Componenti utilizzati per l'igiene orale e la prevenzione della placca. Alcuni esempi:

• Clorexidina. È un potente antisettico utilizzato in vari prodotti per l'igiene orale, come collutori e gel. La clorexidina è efficace nel ridurre la placca batterica e nel prevenire la gengivite. È noto per la sua capacità di aderire alle superfici orali e fornire un'azione antibatterica prolungata (1).
• Lisozima. Una proteina con proprietà antibatteriche, trovata naturalmente nella saliva, nel latte materno e in altri fluidi corporei. Nel contesto dell'igiene orale, il lisozima aiuta a ridurre i batteri nocivi e può contribuire a mantenere un equilibrio sano della flora orale (2).
• Olio di semi di Sesamo (Sesamum indicum seed oil). Questo olio, estratto dai semi di sesamo, è noto per le sue proprietà antibatteriche e antinfiammatorie. È stato utilizzato nella pratica dell'oil pulling, che aiuta a ridurre la placca e a migliorare la salute orale. L'olio di sesamo può anche aiutare a rinforzare le gengive e a ridurre la secchezza della bocca (3).
• Cloruro di cetilpiridinio (CPC). Un antisettico che riduce la placca e il tartaro, oltre a combattere i batteri che causano alitosi (4).
• Olio essenziale di menta Piperita, agente di potenziamento dell'ozono nel controllo dei microrganismi che causano malattie orali in medicina (5).
• Alexidine. È un antisettico efficace contro un'ampia gamma di microrganismi. Alexidine è simile alla clorexidina ma con una minore tendenza a causare macchie sui denti. È utilizzato in alcuni collutori e prodotti per l'igiene orale per la sua azione antibatterica.
• Delmopinol. Questo composto aiuta a prevenire la formazione di placca e tartaro. Funziona interferendo con la formazione del biofilm batterico sulla superficie dei denti, facilitando così la rimozione della placca durante lo spazzolamento. Delmopinol è spesso presente in vari collutori.
• Hexetidine. È un antisettico orale che viene utilizzato per trattare diverse condizioni della bocca, come gengiviti, afte e alitosi. Hexetidine ha proprietà antibatteriche e antifungine, ed è efficace nel ridurre la placca e nel migliorare la salute orale.

I componenti più efficaci secondo la letteratura scientifica sono in verde.

Diversi componenti o fattori possono contribuire o esacerbare la formazione di placca e la gengivite. Alcuni esempi:

• Scarsa igiene orale. La mancata rimozione regolare di placca e tartaro attraverso lo spazzolamento e l'uso del filo interdentale può portare all'accumulo di placca e allo sviluppo di gengivite.
• Dieta ricca di zuccheri e carboidrati. Gli zuccheri e i carboidrati possono essere metabolizzati dai batteri della bocca, producendo acidi che favoriscono la formazione di placca.

• Fumo e uso di tabacco. Il fumo può compromettere la salute delle gengive e aumentare il rischio di gengivite e malattie parodontali.
• Cambiamenti ormonali. Fluttuazioni ormonali, come quelle durante la gravidanza o la pubertà, possono rendere le gengive più suscettibili all'infiammazione.
• Malattie sistemiche. Condizioni come il diabete possono influenzare la salute delle gengive e aumentare il rischio di gengivite.
• Farmaci. Alcuni farmaci possono influenzare la salute orale, causando secchezza della bocca o promuovendo la crescita eccessiva del tessuto gengivale.
• Genetica. La predisposizione genetica può giocare un ruolo nella suscettibilità alla gengivite e alle malattie parodontali.
• Stress. Lo stress può influenzare negativamente il sistema immunitario e aumentare il rischio di problemi gengivali.

Bibliografia_____________________________________________________________________

(1) König J, Storcks V, Kocher T, Bössmann K, Plagmann HC. Anti-plaque effect of tempered 0.2% chlorhexidine rinse: an in vivo study. J Clin Periodontol. 2002 Mar;29(3):207-10. doi: 10.1034/j.1600-051x.2002.290304.x. PMID: 11940138.

Abstract. Objectives: The aim of this in vivo study was to compare the anti-plaque effect of warm and cold chlorhexidine gluconate irrigation on matured human plaque. Methods: In a split-mouth design, the antibacterial effect of 47 degrees C "warm" 0.2% chlorhexidine solution was compared with that of 18 degrees C "cold" rinse at the same concentration on newly-formed supragingival plaque that had been left undisturbed for 72 h. Before and 1 h after a 1-min rinse procedure, plaque was sampled from 10 test persons and vitality determined using vital fluorescence technique. Results: Cold and warm 0.2% chlorhexidine solution reduced plaque vitality significantly from 99.63% to 77.81% (p=0.014) and from 98.98% to 51.77% (p<0.001), respectively. Rinsing with warm chlorhexidine solution reduced plaque vitality to a significantly greater degree (p=0.003) than did cold chlorhexidine. Conclusion: In this study, warm 0.2% chlorhexidine rinse showed a significantly more intensive anti-plaque effect than cold chlorhexidine solution at the same concentration.

(2) Golac-Guzina, N., Novaković, Z., Sarajlić, Z., Šukalo, A., Džananović, J., Glamočlija, U., Kapo, B., Čordalija, V. and Mehić, M., 2019. Comparative study of the efficacy of the lysozyme, benzydamine and chlorhexidine oral spray in the treatment of acute tonsillopharyngitis-results of a pilot study. Acta Medica Academica, 48(2), pp.140-146.

Abstract. Objective. Lysozyme is a natural antimicrobial and immunomodullatory enzyme, which is produced as a host response to infectious agents. The objective of this study was to compare the efficacy and safety of lysozyme-based versus benzydamine and chlorhexidine-based oral spray in patients with an acute tonsillopharyngitis associaated with a common cold. Patients and Methods. A prospective two-arm pilot study (lysozyme/cetylpyridinium/lidocaine spray versus: benzydamine spray—arm 1; chlorhexidine/lidocaine spray—arm 2) was conducted in the primary health care unit. Efficacy was evaluated by the patient’s self-assessment of pain, difficulty in swallowing and the throat swelling, by using the visual analog scale (VAS) at baseline and three follow-up visits. Safety was evaluated by the assessment of the frequency and severity of adverse effects. Results. Lysozyme-based spray reduced pain faster than benzydamine-based spray and slower than chlorhexidine-based spray. Lysozyme-based and chlorhexidine-based sprays similarly reduced difficulty in swallowing, but were faster than benzydamine-based spray. Similar effects on the reduction of throat swelling were seen in all treated groups. All tested products showed proper safety and were well tolerated, with no serious adverse events reported. Conclusions. The lysozyme-based oral spray was shown to be effective and safe in the reduction of pain, difficulty in swallowing and throat swelling in patients with acute tonsillopharyngitis associated with a common cold. Lysozyme-based oral spray (containing natural compound with advantages of influencing immune system and preventing recurrences) had similar activity to benzydamine and chlorhexidine-based oral antiseptic sprays. 

(3) Chandraprakash, R., Shivamurthy, R., Rangaraju, V. M., & Babu, H. M. Evaluation of Cocos nucifera and Sesamum indicum in comparison with Chlorhexidine on gingivitis-A double blind Clinico-Immunological study. International Journal of Ayurvedic Medicine, 12(3), 618-622.

Abstract. Background: Myriad of synthetic products has been used in chemical plaque control. There is a constant search for cost effective herbal products with minimal adverse effect to substitute synthetic compounds. The objective of this study was to evaluate the anti-inflammatory properties of Cocos nucifera and Sesamum indicum and compare their effect with commercially available chlorhexidine on gingivitis. Methods: In this double blind, randomized, control clinical trial, a total of 45 samples from patients aged between 18 to 35 years reporting to the institution, diagnosed with gingivitis were selected and randomly divided into Group-A (Scaling + Cocos Nuciferamouthwash), Group-B (Scaling + Sesamum Indicum mouthwash) and Group C (Scaling + Chlorhexidine mouthwash). Clinical (Plaque index, Gingival index and Sulcus bleeding index), and Immunological (Interleukin-6) parameters were assessed at baseline and 45th day following scaling. Saliva samples were collected and stored at -200C till they were subjected to enzyme-linked immunosorbent assay (ELISA) analysis. Inferential statistics done were analysis of variance, paired t test, post hock Scheffe test and Chi- square test by using SPSS software (22.0). Results: In Clinical parameters, group B (p˂0.001) showed statistical significant reduction compared to group A and group C. In Immunological parameter group A (p˂0.001) showed statistical significant reduction in Interleukin-6 compared to group B and group C (p=0.126 & p=0.196 respectively). Conclusion: Cocos nucifera and Sesamum indicum mouth washes effectively decreased plaque formation and could be used as an adjunct to scaling in treating plaque induced gingivitis. 

(4) Van der Weijden FA, Van der Sluijs E, Ciancio SG, Slot DE. Can Chemical Mouthwash Agents Achieve Plaque/Gingivitis Control? Dent Clin North Am. 2015 Oct;59(4):799-829. doi: 10.1016/j.cden.2015.06.002.

Abstract. Also note that structured abstracts are not allowed per journal style: What is the effect of a mouthwash containing various active chemical ingredients on plaque control and managing gingivitis in adults based on evidence gathered from existing systematic reviews? The summarized evidence suggests that mouthwashes containing chlorhexidine(CHX) and essential oils (EO) had a large effect supported by a strong body of evidence. Also there was strong evidence for a moderate effect of cetylpyridinium chloride(CPC). Evidence suggests that a CHX mouthwash is the first choice, the most reliable alternative is EO. No difference between CHX and EO with respect to gingivitis was observed.

(5) Floare AD, Dumitrescu R, Alexa VT, Balean O, Szuhanek C, Obistioiu D, Cocan I, Neacsu AG, Popescu I, Fratila AD, Galuscan A. Enhancing the Antimicrobial Effect of Ozone with Mentha piperita Essential Oil. Molecules. 2023 Feb 21;28(5):2032. doi: 10.3390/molecules28052032. 

Abstract. This study aimed to obtain and analyse Mentha piperita essential oil (MpEO) for the prospect of being used as an enhancement agent for the antimicrobial potential of ozone against gram-positive and gram-negative bacteria and fungi. The research was done for different exposure times, and it gained time–dose relationships and time–effect correlations. Mentha piperita (Mp) essential oil (MpEO) was obtained via hydrodistillation and further analysed by using GC-MS. The broth microdilution assay was used to determine the strain inhibition/strain mass growth by using spectrophotometric optical density reading (OD). The bacterial/mycelium growth rates (BGR/MGR) and the bacterial/mycelium inhibition rates (BIR/MIR) after ozone treatment in the presence and absence of MpEO on the ATTC strains were calculated; the minimum inhibition concentration (MIC) and statistical interpretations of the time–dose relationship and specific t-test correlations were determined. The effect of ozone on the following tested strains at maximum efficiency was observed after 55 s of single ozone exposure, in order of effect strength: S. aureus > P. aeruginosa > E. coli > C. albicans > S. mutans. For ozone with the addition of 2% MpEO (MIC), maximum efficacy was recorded at 5 s for these strains, in order of effect strength: C. albicans > E. coli > P. aeruginosa > S. aureus > S. mutans. The results suggest a new development and affinity regarding the cell membrane of the different microorganisms tested. In conclusion, the use of ozone, combined with MpEO, is sustained as an alternative therapy in plaque biofilm and suggested as helpful in controlling oral disease-causing microorganisms in medicine.