Comparative Analysis in Vitro of the Application of blue®m Oral Gel versus Chlorhexidine on Porphyromonas gingivalis: A Pilot Study
Tatiana Miranda Deliberador, Suyany Gabriely Weiss, Felipe Rychuv, Gabriele Cordeiro, Michele Caroline Lima Ten Cate, Lucas Leonardi, João Armando Brancher, Rafaela Scariot
Department of Dentistry, School of Health Sciences, Universidade Positivo, Curitiba, Brazil
Published: April 24, 2020
Abstract
Oxygen is an essential nutrient for cellular metabolism, especially energy production. The substance is involved in multiple processes including oxidative killing of bacteria, reepithelialization, angiogenesis, and collagen synthesis. In order to test and compare the effects of the oxygen gel blue®m in vitro on Porphyromonas gingivalis, four groups were evaluated: 100% oxygen gel (B1), 75% oxygen gel (B2), 50% oxygen gel (B3), and 100% 0.12% chlorhexidine digluconate solution (C1). For this purpose, evaluations of the proportion of bacterial growth were performed, using the Agar diffusion test.
The results demonstrated that blue®m at a dose of 100% and 75% is similar to chlorhexidine (p > 0.05); however blue®m at a concentration of 50% showed a lower inhibition halo when compared to chlorhexidine (p = 0.024). blue®m at higher concentrations provided inhibitory halo of Porphyromonas gingivalis similar to chlorhexidine digluconate, while blue®m at lower concentration had a lower bacterial inhibition halo compared to chlorhexidine.
Introduction
Periodontitis is a multifactorial chronic inflammatory disease associated with an altered dental biofilm that causes the progressive destruction of the supporting tissues of the teeth. Some disorders and systemic conditions can affect the periodontium and cause loss of periodontal insertion and alveolar bone, influencing periodontal inflammation or through mechanisms other than periodontitis (such as genetic, immunological factors or some medications).
Periodontitis is treated with basic periodontal procedures and respective maintenance and sometimes may require standard administration of amoxicillin and metronidazole and of topical use of chlorhexidine digluconate. This is necessary due to the high resistance of periodontopathogenic bacteria, such as Porphyromonas gingivalis (PG). PG is a Gram-negative oral anaerobic bacterium, involved in the pathogenesis of periodontitis, which has numerous virulence factors, capable of inducing intense tissue destruction in periodontal infections.
Oxygen is an essential nutrient for cellular metabolism, especially energy production. The substance is involved in multiple processes including oxidative killing of bacteria, reepithelialization, angiogenesis, and collagen synthesis. Maybe the main function attributed to oxygen is energy production, both in eukaryotic cells and in eukaryotic cells; however there is a paradox since oxygen is indispensable for the maintenance of cell life and on the other hand, it can cause cell death when the cell is exposed to high concentrations of it.
A team of dental surgeons led by Dr. Peter Blijdorp in the Netherlands, developed a product based on active oxygen (blue®m), with the intention of putting all the desirable properties of mouthwashes in just one product. blue®m has in its composition sodium perborate, the glucose oxidase enzyme derived from honey, xylitol and lactoferrin. For dental applications, a new product that releases oxygen has recently been brought to market. The company’s main products are oral gel, toothpaste, mouthwash and mouth foam. Inclusion in everyday hygienic oral care of toothpaste and mouthwash blue®m reduced the severity of inflammatory changes and improved the hygienic condition of the oral cavity in cardiology patients suffering from periodontal disease. A Randomized Controlled Clinical Trial showed that toothpastes containing active oxygen and lactoferrin have comparable antiplaque and antigingivitis efficacies with triclosan-containing toothpastes. However, there is lack of studies regarding oxygen therapy for topical antibacterial treatment in periodontitis in the scientific community.
Considering the benefits that slow oxygen release seems to induce in wound healing and its beneficial effects in the few clinical studies related to periodontal diseases, more studies are needed to investigate the effect of this new gel on periodontitis and on Porphyromonas gingivalis.
This pilot study aims to test and compare the in vitro effects of the product in gel with slow release of oxygen (blue®m) and chlorhexidine on Porphyromonas gingivalis.