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M o u t h w a s h e s a n d b a c t e r i a o n s u t u r e t h r e a d s Table 1 Mean ± SD values for BSs calculated from the cfus developed under different conditions. From left to right, the columns report data concerning the quantification of total bacterial load and Lactobacillus spp., respectively, after seeding the BPW solutions that had been in contact with suture thread segments. Growth media were TSA and MRS agar, respectively. Table 2 Contingency table summarizing data resulting from inoculation on BRU. Table 3 Contingency table summarizing data resulting from scraping on TSA. Table 4 Contingency table summarizing data resulting from scraping on MRS. Hydroxyapatite Chlorhexidine Inoculation on BRU Growth No growth Scraping on TSA Absence Presence Seeding on TSA 2.000 ± 1.080 1.462 ± 1.198 P = 0.2668 Seeding on MRS 1.462 ± 1.050 1.077 ± 1.320 P = 0.4084 Hydroxyapatite Chlorhexidine n 6 7 n 3 10 Hydroxyapatite Chlorhexidine n† 2 10 n 3 10 P 0.411 P 1.000 † The total number of suture threads in the H-group was 12 instead of 13 because 1 thread was too short to be cut into segments for scraping on TSA plates. Scraping on MRS Absence Presence Hydroxyapatite Chlorhexidine n† 3 9 n 7 6 P 0.226 † The total number of suture threads in the H-group was 12 instead of 13 because 1 thread was too short to be cut into segments for scraping on MRS plates. Table 1 Table 2 Table 3 Table 4 itive (6 samples), resulted in establishing the presence of Actinomyces meyeri (3 occurrences), Bifidobacterium spp. (1 occurrence), Staphylo- coccus saccharolyticus (1 occurrence) and Actino myces viscosus (1 occurrence). In vitro studies have already demonstrated that hydroxyapatite shows antimicrobial activ- ity; for example, Tin-Oo et al. reported the effi- cacy of HAp against Streptococcus mutans.19 The antimicrobial activity of nHAp was also investi- gated when intercalated by several metal ions, including zinc ions,15, 16 and shown to be higher than that of nHAp alone. Furthermore, zinc ions are known to possess antimicrobial properties, and the activity of zinc in the oral cavity has been well documented.17, 18 PCA possesses a certain antimicrobial activity as well, as demonstrated by Yang et al., who tested it in in vivo studies against several microorganisms.19 Moreover, PCA increases the solubility rate of zinc ions in the saliva such that its antibacterial action is readily exerted. Oral care products based on the association of Zn-nHAp and Zn-PCA could create a combi- nation of 3 active ingredients that are very well tolerated and maintain the same efficacy of chlorhexidine against bacteria. Indeed, the pres- ent study demonstrated that mouthwashes containing Zn-nHAp and Zn-PCA represent a valid alternative to mouthwashes containing chlorhexidine. They do not exert the typical side effects of chlorhexidine, such as alteration of taste perception, tooth staining, tongue discol- oration, and desquamation and soreness of the oral mucosa, while maintaining at least its same antibacterial efficacy.20 Also, Marchetti et al., in a clinical comparative trial, found a similar effect of inhibiting plaque regrowth between zinc and chlorhexidine mouthwashes.21 Further studies are needed to better understand whether this new antimicrobial mouthwash could substitute chlorhexidine as the gold standard in promoting wound healing after surgery owing to its anti- microbial effect and no side effects. Conclusion Within the limitations of this study, the mouth- wash containing Zn-nHAp and Zn-PCA was found to have similar antibacterial efficacy to the mouthwash containing chlorhexidine, but with- out exerting the typical side effects of chlorhex- idine itself. These results should be interpreted with caution owing to the small sample of the study and the few kinds of bacteria analyzed. 28 Volume 3 | Issue 4/2017 Journal of Oral Science & Rehabilitation