Antibiofilm Activity of Mangosteen (Garcinia mangostana L.) Flavonoids against Streptococcus mutans Bacteria

Background: Dental caries is one of the most common infectious diseases and often occurs in the community caused by bacteria. Attached bacteria in the tooth surface for a long time will form a biofilm and will lead to demineralization characterized by damage in the structure of the tooth enamel. The bacteria that cause dental caries and can form biofilms is Streptococcus mutans. The bacteria inside biofilms are more resistant to antibacterial agents. Flavonoids in mangosteen pericarp extract can be a cleaner alternative for the anti-biofilm cavity that has properties against Streptococcus mutans. Purpose: To determine the activity of flavonoids in mangosteen pericarp extract at a certain concentration against Streptococcus mutans bacteria. Methods: This study was a laboratory experimental study with a post-test only control group design. Streptococcus mutans were diluted according to the Mc Farland dilution standard 106 in Tryptic Soy Broth (TSB) medium and put in a flexible U-bottom microtiter plate. Then it was incubated for 5x24 hours and checked using crystal violet simple staining to see the formation of biofilms. Flavonoid extract of mangosteen pericarp performed serial dilution in a concentration of 100%, 50%, 25%, 12.5%, 6.25%, 3.125%, 1.56%, and 0.78% was added, and the incubation process were conducted for 1x24 hours. OD (Optical Density) readings were done with a wavelength of 595 nm. Results: There was a significant difference between the test groups and the positive control group. The concentration of 100% had the anti-biofilm activity and showed the value of the highest percentage of inhibition, whilst the concentration of 0.78% showed a minimum biofilm inhibition concentration. The results were demonstrated by a statistical analysis test. Conclusion: Flavonoid extract of mangosteen pericarp at a certain concentration has anti-biofilm activity against Streptococcus mutans biofilm.

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Uji Konsentrasi Hambat Minimum Ekstrak Daun Gedi (Abelmoschus manihot L.) terhadap Pertumbuhan Bakteri Streptococcus Mutans

e-GIGI ◽

10.35790/eg.6.1.2018.19729 ◽

2018 ◽

Vol 6 (1) ◽

Author(s):

Helen N. Sekeon ◽

Heriyannis Homenta ◽

Michael A. Leman

Keyword(s):

Dental Caries ◽

Streptococcus Mutans ◽

Leaf Extract ◽

Inhibitory Concentration ◽

Inhibitory Effect ◽

Tooth Surface ◽

Control Group ◽

Control Group Design ◽

Cariogenic Bacteria ◽

Group Design

Abstract: Streptococcus mutans is the most common bacterium that causes dental caries due to its ability to ferment carbohydrates into acid resulting in the decreased pH on the tooth surface. Prevention of dental caries could be achieved by inhibiting the growth of cariogenic bacteria. Various efforts to control and prevent the cariogenic bacteria include the usage of herbal ingredients; one of them is gedi leaves (Abelmoschus manihot L.). These gedi leaves contain bioactive compounds such as flavonoids, alkaloids, steroids, and saponins. This study was aimed to prove that gedi leaf extract had inhibitory effect on the growth of S.mutans and to obtain the minimum inhibitory concentration (MIC) of this extract on the growth of S. mutans. This was a true experimental design with a randomized pretest-posttest control group design. Gedi leaf extract was obtained by maceration method in 96% ethanol. The results showed that gedi leaf extract had an antibacterial effect on the growth of S. mutans. We used turbidimetry, UV-Vis spectrophotometer, and two times of treatment to obtain the MIC of gedi leaf extract on Streptococcus mutans which was 6.25%. Conclusion: Gedi leaf extract could inhibit the growth of S. mutans with a MIC of 6.25%.Keywords: dental caries, gedi leaf extract (Abelmoschus manihot L.), Streptococcus mutans Abstrak: Streptococcus mutans merupakan bakteri yang paling banyak menyebabkan karies gigi karena bakteri ini berkemampuan memfermentasi karbohidrat menjadi asam yang berakibat turunnya pH pada permukaan gigi. Pencegahan karies gigi dapat dicapai dengan menghambat pertumbuhan bakteri kariogenik. Berbagai upaya dilakukan untuk mengen-dalikan dan mencegah bakteri kariogenik, antara lain dengan menggunakan bahan herbal; salah satunya yaitu tanaman gedi (Abelmoschus manihot L.). Daun gedi mengandung senyawa bioaktif antara lain flavonoid, alkaloid, steroid, dan saponin. Penelitian ini bertujuan untuk membuktikan efek inhibisi ekstrak daun gedi terhadap pertumbuhan S. mutans dan mendapatkan konsentrasi hambat minimum (KHM) ekstrak daun gedi terhadap pertumbuhan bakteri S. mutans. Jenis penelitian ini ialah eksperimental murni dengan randomized pretest-posttest control group design. Ekstrak daun gedi dibuat dengan metode maserasi dengan menggunakan etanol 96%. Hasil penelitian menunjukkan bahwa ekstrak daun gedi (Abelmoschus manihot L.) memiliki efek antibakteri dalam menghambat pertumbuhan bakteri Streptococcus mutans. Dengan menggunakan metode turbidimetri dan spektrofotometer UV-Vis dalam 2 (dua) kali perlakuan maka diperoleh KHM ekstrak daun gedi (Abelmoschus manihot L.) terhadap bakteri Streptococcus mutans terdapat pada konsentrasi 6,25%. Simpulan: Ekstrak daun gedi dapat meghambat pertumbuhan Streptococcus mutans dengan KHM pada konsentrasi 6,25%.Kata kunci: karies gigi, ekstrak daun gedi (Abelmoschus manihot L.), Streptococcus mutans

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Evaluation of Anti-Biofilm Activity of Virgin Coconut Oil (Avco) Against Streptococcus Mutans ATCC 2157

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v18i2.634 ◽

2020 ◽

Vol 18 (2) ◽

Author(s):

Ummi Aqilah Haron ◽

Zurainie Abllah

Keyword(s):

Fatty Acids ◽

Streptococcus Mutans ◽

Coconut Oil ◽

Laser Scanning Microscopy ◽

Tooth Surface ◽

Confocal Laser ◽

Antibiofilm Activity ◽

Virgin Coconut Oil ◽

Biofilm Inhibition ◽

Significant Difference

Introduction: Dental caries has remained a major oral health problem worldwide. Streptococcus mutans is considered as a vital cariogenic agent in the oral cavity. It can synthesise soluble and insoluble glucans from sucrose by glucosyltransferases enzymes and develops stable biofilm on the tooth surface. In the previous study, the fatty acids profile of activated virgin coconut oil (AVCO) have been described, and it includes the excellent antimicrobial activity of the oil. The current study aims to evaluate the antibiofilm effect of AVCO against the Streptococcus mutans ATCC 2157 biofilm in vitro. Materials and method: The minimum biofilm inhibition concentration (MBIC) and the minimum biofilm eradication concentration (MBEC) for antibiofilm activity were determined by serial dilution method, and biofilm thickness on S. mutans was quantified by confocal laser scanning microscopy (CLSM). Results: At the concentra-tion of 15.63 mg/ml of AVCO, it successfully inhibits the development of S. mutans ATCC 21575 biofilm and AVCO (62.52 mg/ml) eradicate biofilm that was formed by the bacteria. The z-stack images obtained from CLSM allows the construction of 3-D biofilm structure and a significant difference in the thickness of S. mutans ATCC 21575 biofilm pre and post-treatment with AVCO were observed. Conclusion: AVCO showed good potential as anticaries where it possesses the ability to inhibits and eradicate S. mutans ATCC 21575 biofilm. A future study to evaluates the interaction of individuals fatty acids present in AVCO against proteins that relate to biofilm formation of S. mutans can be performed utilising the molecular docking tools.

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THE IMPACT OF ASTHMAAND ITS MEDICATIONS ON DENTAL CARIES STATUS AND STREPTOCOCCUS MUTANS COUNT IN CHILDREN: A CROSS-SECTIONAL STUDY

10.36106/ijsr/7515919 ◽

2020 ◽

pp. 20-23

Author(s):

Sneha Upadhyay ◽

Jyoti Bhavthankar ◽

Mandakini Mandale ◽

Nivedita Kaorey

Keyword(s):

Dental Caries ◽

Streptococcus Mutans ◽

Cross Sectional Study ◽

Control Group ◽

Healthy Children ◽

Sectional Study ◽

Cross Sectional ◽

Asthmatic Children ◽

Significant Difference ◽

The Impact

Background: Asthma and its medications have been linked to oral diseases in asthmatic children. Aim: Assessment of the dental caries status, salivary Streptococcus mutans count and S. mutans colony score in children receiving inhaled anti asthmatic medications and their comparison in healthy children Material and Method: A cross-sectional study was performed on 40 asthmatic children and 40 healthy children in the age group of 6-14 years. DMFT/deft indices were calculated and saliva samples were collected. Diluted saliva was inoculated on MSB agar plates. S. mutans count and colony score were analysed after 24-48 hours of inoculation. Results: Statistically significant difference was observed in the mean DMFT/deft index, salivary S. mutans load and S. mutans colony score in children of the asthmatic group and control group. Conclusion: Prevalence of dental caries and cariogenic bacteria is higher in asthmatic children.

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Cloning, Expression, Purification, and Preliminary Characterization of Single-Crystal X-Ray Diffraction of Glucosyltransferase B of Streptococcus mutans

Natural Product Communications ◽

10.1177/1934578x19849339 ◽

2019 ◽

Vol 14 (5) ◽

pp. 1934578X1984933

Author(s):

Joshua L. Mieher ◽

Norbert Schormann ◽

Manisha Patel ◽

Hui Wu ◽

Champion Deivanayagam

Keyword(s):

Dental Caries ◽

Oral Cavity ◽

Single Crystal ◽

Streptococcus Mutans ◽

Tooth Enamel ◽

Tooth Surface ◽

X Ray Diffraction ◽

Persistent Disease ◽

X Ray

Dental caries characterized by acid damage of tooth enamel is a persistent disease that begins with the formation of biofilms on the tooth surface. The secreted glucosyltransferases enable Streptococcus mutans to synthesize extracellular glucan polymers using ingested starch within the oral cavity, which eventually results in the production of acid, a contributing factor to cariogenesis. In this paper, we report the cloning, expression, purification, crystallization, and preliminary X-ray diffraction characterization of glucosyltransferase B.

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Effectivity of Jatropha multifida L. Leaves Extract as Antibacterial on Streptococcus mutans using In Vitro Testing Methods

Biomedical Journal of Indonesia: Jurnal Biomedik Fakultas Kedokteran Universitas Sriwijaya ◽

10.32539/bji.v7i2.384 ◽

2021 ◽

Vol 7 (2) ◽

pp. 415-421

Author(s):

Listyaning Kartiko Kinasih ◽

Idamawati Nababan ◽

Suci Erawati ◽

Rouli Natasia M Simanjuntak

Keyword(s):

Dental Caries ◽

Streptococcus Mutans ◽

Leaf Extract ◽

Control Group ◽

Entire Body ◽

Body Parts ◽

Control Group Design ◽

The Individual ◽

Jatropha Multifida

Intoduction: Health is the condition of the entire body and body parts of an individual who is free from disease both physically, mentally and socially, thus enabling the individual to be able to carry out daily activities more productively. However, many people neglect their own health, especially in the field of dental and oral health. Caries is one of the most common oral and dental problems. The prevalence of dental caries in Indonesia is high, namely 88.8%. Dental caries is caused by Streptococcus mutans bacteria which plays a role in the conversion of sucrose to lactic acid. Infection due to Streptococcus mutans bacteria can be treated by taking antibiotics. Apart from drugs, antibiotics can also be obtained from natural ingredients, one of which is the tintir castor plant (Jatropha multifida Linn) or commonly known as the betadine. Objective: To see the effect of the antibacterial content of tintir leaves against Streptococcus mutans bacteria and to determine the differences in the antibacterial effect of betadine leaf extract (Jatropha multifida L.) from a concentration of 25%, 50%, 75%, and 100% against Streptococcus mutans. Methods: The type of research used in this study was a laboratory experimental study with a post-test-only control group design as the research design and to test the sensitivity of bacteria using the paper disc diffusion test. Data analysis using One-Way ANOVA. Result: The results of this study indicate the effect of tintir castor leaf extract (Jatropha multifida L.) in inhibiting the growth of Streptococcus mutans bacteria.

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ANTIBACTERIAL EFFECTIVITY OF KASTURI LEAF EXTRACT (Mangifera casturi) AGAINST THE GROWTH OF Streptococcus sanguinis BACTERIA

Dentino : Jurnal Kedokteran Gigi ◽

10.20527/dentino.v5i1.8118 ◽

2020 ◽

Vol 5 (1) ◽

pp. 33

Author(s):

Dita Puspita Sari ◽

Didit Aspriyanto ◽

Irham Taufiqurrahman

Keyword(s):

Leaf Extract ◽

Periodontal Diseases ◽

Tooth Surface ◽

Control Group ◽

Dilution Method ◽

Control Group Design ◽

Streptococcus Sanguinis ◽

Significant Difference ◽

Post Hoc ◽

One Way Anova

Background: Caries is a disease that occurs because of the fermentation carbohydrates process by microorganisms in the oral cavity. One of the bacteria that causes caries is Streptococcus sanguinis. These bacteria will colonize on the tooth surface, then form dental plaques and contribute to the causes of caries and other periodontal diseases. Kasturi leaf extract (Mangifera casturi) has various compounds such as tannins, terpenoids, alkaloids, and flavonoids that have antimicrobial substances. Purpose: The aim of this study was to determine antibacterial effectivity of kasturi leaf extract (Mangifera casturi) against the growth of Streptococcus sanguinis bacteria. Method: This research was an experimental method laboratory (true experimental), with a randomized pre test and post test with control group design using 5 treatments: kasturi leaf extract (concentration: 20 mg/ml, 25 mg/ml, and 30 mg/ml); and two groups of control: positive control and negative control. Each treatment was repeated 5 times. Antibacterial activity testing used a liquid dilution method. Measurement of minimum inhibitory concentration (MIC) used a Uv-Vis Spectrophotometer and measurement of the minimum bactericidal concentration (MBC) used a colony counter. The MIC data were analyzed using One Way Anova and continued with the Dunnet Post Hoc test. MBC data were analyzed using the Kruskal-Wallis test and continued with the Mann-Whitney Post Hoc test. Result: One-Way Anova test showed that MIC had a significant difference, and the Kruskal-Wallis test showed that MBC also had significant differences. MIC was obtained at the concentration of 20 mg/ml and MBC was obtained at the concentration of 30 mg / ml. Conclusion: There is antibacterial effectiveness in kasturi leaf extract (Mangifera casturi) against the growth of Streptococcus sanguinis.

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PERBANDINGAN EFEKTIFITAS JUS LIDAH BUAYA DAN KLORHEXIDIN 0.06% TERHADAP JUMLAH KOLONI STREPTOCOCCUS MUTANS SALIVA ANAK DENGAN KARIES

ODONTO Dental Journal ◽

10.30659/odj.5.1.54-59 ◽

2018 ◽

Vol 5 (1) ◽

pp. 54

Author(s):

Shanty Chairani ◽

Sri W Rais ◽

Rani Purba ◽

Amalia AH

Keyword(s):

Dental Caries ◽

Streptococcus Mutans ◽

Aloe Vera ◽

Antimicrobial Properties ◽

In Vitro Study ◽

Control Group ◽

Mouth Rinse ◽

Active Components ◽

Control Group Design

Background: Aloe vera contains active components such as antrhaquinones,saponin, glucomannans, and acemannans that have been known for its antimicrobial properties. In vitro study showed that Aloe vera extract can inhibit the growth of Streptococcus mutans. Studies reported that children with caries have high level of salivary S. mutans which is the main pathogen in dental caries. The gold standard mouthrinse for dental caries is chlorhexidine gluconate, but it has several side effects. The objective of this study was to compare the effect between Aloe vera juice and 0.06% chlorhexidine mouth rinse on salivary S. mutans in children with caries.Methods: This experimental research with pretest and post-test control group design conducted on 30 children (6-12 years old) with number of carious teeth >4. Subjects divided into 2 groups: Aloe vera juice group and 0.06% chlorhexidine group, which instructed to rinse their mouth with 10 ml stated mouthwash, twice a day, during 7-day period. Unstimulated saliva was collected at baseline and after 7 days then inoculated on mitis salivarius bacitracin agar. S. mutans were counted and expressed in CFU/ml. Data were analyzed using paired t-test and independent t-test.Result: The result showed that a significant reduction in salivary S.mutanscounts was observed with Aloe vera juice mouth rinse and 0.06% chlorhexidine (p<0.05). The mean reduction of S. mutans counts was not statistically significantly between grup (p>0.05).Conclusion: These findings suggest that Aloe vera juice can reduce salivary S. mutans in children with caries so it can be considered as alternative mouthwash to prevent caries.

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The Effectiveness Of Anchovy Concentration (Stolephorus insularis) as Antimicrobial to Streptococcus mutans (In Vitro)

DENTA ◽

10.30649/denta.v10i1.37 ◽

2016 ◽

Vol 10 (1) ◽

pp. 71

Author(s):

Almira Fa’Izah ◽

Istien Wardani ◽

Diana Soesilo

Keyword(s):

Dental Caries ◽

Streptococcus Mutans ◽

Positive Control ◽

Negative Control ◽

Diffusion Method ◽

Control Group ◽

Oral Diseases ◽

Clear Zone ◽

Control Group Design

Background: Dental and oral diseases which are often found in children is dental caries. Streptococcus mutans is the main cause of caries. Caries can be prevented by using a topical application of fluoride. The Anchovy (Stolephorus insularis) contains protein, vitamins (A, B1, C), and minerals (Fe, Ca, K, F). Calcium fluoride (CaF2) within the anchovy can inhibit the occurrence of dental caries. Purpose: The aim of this study was to determine the antimicrobial ability of anchovy extract (Stolephorus insularis) to Streptococcus mutans. Materials and Methods: This study was a laboratory experimental research with post test only control group design. Diffusion method were applied with 2 controls: negative control used DMSO 1%, positive control used NaF solution, and 3 concentrations of anchovy extract (Stolephorus insularis) 3%, 6%, and 12%, each group were composed of 6 samples. Antimicrobial was assessed by measuring the diameter of the clear zone around the discs contained the anchovy extract (Stolephorus insularis). Data were analyzed by Kruskal-Wallis test followed by Mann-Whitney test. Result: The results from this study showed clear zone around the discs of the anchovy extract (Stolephorus insularis). The more concentration of the extract showed the more antimirobial zone diameter. The average zone of antimicrobial at the concentration of 3% were 7,11 mm, 6% 9,5 mm, 12% 10,78 mm, for the negative control DMSO 1% 6 mm and the positive control NaF solution 8,16 mm. The largest diameter of the clear zone was at concentration of 12% (P < 0,05). Conclusion: The anchovy extract (Stolephorus insularis) had an antimicrobial effect to the growth of Streptococcus mutans.

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Cytotoxicity test of 0,78% xanthone from mangosteen pericarp (Garcinia mangostana L.) and 0,2% chlorhexidine gluconate toward BHK-21 fibroblast cells

Conservative Dentistry Journal ◽

10.20473/cdj.v10i2.2020.54-57 ◽

2020 ◽

Vol 10 (2) ◽

pp. 54

Author(s):

Afin Aslihatul Ummah ◽

Laksmiari Setyowati ◽

Ketut Suardita

Keyword(s):

Pathogenic Bacteria ◽

Chlorhexidine Gluconate ◽

The Body ◽

Assay Method ◽

Control Group ◽

Cytotoxicity Test ◽

Fibroblast Cells ◽

Garcinia Mangostana ◽

Control Group Design ◽

Significant Difference

Background. Chlorhexidine gluconate is one of endodontic irrigants that has excellence capability to penetrate into dentin tubules and kill the pathogenic bacteria there. On the other hand, chlorhexidine gluconate has side effects to cause allergic reactions of the tissue and discoloration of the teeth. Xanthone from mangosteen pericarp can be considered as a natural alternative irrigant that usually has a good tolerance to the body. Purpose. The aim of this study compared the cytotoxicity between 0,78% xanthone from mangosteen pericarp and 0,2% chlorhexidine gluconate toward BHK-21 fibroblast cells. Methods. This study used experimental post-test only control group design. Xanthone from mangosteen pericarp preliminary cytotoxicity tested in various concentrations. Xanthone from mangosteen pericarp classified as a non-toxic concentration at 0,78%. Cytotoxicity of 0,78% xanthone from mangosteen pericarp compare with cytotoxicity of 0,2% chlorhexidine gluconate using MTT assay method. Cytotoxicity of material can be seen from % of cell viability. Viable cell measured by the result of optical density that read by ELISA reader 620 nm. Result. 0,78% xanthone from mangosteen pericarp showed lower cytotoxicity than 0,2% chlorhexidine gluconate toward BHK-21fibroblast cells. One-way ANOVA showed a significant difference between the study groups (P<0,05). Conclusion. 0,78% xanthone from mangosten pericarp showed lower cytotoxicity than 0,2% chlorhexidine gluconate toward BHK-21 fibroblast cells.

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DAYA HAMBAT OBAT KUMUR CETYLPYRIDINIUM CHLORIDE DAN OBAT KUMUR DAUN SIRIH TERHADAP PERTUMBUHAN STREPTOCOCCUS MUTANS

JURNAL BIOMEDIK (JBM) ◽

10.35790/jbm.5.1.2013.2639 ◽

2013 ◽

Vol 5 (1) ◽

Author(s):

Amelia I. Toar ◽

Jimmy Posangi ◽

Vonny Wowor

Keyword(s):

Streptococcus Mutans ◽

Periodontal Diseases ◽

Cetylpyridinium Chloride ◽

Diffusion Method ◽

Control Group ◽

Piper Betle ◽

Control Group Design ◽

Group Design ◽

Significant Difference ◽

Post Test

Abstract: Dental caries and periodontal diseases are still the major problems of oral health among the community. The microbes Streptococcus mutans that accumulate in plaques have an important role in the occurences of these two diseases. The control of plaque forming can be done chemically by using mouthwash. Cetylpyridinium chloride (CPC) and betle leaf (Piper betle Linn.), among others, are active ingredients that are added in the preparation of alcohol-free mouthwash. This study aimed to determine whether there was a difference between the inhibition of alcohol-free mouthwash containing CPC, and betle-leaf mouthwash to the growth of S. mutans. This was an experimental study with a post-test-only control-group design. The technique for testing inhibition used the Kirby Baurer disc diffusion method with samples of cultures of S. mutans The trial materials were commercial alcohol-free mouthwash and betle-leaf mouthwash; and aquadest as the negative control. There were nine repetitions for each trial material group. The results of the Kruskal Wallis test showed significant differences (P <0.05) between alcohol-free mouthwash containing CPC, alcohol-free mouthwash containing piper betle Linn extract, and aquadest. The result of the Mann Withney test showed that there was a significant difference (P <0.05) between alcohol-free mouthwash containing CPC and alcohol-free mouthwash containing piper betle Linn extract. Alcohol-free mouthwash containing CPC had a wider zone of inhibition than the alcohol-free mouthwash containing betle leaf extract. Conclusion: Inhibition of the alcohol-free mouthwash containing cetylpyridinium chloride on the growth of S.mutans was significantly better than the alcohol-free mouthwash containing piper betle Linn extract. Keywords: cetylpyridinium chloride, betle leaf, mouthwash, Streptococcus mutans. Abstract: Karies gigi dan penyakit periodontal merupakan masalah bagi kesehatan gigi dan mulut di masyarakat. Streptococcus mutans dalam plak berperan dalam terjadinya kedua penyakit ini. Pengontrolan plak dapat dilakukan secara kimiawi dengan menggunakan obat kumur. Cetylpyridinium chloride (CPC) dan daun sirih merupakan bahan aktif yang ditambahkan dalam sediaan obat kumur bebas alkohol. Penelitian ini bertujuan untuk melihat apakah terdapat perbedaan daya hambat antara obat kumur bebas alkohol yang mengandung CPC dengan obat kumur daun sirih terhadap pertumbuhan S. mutans. Penelitian ini bersifat eksperimental dengan post-test only control group design. Teknik pengujian daya hambat menggunakan metode difusi cakram Kirby Baurer dengan sampel S. mutans. Bahan coba yang digunakan yaitu obat kumur bebas alkohol, dan akuades sebagai kontrol negatif. Jumlah pengulangan pada masing-masing kelompok bahan coba sebanyak 9 kali. Uji Kruskal Wallis menunjukkan perbedaan bermakna (P <0,05) antara obat kumur CPC, obat kumur daun sirih, dan akuades terhadap pertumbuhan S. mutans. Uji Mann-Whitney menunjukkan perbedaan bermakna (P <0,05) antara obat kumur CPC dan obat kumur daun sirih terhadap pertumbuhan S. mutans. Obat kumur CPC memiliki zona hambat lebih besar dibandingkan obat kumur daun sirih. Simpulan: Sediaan obat kumur bebas alkohol yang mengandung cetylpyridinium chloride memilliki daya hambat terhadap pertumbuhan Streptococcus mutans yang lebih tinggi secara bermakna dibandingkan sediaan obat kumur bebas alkohol yang mengandung ekstrak daun sirih.

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