Justification of the antiradical, antimicrobial, and antifungal effect of an adhesive agent containing cetyldimonium chloride and choline salicylate in the complex local treatment of recurrent oral aphthae. A clinical and experimental study

The antiradical, antimicrobial and antifungal effects of the adhesive agent “Cholisal®”, containing cetyldimonium chloride and choline salicylate, were investigated within the complex local treatment of recurrent oral aphthae occurring against the background of clinical manifestations of classical and mediated hypersecretory gastrointestinal diseases. Materials and methods. The study included 58 young patients presenting with aphthous lesions on the mucous membrane of the oral vestibule. The examination consisted of measuring pH in samples of unstimulated mixed saliva and assessing free radical oxidation using chemiluminescence. The species composition of the microbiota on the surface of aphthous lesions was evaluated. Both qualitative and quantitative analysis of the microbiota was performed using sectorial culturing on selective differential diagnostic media. In an in vitro experiment, the antioxidant effect of choline salicylate in saliva samples and the sensitivity of studied bacterial strains to cetyldimonium chloride were assessed using the disk diffusion method on different culture media. Results. Antiseptic treatment of the aphthous lesion surface with “Cholisal®” gel exhibited pronounced antiseptic, antimicrobial, and antifungal properties. In samples of unstimulated saliva, the “Cholisal®” gel demonstrated significant antioxidant effect due to choline salicylate, reducing all chemiluminescence parameters, with the most prominent effect observed in patients with aphthous lesions on the oral vestibule mucosa against the background of chronic secondary biliary pancreatitis and hyperacid gastric secretion (p<0.05). Disk diffusion tests in vitro on Petri dishes showed significant growth inhibition zones (measured in millimeters) indicating bacterial sensitivity to cetyldimonium chloride. Candida spp. showed sensitive and highly sensitive growth inhibition in 90% of cases (15—25 mm, >25 mm), with 10% showing resistance (<15 mm). For Streptococcus spp. and Staphylococcus spp., a sensitive growth inhibition zone of 15—25 mm was observed in 74.5% and 67% of cases respectively, with 25.5% and 33% showing resistance (>15 mm). The measured sizes of inhibition zones confirm the pronounced antibacterial effect of “Cholisal®” gel on the microbiota of the aphthous lesion surface. Conclusion. Including “Cholisal®” gel containing choline salicylate and cetyldimonium chloride in the complex local treatment of aphthous lesions helps normalize pH and free radical oxidation in unstimulated mixed saliva samples. It also modulates the microbiota composition on the aphthous lesion surface through a significant antioxidant, antimicrobial, and antifungal effect, which is critical for enhancing epithelialization and regeneration of the oral vestibule mucosa in the complex local treatment of recurrent aphthous stomatitis (K12.0).