Shiina Natsuki, Shimpo Yudai, Kikuchi Kou, Sekiya Toshiko, Tomonari Hiroshi
Department of Orthodontics, Tsurumi University School of Dental Medicine, Yokohama 230-8501, Japan.
J Clin Med. 2025 Jun 27;14(13):4576. doi: 10.3390/jcm14134576.
: Halitosis is frequently observed in patients undergoing orthodontic treatment with multibracket appliances, primarily due to volatile sulfur compounds (VSCs) produced by oral anaerobic bacteria. Cetylpyridinium chloride (CPC) is a widely used antimicrobial agent in oral care products and may help alleviate halitosis.This study aimed to evaluate the effects of 0.05% CPC mouthwash on halitosis, oral hygiene indices, and the tongue microbiota in orthodontic patients with elevated VSC levels. : In this randomized, double-blind, placebo-controlled clinical trial, 30 orthodontic patients with elevated VSCs (≥150 ppb) were assigned to a CPC mouthwash group or a placebo group. Participants used the assigned mouthwash three times daily for 1 month. Halitosis was quantitatively assessed by gas chromatography (Oral Chroma™), and oral hygiene parameters including Plaque Index (PI), Gingival Index (GI), Tongue Coating Index (TCI), and unstimulated salivary flow rate were evaluated at baseline and after the intervention. The tongue microbiota was analyzed by 16S rRNA sequencing. : The CPC mouthwash group showed significant reductions in total VSCs, hydrogen sulfide, methyl mercaptan, PI, GI, and TCI ( < 0.05), while salivary flow rate and dimethyl sulfide remained unchanged. Microbiome analysis revealed decreases in halitosis-associated genera (, , ) and increases in beneficial species such as . : CPC mouthwash (0.05%) effectively reduced halitosis and improved oral hygiene parameters in orthodontic patients, likely through modulation of the tongue microbiota. This mouthwash may serve as a safe and practical adjunct to conventional oral hygiene practices during orthodontic treatment.
口臭在使用多托槽矫治器进行正畸治疗的患者中很常见，主要是由于口腔厌氧菌产生的挥发性硫化物（VSCs）所致。西吡氯铵（CPC）是口腔护理产品中广泛使用的抗菌剂，可能有助于减轻口臭。本研究旨在评估0.05% CPC漱口水对VSC水平升高的正畸患者口臭、口腔卫生指数和舌部微生物群的影响。：在这项随机、双盲、安慰剂对照的临床试验中，30名VSCs水平升高（≥150 ppb）的正畸患者被分为CPC漱口水组或安慰剂组。参与者每天使用指定的漱口水3次，持续1个月。通过气相色谱法（Oral Chroma™）对口臭进行定量评估，并在基线和干预后评估包括菌斑指数（PI）、牙龈指数（GI）、舌苔指数（TCI）和非刺激性唾液流速在内的口腔卫生参数。通过16S rRNA测序分析舌部微生物群。：CPC漱口水组的总VSCs、硫化氢、甲硫醇、PI、GI和TCI均显著降低（<0.05），而唾液流速和二甲基硫保持不变。微生物组分析显示，与口臭相关的菌属（如、、）减少，而有益菌种如增加。：0.05%的CPC漱口水可有效降低正畸患者的口臭并改善口腔卫生参数，可能是通过调节舌部微生物群实现的。这种漱口水可作为正畸治疗期间常规口腔卫生措施的一种安全实用的辅助手段。
