during 7 hours compared to CHX rinses and a placebo.
Materials and Methods: A randomized, double-blind clinical trial with 75 participants was conducted. Participants were randomly assigned using block randomization in five groups: HOCl 0.025% and 0.05%, CHX 0.12 and 0.2% and sterile water as placebo. Participants were instructed to use each rinse with 10 ml of each solution for 30 seconds after dental prophylaxis. Samples of saliva were taken at baseline and after 30 seconds, 1, 3.5 and 7 hours to assess substantivity establishing the bacterial viability by the fluorescence method with the SYTO 9/propidium iodide dual staining. All participants were assessed with the Turesky visible plaque index at baseline and at 7 hours and adverse events were assessed. For the comparisons of the viability of the different rinses between times, the statistical test of generalized linear mixed model [GT1] adjusted to treatment, time and treatment-time interaction was used.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| HOCl 0.025% | Experimental | 15 ml of Hypochlorous acid mouthwash at 0.025% |
|
| HOCl 0.05% | Experimental | 15 ml of Hypochlorous acid mouthwash at 0.05% |
|
| CHX 0.2% | Active Comparator | 15 ml of chlorhexidine mouthwash at 0.2% |
|
| CHX 0.025% | Active Comparator | 15 ml of chlorhexidine at mouthwash0.025% |
|
| Placebo | Placebo Comparator | 15 ml of Sterile water |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Hypochlorous Acid | Drug | Mouthwashes of antiplaque agents |
|
| Measure | Description | Time Frame |
|---|---|---|
| Substantivity | Viability reduction (VR) was calculated for each saliva sample by the difference in the percentage of viable bacteria between two times. | Baseline, 30 Seconds, 1, 3, 5 and 7 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Plaque Index | Visible plaque was evaluated by Turesky Index 1970 | Baseline and 7 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Adverse effect | A survey was applied to each of the patients in order to record if any adverse effects occurred after the use of each of the interventions as burning and pain in the oral mucosa and was investigated by the taste of substances and sensation of dryness. An examiner evaluated the buccal, labial, lingual, pharyngeal and teeth tissues to establish changes and alterations visible to the clinical examination and the presence of candidiasis. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Gloria Ines Lafaurie, MS | El Bosque University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gloria Ines Lafaurie | Bogotá | 1101 | Colombia |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Result | Lafaurie GI, Calderón JL, Zaror C, Millán LV, Castillo DM. Hypochlorous Acid: A New Alternative as Antimicrobial Agent and For Cell Proliferation for Use in Dentistry. International journal of odontostomatology. 9: 475-481. 2015 | ||
| 26647939 | Result | Castillo DM, Castillo Y, Delgadillo NA, Neuta Y, Jola J, Calderon JL, Lafaurie GI. Viability and Effects on Bacterial Proteins by Oral Rinses with Hypochlorous Acid as Active Ingredient. Braz Dent J. 2015 Oct;26(5):519-24. doi: 10.1590/0103-6440201300388. | |
| 27447617 |
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No requerid
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| ID | Term |
|---|---|
| D006997 | Hypochlorous Acid |
| D002710 | Chlorhexidine |
| ID | Term |
|---|---|
| D000148 | Acids, Noncarboxylic |
| D000143 | Acids |
| D007287 | Inorganic Chemicals |
| D017606 | Chlorine Compounds |
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A double-blind randomized controlled trial with 75 participants was conducted. Participants were assigned using block randomization in five groups: HOCl 0.025% and 0.05%, CHX 0.12% and 0.2% and sterile water as placebo. Participants were instructed to use each rinse solution for 30 seconds after dental prophylaxis. Samples of saliva were taken at baseline and after 30 seconds, 1, 3.5 and 7 hours to assess substantivity establishing the bacterial viability by the fluorescence method.
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The treatment codes of the study were not accessible to the investigators and to the examiner until the data were analyzed
| Chlorhexidine | Drug | A disinfectant and topical anti-infective agent used also as mouthwash to prevent oral plaque. |
|
|
| Placebo | Other | Sterile water as placebo |
|
|
| 24 hours |
| Result |
| Chen CJ, Chen CC, Ding SJ. Effectiveness of Hypochlorous Acid to Reduce the Biofilms on Titanium Alloy Surfaces in Vitro. Int J Mol Sci. 2016 Jul 19;17(7):1161. doi: 10.3390/ijms17071161. |
| 8682921 | Result | Moran J, Addy M, Wade W, Milson S, McAndrew R, Newcombe RG. The effect of oxidising mouthrinses compared with chlorhexidine on salivary bacterial counts and plaque regrowth. J Clin Periodontol. 1995 Oct;22(10):750-5. doi: 10.1111/j.1600-051x.1995.tb00257.x. |
| 17492050 | Result | Wang L, Bassiri M, Najafi R, Najafi K, Yang J, Khosrovi B, Hwong W, Barati E, Belisle B, Celeri C, Robson MC. Hypochlorous acid as a potential wound care agent: part I. Stabilized hypochlorous acid: a component of the inorganic armamentarium of innate immunity. J Burns Wounds. 2007 Apr 11;6:e5. |
| D017382 |
| Reactive Oxygen Species |
| D005609 | Free Radicals |
| D010087 | Oxides |
| D017601 | Oxygen Compounds |
| D001645 | Biguanides |
| D006146 | Guanidines |
| D000578 | Amidines |
| D009930 | Organic Chemicals |