CETYLPYRIDINIUM CHLORIDE

Synonyms:
CETYLPYRIDINIUM CHLORIDE; cetylpyridinium chloride; 123-03-5; Pristacin; 1-Hexadecylpyridinium chloride; hexadecylpyridinium chloride; Cepacol; Cetamium; 1-hexadecylpyridin-1-ium chloride; Dobendan; Pyrisept; Tserigel; Aktivex; Biosept; Ceprim; Ceepryn chloride; Cepacol chloride; Quaternario CPC; Acetoquat CPC; Intexsan CPC; Swabettes Hoechst; Ammonyx CPC; N-Hexadecylpyridinium chloride; Cetyl pyridinium chloride; N-Cetylpyridinium chloride; 1-Cetylpyridinium chloride; Medilave; Merocet; Ceeprin chloride; Pyridinium, 1-hexadecyl-, chloride; hexadecyl pyridinium chloride; 1-Palmitylpyridinium chloride; Cetylpyridini chloridum; Caswell No. 166A; Cetylpyridinii chloridum; Cloruro de cetilpiridinio; Chlorure de cetylpyridinium; UNII-6BR7T22E2S; HSDB 38; Cetilpiridinio cloruro [DCIT]; CETYLPYRIDINIUM CHLORIDE ANHYDROUS; EINECS 204-593-9; Cetylpyridinii chloridum [INN-Latin]; NSC 14864; Cetylpyridinium (chloride); 1-Setilpiridinyum klorür monohidrat; SETİL PİRİDİNİUM KLORÜR; SETİL PİRİDİNYUM KLORÜR; SETİLPİRİDİNİUM KLORÜR 

CETYLPYRIDINIUM CHLORIDE

Cetylpyridinium Chloride (CPC)
Cetylpyridinium Chloride is a well-known, broad-spectrum antimicrobial agent used in over-the-counter rinses to promote gingival health. It acts by penetrating the cell membrane, causing cell components to leak, which eventually leads to cell death.16 This action can be described to patients using the analogy of puncturing a water balloon. Recently, over-the-counter therapeutic Cetylpyridinium Chloride rinses have been introduced in alcohol-free formulations

Cetylpyridinium Chloride is recognized to be effective against plaque and gingivitis when formulated at concentrations of 0.045% to 0.1% with at least 72% to 77% chemically available cetylpyridinium chloride.7 CPC’s efficacy can be affected by other ingredients in the product formulation thus necessitating specific criteria to be established for its concentration and bioavailability.18 Studies have reported formulations with high bioavailable Cetylpyridinium Chloride are associated with greater biological activity, consequently indicating an increased probability for clinical efficacy.19 Rinses with lower Cetylpyridinium Chloride concentrations or with less chemically available Cetylpyridinium Chloride are long standing marketed products identified as cosmetic products used for the temporary control of halitosis.

Cetylpyridinium chloride reduces plaque, calculus
Cetylpyridinium chloride (CPC) is a cationic surface-active agent and has a broad antimicrobial spectrum, and kills gram-positive pathogens and yeast. Maria Perno Goldie, RDH, MS, reviews the quaternary compound

Cetylpyridinium chloride (CPC) is a quaternary compound that reduces plaque and calculus. It is a cationic surface-active agent and has a broad antimicrobial spectrum, and kills gram-positive pathogens and yeast. (Scheie Aa. Modes of action of currently known chemical antiplaque agents other than chlorhexidine. Dent Res 1989; 68: 1609–1616.). Contact with bacteria occurs by the disturbance of the cell membrane, inhibition of cell function, seepage of cell contents, and eventually cell death. This article will be a brief review of CPC.

The study discusses that Cetylpyridinium Chloride was one of only three antimicrobial systems to be classified as safe and efficacious for the treatment of plaque-induced gingivitis, along with stannous fluoride and essential oils. This was when they were formulated within a concentration range of 0.05 and 0.10%, by the FDA Plaque Subcommittee following a six year review of over 40 active ingredients. The study reviews results from an in vitro pre-clinical study and an in vivo clinical study evaluating the antibacterial and antiplaque benefits a new Cetylpyridinium Chloride rinse technology. The study results support the antibacterial and antiplaque benefits of 0.07% Cetylpyridinium Chloride rinse (Crest Pro-Health Rinse). The Cetylpyridinium Chloride rinse showed significant antiplaque benefits in vivo, reducing plaque on brushed surfaces by 39% and on non-brushed surfaces by 25% versus placebo. These benefits were shown to be comparable to those provided by a positive control, essential oils mouthrinse. This study is available free online.

Crest Pro-Health Rinse product does not contain alcohol. Alcohol has an extensive history of safety when used in products as recommended, for the vast majority of the population. (Riep BG, Bernimoulin JP, Barnett ML. Comparative antiplaque effectiveness of an essential oil and an amine fluoride/stannous fluoride mouthrinse. J Clin Periodontol 1999; 26:164-168). However, certain individuals may not be able to tolerate alcohol-containing mouthrinses for a variety of reasons, and we have choices available to recommend to our patients.

The standards for the concentration and bioavailability of Cetylpyridinium Chloride were put in place because the effectiveness of Cetylpyridinium Chloride may be affected by other ingredients in the product, whether those ingredients are active or inert. (Jenkins S, Addy M, Wade W, Newcombe RG. The magnitude and duration of the effects of some mouthrinse products on salivary bacteria counts. J Clin Periodontol. 1994; 21:397-401). Some components added to rinses have the ability to bind CPC, causing it to be less effective.

One study showed discrepancies in the availability of Cetylpyridinium Chloride and chlorhexidine in some mouthrinse products. (S. Sheen and M. Addy. Which mouthrinses are the most effective at plaque prevention? Br Dent J 2003; 194: 207-210). This is important, as it may have an effect on the potential of some rinses to provide the expected plaque inhibitory activity.

Products containing Cetylpyridinium Chloride are generally considered to be safe, when used as recommended. Side effects of Cetylpyridinium Chloride are usually mild, and may include staining of the teeth and tongue. In a meta analysis of eight studies, only one study reported that that the staining was significant in any way. The same systematic review stated that the existing evidence supports that Cetylpyridinium Chloride containing mouth rinses provide a small but significant additional benefit in reducing plaque accumulation and gingival inflammation, when used as adjuncts to either supervised or unsupervised oral hygiene. (Haps S, Slot DE, Berchier CE, and Van der Weijden GA. The effect of cetylpyridinium chloride-containing mouth rinses as adjuncts to toothbrushing on plaque and parameters of gingival inflammation: a systematic review. Int J Dent Hygiene 6, 2008; 290–303).

In a review of this meta analysis, strengths and weaknesses were highlighted. (Powell LV. Cetylpyridinium chloride-containing mouthwashes may provide additional benefits for gingival health. ADA Center for Evidence-Based Dentistry. ebd.ada.org/SystematicReviewSummaryPage.aspx. Accessed August 31, 2011). The conclusion was that the weighted mean difference between the test and control treatment at endpoint was significant in favor of Cetylpyridinium Chloride for plaque scores and gingivitis in studies greater or equal to four weeks' duration. According to the reviewer, patients unable to attain sufficient plaque removal with routine brushing and self care may benefit by the addition of a CPC-containing mouth rinse to their oral care regimen.

Molecular Weight of Cetylpyridinium Chloride    340 g/mol    Computed by PubChem 2.1 (PubChem release 2019.06.18)
Hydrogen Bond Donor Count of Cetylpyridinium Chloride    0    Computed by Cactvs 3.4.6.11 (PubChem release 2019.06.18)
Hydrogen Bond Acceptor Count of Cetylpyridinium Chloride    1    Computed by Cactvs 3.4.6.11 (PubChem release 2019.06.18)
Rotatable Bond Count of Cetylpyridinium Chloride    15    Computed by Cactvs 3.4.6.11 (PubChem release 2019.06.18)
Exact Mass of Cetylpyridinium Chloride    339.269278 g/mol    Computed by PubChem 2.1 (PubChem release 2019.06.18)
Monoisotopic Mass of Cetylpyridinium Chloride    339.269278 g/mol    Computed by PubChem 2.1 (PubChem release 2019.06.18)
Topological Polar Surface Area of Cetylpyridinium Chloride    3.9 Ų    Computed by Cactvs 3.4.6.11 (PubChem release 2019.06.18)
Heavy Atom Count of Cetylpyridinium Chloride    23    Computed by PubChem
Formal Charge of Cetylpyridinium Chloride    0    Computed by PubChem
Complexity of Cetylpyridinium Chloride    208    Computed by Cactvs 3.4.6.11 (PubChem release 2019.06.18)
Isotope Atom Count of Cetylpyridinium Chloride    0    Computed by PubChem
Defined Atom Stereocenter Count of Cetylpyridinium Chloride    0    Computed by PubChem
Undefined Atom Stereocenter Count of Cetylpyridinium Chloride    0    Computed by PubChem
Defined Bond Stereocenter Count of Cetylpyridinium Chloride    0    Computed by PubChem
Undefined Bond Stereocenter Count of Cetylpyridinium Chloride    0    Computed by PubChem
Covalently-Bonded Unit Count of Cetylpyridinium Chloride    2    Computed by PubChem
Compound  of Cetylpyridinium Chloride Is Canonicalized    Yes