Mucoadhesive Pharmacology: Latest Clinical Technology in Antiseptic Gels

Abstract

Chlorhexidine (CHX) is one of the most widely used antiseptics in the oral cavity due to its high antimicrobial potential. However, many authors have stated that the effect of CHX in nonsurgical periodontal therapy is hampered by its rapid elimination from the oral environment. The aim of this study was to determine the antibacterial efficacy of a new compound of chlorhexidine 0.20% + cymenol (CYM) 0.10% on a multispecies biofilm. For this, an in vitro study was designed using a multispecies biofilm model of Streptococcus mutans, Fusobacterium nucleatum, Prevotella intermedia, and Porphyromonas gingivalis. Quantification of the microbial viability of the biofilm was performed using 5-cyano-2,3-ditolyl tetrazolium-chloride (CTC) to calculate the percentage of survival, and the biofilms were observed using a a confocal laser scanning microscopy (CLSM). It was observed that the bactericidal activity of the CHX + cymenol bioadhesive gel was superior to that of the CHX bioadhesive gel, in addition to higher penetrability into the biofilm. Therefore, there was greater elimination of bacterial biofilm with the new compound of chlorhexidine 0.2% plus cymenol 0.1% in a bioadhesive gel form compared to the formulation with only chlorhexidine 0.2% in a bioadhesive gel form.

Keywords: antibacterial gels; antimicrobial gels; chlorhexidine; cymenol; periodontal application; substantivity.

Figure 1

Representative micrographs of bacterial viability using CLSM. Biofilm with application of chlorhexidine 0.20% + cymenol 0.10% gel (HB31). Note: green: viable bacteria; red: dead bacteria; yellow/orange: intermediate colors that can sometimes be observed in bacterial cells stained with a live/dead kit, resulting from the superposition of a green pixel and red pixel in the same z-plane. The yellow cells were considered viable, while orange cells were considered damaged. Scale bar = 20 μm.

Figure 2

Representative micrographs of bacterial viability using CLSM: (a) biofilm control; (b) biofilm with application of chlorhexidine 0.20% gel (CLB). Note: green: viable bacteria; red: dead bacteria; yellow/orange: intermediate colors. Scale bar = 20 μm.

Figure 3

Representative 3D micrographs of bacterial viability using CLSM: (a) biofilm control; (b) chlorhexidine 0.20% gel (CLB); (c) chlorhexidine 0.20% + cymenol 0.10% gel (HB31). Note: green: viable bacteria; red: dead bacteria; yellow/orange: intermediate colors.