Determination of the antimicrobial activity of a gel composition based on a flavonoid complex and benzidamine hydrochloride intended for the treatment of periodontal diseases in orthodontic patients
Authors: Hodovanyi O. V. , Chukhray N. L. , Kuzminov B. P. , Motyka O. I. , Martovlos O. I. 
Published: November 2023

Summary. It is important to solve the problem of complex treatment and prevention of periodontal diseases in orthodontic patients by developing new drugs that have antimicrobial, anti-inflammatory, antioxidant effects and are included in effective treatment regimens. Orthodontic treatment with fixed orthodontic appliances contributes to a significant decrease in the level of individual oral hygiene against the background of oxidative stress. Therefore, the aggressiveness of periodontal pathogenic microflora increases, which contributes to the deepening of the inflammatory process in the tissues of the periodontal complex.
The aim of the study – to determine the antimicrobial activity of the developed periodontal gel composition based on flavonoid complex and benzidamine hydrochloride against microorganisms isolated from periodontal pockets of orthodontic patients with dystrophic-inflammatory diseases of periodontal tissues.
Materials and Methods. The efficacy of antimicrobial preservatives of the patented gel composition “Benzidaflaziverdine” (GCB) and the comparison drug “Cholisal” was evaluated according to the recommendations given in the State Pharmacopoeia of Ukraine (SPU). GCB samples were inoculated with suspensions of daily cultures of reference strains of S. aureus, P. aeruginosa, C. albicans and Aspergillus so that the final concentration of colony forming units (CFU) was 105-106 per ml. Isolates obtained from the oral cavity and periodontal pockets of orthodontic patients (S. aureus, S. pyogenes, S. mutans, E. faecalis, Rothia sp, bacteria of the Actinomycetaceae family, P. aeruginosa, C. albicans) were also used. Samples were taken after 2, 7, 14 and 28 days and the concentration of CFU of microorganisms was determined. Two methods were used to determine the antimicrobial activity: the standard “well” method regulated by the SPU, as well as a modification of the suspension method for determining the specific activity of disinfectants and other antimicrobial substances and compounds. To assess the reduction in the concentration of microorganisms, the decimal logarithm of the reduction in CFU in the samples (Log10 rate of reduction) was calculated.
Results and Discussion. The results of using a modification of the suspension method, the peculiarity of which was to dilute equal proportions of GCB with a bacterial suspension, showed a well-pronounced antibacterial activity of GCB. At the same time, the activity of GCB against methicillin-resistant S. aureus isolate did not differ from that against sensitive isolates. The activity of GCB can be characterized as species-specific; the effect on individual isolates of the same species differed slightly. GCB activity was high against streptococci, Rothia sp. and pseudomonas (P. aeruginosa). For S. aureus, S. pyogenes and C. albicans, the dynamics of the decrease in CFU during exposure to GCB for 40 minutes was determined. It was found that the maximum Lоg10 rate of reduction of CFU of staphylococcus aureus and pyogenic streptococcus occurred in the first 10-15 minutes of incubation. Thus, analyzing the results obtained, we found no statistically significant differences between the absolute values of Lоg10 CFU reduction for GCB and the comparison drug “Cholisal”.
Conclusions. The developed GCB in terms of its antimicrobial properties fully meets the requirements of the SPU in terms of the indicator “antimicrobial activity of preservatives”. The probable synergism of a low dose of nipagine introduced into the composition and the antimicrobial properties of benzidamine hydrochloride, which is in optimal ratio with Proteflazid® (flavonoid complex), provided high antimicrobial properties of the developed drug, which can be recommended as a periodontal dressing for the treatment of periodontal tissue diseases in orthodontic patients in preparation for the active period of orthodontic treatment, and in cases of stopped remission at different periods of bracket systems use.