Mouthwashes: multifunctional aids
Nowadays, mouthwashes are expected to do much more than simply fight off bacteria, which means they need extra ingredients in addition to the traditional chlorhexidine. Curasept ADS® Perio and Curasept ADS® Implant offer exactly that, with
Chemical plaque control is an important feature of daily dental care and prescribing a mouthwash is standard practice when it comes to providing professional treatment for this. A key ingredient in any effective mouthwash is chlorhexidine, however, there are also many others that can significantly boost the effectiveness of a mouthwash without causing any side effects.
Demands from dentistry
Chlorhexidine, which is generally considered to be the most effective antiseptic on the market, acts as both an antibiotic and a bactericide1-14. There are numerous clinical protocols which show how effective chlorhexidine is both before and after treatment. Nowadays, however, dental professionals want a dental rinse that is not only highly efficient, but also has as few side effects as possible – and ideally one that offers additional functions too. This means that extra elements need to be added. Combining chlorhexidine with other antiseptics, for example, can enhance a mouthwash's antibacterial properties. However, it is unclear what additional benefits this actually brings in clinical terms and there is a great deal of disagreement over this in the corresponding literature.
A mouthwash with positive side effects
Nevertheless, a number of studies have shown that it is possible to reduce the staining of the teeth caused by chlorhexidine without compromising its antiseptic effect. This is done with the help of an Anti-Discolouration System (ADS™). In actual fact, Curasept ADS™ is the only system proven to be effective in combating staining without diminishing the effectiveness of the chlorhexidine15-18. Two of the other key ingredients in Curasept are – polyvinylpyrrolidone-vinyl acetate (PVP-VA) and hyaluronic acid (HA) – and both offer highly effective additional benefits.
Polyvinylpyrrolidone-vinyl acetate (PVP-VA) is a polymer derived from polyvinylpyrrolidone (PVP) which has outstanding mucoadhesive properties and forms a protective film over teeth, gums and mucous membranes19. PVP-VA is mainly used in the industrial manufacture of cosmetics, foodstuffs and medicines. However, the maximum permitted daily dose (50 mg/kg) is considerably higher in a mouthwash than it is in a food product or medicine. PVP-VA dissolves very easily in water19 and has no known side effects. Even mouthwashes that consist exclusively of PVP-VA have proved effective in clinical trials. They have been shown to significantly reduce the formation of plaque in both in vitro (Minghetti et al, 201320) and in vivo (Basso et al, 201421) testing.
A natural aid
Hyaluronic acid (HA) is a natural component of the connective tissue in the gums and the extracellular matrix. It has several biologically relevant properties, including antibacterial and anti-inflammatory characteristics which help to activate the immune system's defences against bacterial attacks. It also stabilises the tissue and helps wounds to heal thanks to its antioedematous effect. Numerous studies have investigated the role played by hyaluronic acid in terms of gingival health. Jentsch23, Pistorius24, Johannsen25, Bansal26 and Jain 27, for example, have demonstrated that topical application of HA during treatment for gingivitis has a positive effect.
Maximum benefits with minimal side effects
Curasept ADS® Perio is a mouthwash developed specially for patients with periodontitis. It contains 0.12% chlorhexidine, which has proved effective in both surgical and non-surgical treatment. Thanks to the synergy effect of combining chlorhexidine, PVP-VA and HA, Curasept ADS® Perio reduces post-operative pain, provides protection against gingivitis, periodontitis and tissue trauma and slows down the build-up of plaque.
An effective multifunctional mouthwash for post-operative treatment
Curasept ADS® Implant was developed specifically for chemical plaque control after surgery – especially after particularly complicated operations such as implant placements, bone regeneration treatment or periodontal and peri-implant plastic surgery procedures. The chlorhexidine concentration of 0.2% guarantees highly effective action against plaque and bacteria and protects the surgically treated areas from superinfections. The combination of chlorhexidine with PVP-VA and HA offers even more important benefits for both patients and dental professionals: it promotes healing and tissue regeneration, reduces pain and plays a strong supporting role in professional treatment for peri-implantitis and mucositis.
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- Cortellini P, Labriola A, Zambelli R, Prato GP, Nieri M, Tonetti MS. Chlorhexidine with an anti discoloration system after periodontal flap surgery: a cross-over, randomized, triple-blind clinical trial. J Clin Periodontol. 2008 Jul;35(7):614-20.
- Bernardi F, Pincelli MR, Carloni S, Gatto MR, Montebugnoli L. Chlorhexidine with an Anti Discoloration System. A comparative study. Int J Dent Hyg. 2004 Aug;2(3):122-6.
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- Marrelli M, Amantea M, Tatullo M: A comparative, randomized, controlled study on clinical efficacy and dental staining reduction of a mouthwash containing Chlorhexidine 0.20% and Anti Discoloration System (A.D.S.). Annali di Stomatologia 2015; VI (2): 35-42.
- European Food Safety Authority (EFSA). Scientific Opinion on the safety of polyvinylpyrrolidone-vinyl acetate copolymer for the proposed uses as a food additive. EFSA Journal 8(12):1948. 2010.
- Minghetti P, Rumio C: Evaluation of plaque development with the use of an artificial mouth: activity evaluation of mouthwash solution containing poly(vinylpyrrolidone-co-vinylacetate) as plaque-inhibiting compound. University of Milan, Clinical Trial. 2013.
- Basso M, Ionescu A, Bordini G: Antiplaque Activity of Polyvinylpyrrolidone-Vinylacetate (PVP-VA) in Mouthwashes. A Pilot Study. Poster 192739 in PER-IADR International Congress, Dubrovnik, 2014.
- Claydon et al. The effect of polyvinyl pyrrolidone on the clinical activity of 0.09% and 0.2% chlorhexidine mouthrinses. J Clin Periodontol. 2001 Nov;28(11):1037-44.
- Jentsch H, Pomowski R, Kundt G, Gocke R: Tretment of gingivitis with Hyaluronan. J Clin Periodontol 30: 159-164. 2003.
- Pistorius A, Martin M, Willershausen B, Rockmann P.: The clinical application of hyaluronic acid in gingivitis therapy. Quintessence Int. Jul-Aug;36(7-8):531-8. 2005.
- Johannsen A, Tellefsen M, Wikesjo U, Johannsen G.: Local Delivery of Hyaluronan as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis. J Periodontol, 80: 1493-1497. 2009.
- Bansal J, Kedige SD, Anand S. Hyaluronic acid: A promising mediator for periodontal regeneration. Indian J Dent Res, 21: 575-8. 2010.
- Jain Y. Clinical evaluation of 0.2% hyaluronic acid containing gel in the treatment of gingivitis. Med J DY Patil Univ, 6: 416-20. 2013.