Nanoparticles for controlled delivery and sustained release of chlorhexidine in the oral environment.

PubMed

Garner, S; Barbour, M E

2015-07-01

Chlorhexidine (CHX) is in widespread use as a topical antimicrobial agent. Within the field of oral medicine, it is used in the prevention of ventilator-associated pneumonia as well as in the treatment of oral candidosis and microbial-associated lichenoid reactions. The objective of this study was to develop a strategy for controlled, sustained topical delivery of CHX using nanoparticle technology. Chlorhexidine was applied to hydroxyapatite, selected as a tooth analogue, as conventional CHX digluconate solutions and as aqueous suspensions of CHX hexametaphosphate nanoparticles with total CHX concentrations of 1, 2.2 and 5 mM. Soluble CHX release from the treated hydroxyapatite was monitored over a period of 7 days. A repeated-measures ANOVA with post hoc LSD test indicated that CHX release was 2-3× greater, and sustained for longer, when CHX was delivered as CHX hexametaphosphate nanoparticles than in aqueous solution with 2.2 and 5 mM CHX (P = 0.020 and 0.013, respectively), but there was no statistically significant difference at 1 mM CHX (P = 0.172). Chlorhexidine hexametaphosphate nanoparticles increased both the local dose and duration of soluble CHX delivery when applied to hydroxyapatite surfaces. This may provide a means to deliver a sustained dose of CHX with less frequent interventions. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate: a randomized controlled trial.

PubMed

Segers, Patrique; Speekenbrink, Ron G H; Ubbink, Dirk T; van Ogtrop, Marc L; de Mol, Bas A

2006-11-22

Nosocomial infections are an important cause of morbidity and mortality after cardiac surgery. Decolonization of endogenous potential pathogenic microorganisms is important in the prevention of nosocomial infections. To determine the efficacy of perioperative decontamination of the nasopharynx and oropharynx with 0.12% chlorhexidine gluconate for reduction of nosocomial infection after cardiac surgery. A prospective, randomized, double-blind, placebo-controlled clinical trial conducted at the Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands, between August 1, 2003, and September 1, 2005. Of 991 patients older than 18 years undergoing elective cardiothoracic surgery during the study interval, 954 were eligible for analysis. Oropharyngeal rinse and nasal ointment containing either chlorhexidine gluconate or placebo. Incidence of nosocomial infection, in addition to the rate of Staphylococcus aureus nasal carriage and duration of hospital stay. The incidence of nosocomial infection in the chlorhexidine gluconate group and placebo group was 19.8% and 26.2%, respectively (absolute risk reduction [ARR], 6.4%; 95% confidence interval [CI], 1.1%-11.7%; P = .002). In particular, lower respiratory tract infections and deep surgical site infections were less common in the chlorhexidine gluconate group than in the placebo group (ARR, 6.5%; 95% CI, 2.3%-10.7%; P = .002; and 3.2%; 95% CI, 0.9%-5.5%; P = .002, respectively). For the prevention of 1 nosocomial infection, 16 patients needed to be treated with chlorhexidine gluconate. A significant reduction of 57.5% in S aureus nasal carriage was found in the chlorhexidine gluconate group compared with a reduction of 18.1% in the placebo group (P<.001). Total hospital stay for patients treated with chlorhexidine gluconate was 9.5 days compared with 10.3 days in the placebo group (ARR, 0.8 days; 95% CI, 0.24-1.88; P = .04). Decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate appears to be an effective method to reduce nosocomial infection after cardiac surgery. clinicaltrials.gov Identifier: NCT00272675.

Short-term relative antibacterial effect of octenidine dihydrochloride on the oral microflora in orthodontically treated patients.

PubMed

Dogan, Alev Aksoy; Adiloglu, Ali K; Onal, Suleyman; Cetin, Emel Sesli; Polat, Esra; Uskun, Ersin; Koksal, Fatih

2008-11-01

To evaluate the efficacy of common antiseptic mouth rinses and octenidine dihydrochloride (OCT). The antibacterial activities of antiseptics against total and cariogenic bacteria (Streptococcus mutans and Lactobacillus species) in saliva were studied in vitro and in vivo. After unstimulated saliva was collected, one of the mouth rinse solutions was applied for 30seconds. Saliva samples were collected 15, 30, 60, and 120min later and evaluated for their bacterial count. OCT had a significantly greater inhibitory effect on the studied bacteria than 0.2% chlorhexidine gluconate (CHX) and 7.5% polyvinylpyrrolidone-iodine complex (PVP-I) from 15min to 120min following the application (p<0.01). The antiseptic efficacy of 0.2% CHX on total bacteria and Lactobacillus species was very similar to the efficacy observed with 7.5% PVP-I mouth solution from 15min up to 120min. Streptococcus mutans was completely inhibited by 0.15mg/ml PVP-I, 0.5mg/ml CHX, and 0.1mg/ml OCT concentrations, while Streptococcus salivarius was inhibited by 0.15mg/ml PVP-I, 2mg/ml CHX, and 0.8mg/ml OCT concentrations. Lactococcus lactis subspecies lactis was inhibited with 0.00313mg/ml OCT, 30mg/ml PVP-I, and 0.0063mg/ml CHX concentrations. OCT compared favorably with CHX and PVP-I in its antibacterial effects, both in vitro and in vivo (p<0.01).

Reduced susceptibility to chlorhexidine disinfectant among New Delhi metallo-beta-lactamase-1 positive Enterobacteriaceae and other multidrug-resistant organisms: Report from a tertiary care hospital in Karachi, Pakistan.

PubMed

Mal, P B; Farooqi, J; Irfan, S; Hughes, M A; Khan, E

2016-01-01

We analysed susceptibility of multidrug-resistant organisms (MDROs) including New Delhi metallo-beta-lactamase-1 positive Enterobacteriaceae to chlorhexidine and compared results to their susceptible counterparts. Susceptibilities of chlorhexidine digluconate in a standard (CHX-S) preparation and two commercial disinfectants containing different CHX concentrations (2% w/v and 4% w/w) were performed. MDROs had narrower range of higher CHX-S minimum inhibitory concentrations (MICs) as compared to pan-sensitive organisms. The MIC values for commercial disinfectants products for MDROs were many folds higher (20-600 times), than CHX-S for in vitro use. Increasing antibiotic resistance among bacterial isolates can be an indirect marker of reduced susceptibility to chlorhexidine in hospital setting.

Chlorhexidine Uptake and Release From Modified Titanium Surfaces and Its Antimicrobial Activity.

PubMed

Ryu, Hyo-Sook; Kim, Yoon-Il; Lim, Bum-Soon; Lim, Young-Jun; Ahn, Sug-Joon

2015-11-01

Decontamination by adjunctive antiseptic agents such as chlorhexidine (CHX) is often recommended for the treatment of peri-implant infections. However, its action on the titanium implant surface needs further research. This study is designed to evaluate the ability of modified titanium surfaces to release chlorhexidine after periodic CHX exposure. Four titanium surfaces were prepared: 1) no surface treatment control (machined surface [MA]); 2) an acid mix of 10% HNO3 and 5% HF (HNF); 3) resorbable blast media (RBM); and 4) sandblasting and acid etching (SLA). Each surface was analyzed using a confocal laser scanning microscope and a scanning electron microscope. Each sample was incubated with whole saliva or phosphate-buffered saline for 2 hours. Measurements of CHX release were performed using spectrometry on days 1, 2, and 5 after 1-minute exposure to 0.5% chlorhexidine digluconate solution during a 5-day cycle. CHX-releasing experiments were repeated three consecutive times for 15 days. The antimicrobial activity of CHX-adsorbed disks was determined by a disk diffusion test using Streptococcus gordonii. The CHX-adsorbed titanium surfaces exhibited a short-term release of CHX, and CHX levels dropped rapidly within 3 days. SLA and RBM with smaller and narrower depressions released more CHX than HNF and MA, specifically in the saliva-coated group. The disk diffusion test revealed that after CHX uptake, saliva-coated SLA and RBM showed the highest antimicrobial activity. This study suggests that CHX release is significantly influenced by titanium surface modifications and that SLA and RBM might provide effective CHX uptake capacity in the saliva-filled oral cavity.

Antifungal activity of synthetic antiseptics and natural compounds against Candida dubliniensis before and after in vitro fluconazole exposure.

PubMed

Reginato, Cássia Franco; Bandeira, Laíssa Arévalo; Zanette, Régis Adriel; Santurio, Janio Morais; Alves, Sydney Hartz; Danesi, Cristiane Cademartori

2017-01-01

This study evaluated the susceptibilities of oral candidiasis-derived Candida albicans, fluconazole-resistant (FR) Candida dubliniensis, and fluconazole-susceptible (FS) C. dubliniensis to synthetic antiseptics [chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), and triclosan (TRC)] and natural compounds (carvacrol, eugenol and thymol). Susceptibility tests were performed based on the M27-A3 reference method. The fluconazole-resistant C. dubliniensis strains were obtained after prolonged in vitro exposure to increasing fluconazole concentrations. The geometric mean values for minimum inhibitory concentrations and minimum fungicidal concentrations were compared among the groups. Fluconazole-susceptible C. dubliniensis was more sensitive to CPC and TRC than FR C. dubliniensis and C. albicans were. However, eugenol and thymol were more active against FR C. dubliniensis. The fungicidal activities of CHX and TRC were similar for the three groups, and FR C. dubliniensis and C. albicans had similar sensitivities to CPC. The resistance of C. dubliniensis to fluconazole affects its sensitivity the synthetic antiseptics and natural compounds that were tested.

Evaluation of chlorhexidine gluconate mouthrinse-induced staining using a digital colorimeter: an in vivo study.

PubMed

Bagis, Bora; Baltacioglu, Esra; Özcan, Mutlu; Ustaomer, Seda

2011-03-01

To investigate the persistence of staining after the use of chlorhexidine gluconate mouthrinse. Twenty-four subjects (nine women and 15 men) who underwent periodontal therapy and were prescribed the use of 0.2% chlorhexidine gluconate mouthrinse participated in this study. Color values of maxillary central incisors, canines, and first molars were recorded at baseline; 3 days; and 1, 2, and 3 weeks of twice-daily chlorhexidine gluconate use with a digital intraoral colorimeter according to the CIE L*a*b* coordinates. While color-change (Delta E) values showed significant differences (P=.020) at different time points (10.1, 8.9, 8.9, 9.4, after 3 days and 1, 2, and 3 weeks, respectively), the duration of chlorhexidine gluconate use did not significantly affect the results (P=.873) (two-way ANOVA, Tukey test). No significant difference was found among Delta L* (P=.070), Delta a* (P=.169), and Delta b* (P=.691) values at any time point (one-way ANOVA). Measurements of baseline to day 3 differences showed significantly higher Delta E values than those at other time points (P<.05), but this change remained nonsignificant after 1, 2, and 3 weeks of chlorhexidine gluconate use (P>.05) (Tukey test). The highest visible staining occurred on the first molars at all time points (83%, 79%, 79%, and 96% after 3 days and 1, 2, and 3 weeks, respectively) compared to the other teeth evaluated. The staining effect of chlorhexidine gluconate mouthrinse on natural dentition should be expected to be the highest in the first few days of use.

[Comparison of antibacterial effects of different antiseptics after hand washing].

PubMed

Buluş, Nesrin; Kaleli, Ilknur

2004-01-01

The aim of this study was to compare 4% chlorhexidine gluconate, 7.5% povidone iodine and liquid soap, which are used as hand washing solutions for the immediate, cumulative and residual effects in bacterial growth. For this purpose, 18 volunteers washed their hands with 7.5% povidone iodine, 4% chlorhexidine gluconate and liquid soap by applying standard hygienic hand washing technique. In order to find out the bacterial amount in the hands of study group, glove liquid test was used. For the evaluation of immediate effects, samples were collected just after the washing procedure, for the residual effects samples were collected from gloved hands after 3 hours, and for the cumulative effects, samples were collected after 5 days with daily hand washings. It is found that the immediate effects of 4% chlorhexidine gluconate was superior than others, and 7.5% povidone iodine was superior to liquid soap. There was no difference between 4% chlorhexidine gluconate and 7.5% povidone iodine for residual effects. The cumulative effects were observed for 4% chlorhexidine gluconate and 7.5% povidone iodine, while there was no cumulative effect for liquid soap. According to these results, it can be suggested that 4% chlorhexidine gluconate can be used as a reliable antiseptic agent in the hospitals, especially for laboratories, intensive care units and operating rooms, owing to its favourable immediate, residual and cumulative effects.

Mouth sores

MedlinePlus

... gel (Lidex), anti-inflammatory amlexanox paste (Aphthasol), or chlorhexidine gluconate (Peridex) mouthwash. Over-the-counter medicines, such as ... Aphthasol). A special type of mouthwash such as chlorhexidine gluconate (such as Peridex). Alternative Names Aphthous stomatitis; Herpes ...

Chlorhexidine possesses unique cytotoxic actions in rat thymic lymphocytes: Its relation with electrochemical property of membranes.

PubMed

Nonami, Kayo; Saitoh, Shohei; Nishimura-Danjobara, Yumiko; Ishida, Shiro; Oyama, Yasuo

2016-12-01

Chlorhexidine (CHX) is an antibacterial agent used in various types of pharmaceutical products. Therefore, CHX is easily found around us. Owing to its positive charge, the electrochemical property of cell membranes was assumed to be a key point of cytotoxic action of CHX. Depolarization of membranes attenuated the cytotoxic action of CHX in rat thymic lymphocytes. CHX interfered with annexin V binding to membranes. Manipulations to induce exposure of phosphatidylserine on the outer membrane surface augmented the cytotoxic action of CHX, indicating that changes in the electrochemical property of membranes affected the cytotoxic action of CHX. Hence, CHX might kill cells physiologically undergoing apoptosis, resulting instead in necrotic cell death. However, the threshold CHX concentration in this in vitro study was slightly higher than blood CHX concentrations observed clinically. Therefore, these results may support the safety of CHX use although CHX possesses unique cytotoxic actions described in this study. Copyright © 2016 Elsevier B.V. All rights reserved.

Development of resistance to chlorhexidine diacetate in Pseudomonas aeruginosa and the effect of a "residual" concentration.

PubMed

Thomas, L; Maillard, J Y; Lambert, R J; Russell, A D

2000-12-01

Stable resistance in Pseudomonas aeruginosa NCIMB 10421 was obtained by step-wise exposure to gradually increasing concentrations of chlorhexidine diacetate (CHX). Repeated exposure to a proposed "residual" (sub-MIC) concentration of CHX also created stable resistance. Resistance was also developed by a single exposure to the "residual" concentration of CHX, but this was unstable. Similar experiments with Escherichia coli and CHX or cetylpyridinium chloride resulted in no significant increase in resistance. Antibiotic susceptibility profiles of the CHX-resistant P. aeruginosa cultures showed no cross-resistance, although some of the cultures were resistant to benzalkonium chloride. Copyright 2000 The Hospital Infection Society.

Microbiological evaluation of octenidine dihydrochloride mouth rinse after 5 days' use in orthodontic patients.

PubMed

Dogan, Alev Aksoy; Cetin, Emel Sesli; Hüssein, Emad; Adiloglu, Ali Kudret

2009-07-01

To determine the absolute and relative antibacterial activity of octenidine dihydrochloride (OCT) against total and cariogenic bacteria in saliva samples of patients with fixed orthodontic appliances during 5 days of usage. The study group consisted of 5 male and 13 female subjects who were selected from patients in the Clinic of Orthodontics. Each patient was given physiologic saline (PS), chlorhexidine gluconate (CHX), polyvinylpyrrolidone-iodine complex (PVP-I), and OCT every morning for 5 days, each separated by a 2-week interval. Total and cariogenic bacteria in saliva samples of orthodontically treated patients with fixed appliances were collected during 5 days of usage. Unstimulated saliva was collected as a baseline sample. Saliva samples were collected at 15 minutes, and on the second, third, and fifth day after rinsing the mouth with any of the solutions for 30 seconds, and bacterial counts were detected. OCT showed an ultimate reduction of total viable oral bacteria, Lactobacillus species, and Streptococcus mutans in vivo. OCT also had a significantly greater inhibitory effect than 0.2% CHX and 7.5% PVP-I, from the beginning of the study until the fifth day after the orthodontic appliances were bonded (P < .1). OCT compared favorably with respect to CHX and PVP-I complex in orthodontically treated patients with fixed appliances (P

Surgical hand antisepsis in veterinary practice: evaluation of soap scrubs and alcohol based rub techniques.

PubMed

Verwilghen, Denis R; Mainil, Jacques; Mastrocicco, Emilie; Hamaide, Annick; Detilleux, Johann; van Galen, Gaby; Serteyn, Didier; Grulke, Sigrid

2011-12-01

Recent studies have shown that hydro-alcoholic solutions are more efficient than traditional medicated soaps in the pre-surgical hand antisepsis of human surgeons but there is little veterinary literature on the subject. The aim of this study was to compare the efficiency of medicated soaps and a hydro-alcoholic solution prior to surgery using an in-use testing method in a veterinary setting. A preliminary trial was performed that compared the mean log(10) number of bacterial colony forming units (CFU) and the reduction factors (RF) between two 5-min hand-scrubbing sessions using different soaps, namely, povidone iodine (PVP) and chlorhexidine gluconate (CHX), and the 1.5-min application of a hydro-alcoholic rub. A clinical in-use trial was then used to compare the hydro-alcoholic rub and CHX in a surgical setting. Sampling was performed using finger printing on agar plates. The hydro-alcoholic rub and CHX had a similar immediate effect, although the sustained effect was significantly better for the hydro-alcoholic rub, while PVP had a significantly lower immediate and sustained effect. The hydro-alcoholic rub showed good efficiency in the clinical trial and could be considered as a useful alternative method for veterinary surgical hand antisepsis. Copyright © 2010 Elsevier Ltd. All rights reserved.

21 CFR 216.24 - Drug products withdrawn or removed from the market for reasons of safety or effectiveness.

Code of Federal Regulations, 2011 CFR

2011-04-01

...: All oral gel drug products containing carbetapentane citrate. Casein, iodinated: All drug products containing iodinated casein. Chlorhexidine gluconate: All tinctures of chlorhexidine gluconate formulated for...

Five-year Effects of Chlorhexidine on the In Vitro Durability of Resin/Dentin Interfaces.

PubMed

Loguercio, Alessandro D; Hass, Viviane; Gutierrez, Mario Felipe; Luque-Martinez, Issis Virginia; Szezs, Anna; Stanislawczuk, Rodrigo; Bandeca, Matheus Coelho; Reis, Alessandra

2016-01-01

To evaluate the effect of an acid containing 2% chlorhexidine (Ac/CHX) or a 2% CHX aqueous solution (Aq/CHX) on the immediate and 5-year bonding properties of resin/dentin interfaces produced by two adhesives. The presence of CHX in these interfaces was also evaluated under micro-Raman spectroscopy. Forty-two molars were ground to expose a flat dentin surface. In the control group, the surfaces were etched with conventional phosphoric acid, and Prime&Bond NT (PB) and Adper Single Bond 2 (SB) were applied. In Ac/CHX, an acid containing 2% CHX was applied after adhesive application. In the Aq/CHX group, an aqueous solution of 2% CHX was applied for 60 s after etching. After placing the restoration, specimens were prepared and tested using the microtensile bond strength test (μTBS, 0.5 mm/min) immediately or after 5 years. For nanoleakage (NL), specimens at each period were immersed in silver nitrate solution and examined by EDX-SEM. In addition, specimens at each period underwent examination for CHX using micro-Raman spectroscopy. Data were submitted to appropriate statistical analysis (a=0.05). After 5 years, NL was more pronounced in the control than in the Ac/CHX or Aq/CHX (p<0.001). Significant reductions in the μTBS were observed for all groups; however, they were more pronounced for the control (p<0.001). CHX was still present in the hybrid layers Ac/CHX or Aq/CHX groups after 5 years. The use of a 2% chlorhexidine-containing acid or the application of an aqueous CHX primer may increase the long-term stability of resin/dentin interfaces.

Comparing the efficacy of hyper-pure chlorine-dioxide with other oral antiseptics on oral pathogen microorganisms and biofilm in vitro.

PubMed

Herczegh, Anna; Gyurkovics, Milán; Agababyan, Hayk; Ghidán, Agoston; Lohinai, Zsolt

2013-09-01

This study examines the antibacterial properties of sodium hypochlorite (NaOCl), chlorhexidine gluconate (CHX), Listerine®, and high purity chlorine dioxide (Solumium, ClO2) on selected common oral pathogen microorganisms and on dental biofilm in vitro. Antimicrobial activity of oral antiseptics was compared to the gold standard phenol. We investigated Streptococcus mutans, Lactobacillus acidophilus, Enterococcus faecalis, Veillonella alcalescens, Eikenella corrodens, Actinobacillus actinomycetemcomitans and Candida albicans as some important representatives of the oral pathogens. Furthermore, we collected dental plaque from the upper first molars of healthy young students. Massive biofilm was formed in vitro and its reduction was measured after treating it with mouthrinses: CHX, Listerine® or hyper pure ClO2. Their biofilm disrupting effect was measured after dissolving the crystal violet stain from biofilm by photometer. The results have showed that hyper pure ClO2 solution is more effective than other currently used disinfectants in case of aerobic bacteria and Candida yeast. In case of anaerobes its efficiency is similar to CHX solution. The biofilm dissolving effect of hyper pure ClO2 is significantly stronger compared to CHX and Listerine® after 5 min treatment. In conclusion, hyper pure ClO2 has a potent disinfectant efficacy on oral pathogenic microorganisms and a powerful biofilm dissolving effect compared to the current antiseptics, therefore high purity ClO2 may be a new promising preventive and therapeutic adjuvant in home oral care and in dental or oral surgery practice.

Surgical hand preparation with chlorhexidine soap or povidone iodine: new methods to increase immediate and residual effectiveness, and provide a safe alternative to alcohol solutions.

PubMed

Herruzo, R; Vizcaino, M J; Yela, R

2018-04-01

Surgical use of 4% chlorhexidine soap (CHX-4) and 10% povidone iodine (PVP-I-10) does not meet the standards defined by EN 12791. To investigate the possibility of increasing the immediate and residual effects of these antiseptics. Over three consecutive weeks, n-propanol, standard CHX-4 and PVP-I-10 were tested in two experimental groups of volunteers. The new method for applying the antiseptic substances involved standard hand rub and rinse of CHX-4 or PVP-I-10, followed by application of an aqueous solution based on 5% chlorhexidine or PVP-I-10 with no further rinsing of the hands prior to donning gloves. Samples were taken to assess immediate and residual effects, analysing the logarithmic reduction of colony-forming units. At t=0 h, n-propanol was superior in bactericidal effect to standard CHX-4 (P<0.05), but the new chlorhexidine protocol was superior to both standard CHX-4 (P<0.01) and n-propanol (P<0.05); the same effect was observed at t=3 h (residual effect). At t=0 h, n-propanol was significantly superior to standard PVP-I-10, but the new PVP-I-10 protocol was superior, although not significantly, to n-propanol. There was no significant residual effect at t=3 h. The new protocol for chlorhexidine application permits surgical hand preparation with chlorhexidine, as a safe alternative to alcohol solutions, because it meets the standards defined by EN 12791. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Chlorhexidine controlled-release profile after EDTA root surface etching: an in vivo study.

PubMed

Gamal, Ahmed Y; Kumper, Radi M; Sadek, Hesham S; El Destawy, Mahmoud T

2011-05-01

The main objective of the present study was to quantify chlorhexidine (CHX) release after the use of CHX-EDTA root surface treatment as a local-delivery antimicrobial vehicle. Twenty non-smoking patients clinically diagnosed as having moderate-to-severe chronic periodontitis were selected to participate in this study. After cause-related therapy, one site in every patient received defect overfill with CHX gel 2% (20 sites). In addition, twenty contralateral sites received defect fill of CHX gel after 3 minutes of 24% EDTA gel root surface etching (20 sites). Gingival crevicular fluid samples were collected at 1, 3, 7, and 14 days post-therapy. The CHX-EDTA group showed statistically significantly higher levels of CHX than those of the control group at 1, 3, and 7 days. At 14 days, the CHX-EDTA group showed 0.8 mg/mL values. The use of CHX-EDTA root surface treatment as a local-delivery antimicrobial improves CHX substantivity.

A microleakage study of gutta-percha/AH Plus and Resilon/Real self-etch systems after different irrigation protocols.

PubMed

Prado, Maíra; Simão, Renata Antoun; Gomes, Brenda Paula Figueiredo de Almeida

2014-06-01

The development and maintenance of the sealing of the root canal system is the key to the success of root canal treatment. The resin-based adhesive material has the potential to reduce the microleakage of the root canal because of its adhesive properties and penetration into dentinal walls. Moreover, the irrigation protocols may have an influence on the adhesiveness of resin-based sealers to root dentin. The objective of the present study was to evaluate the effect of different irrigant protocols on coronal bacterial microleakage of gutta-percha/AH Plus and Resilon/Real Seal Self-etch systems. One hundred ninety pre-molars were used. The teeth were divided into 18 experimental groups according to the irrigation protocols and filling materials used. The protocols used were: distilled water; sodium hypochlorite (NaOCl)+eDTA; NaOCl+H3PO4; NaOCl+eDTA+chlorhexidine (CHX); NaOCl+H3PO4+CHX; CHX+eDTA; CHX+ H3PO4; CHX+eDTA+CHX and CHX+H3PO4+CHX. Gutta-percha/AH Plus or Resilon/Real Seal Se were used as root-filling materials. The coronal microleakage was evaluated for 90 days against Enterococcus faecalis. Data were statistically analyzed using Kaplan-Meier survival test, Kruskal-Wallis and Mann-Whitney tests. No significant difference was verified in the groups using chlorhexidine or sodium hypochlorite during the chemo-mechanical preparation followed by eDTA or phosphoric acid for smear layer removal. The same results were found for filling materials. However, the statistical analyses revealed that a final flush with 2% chlorhexidine reduced significantly the coronal microleakage. A final flush with 2% chlorhexidine after smear layer removal reduces coronal microleakage of teeth filled with gutta-percha/AH Plus or Resilon/Real Seal SE.

A randomised clinical study to evaluate the efficacy of alcohol-free or alcohol-containing mouthrinses with chlorhexidine on gingival bleeding

PubMed Central

Jose, A.; Butler, A.; Payne, D.; Maclure, R.; Rimmer, P.; Bosma, M. L.

2015-01-01

Objectives Gingival bleeding following twice-daily use of 0.2% w/v chlorhexidine digluconate mouthrinse with and without alcohol (0.2% CHX-alcohol; 0.2% CHX-alcohol-free, respectively) and brushing with a standard fluoride toothpaste was compared to brushing alone. Methods Three hundred and nineteen subjects with mild-to-moderate gingivitis (with ≥16 gradable permanent teeth including four molars, bleeding after brushing and ≥20 bleeding sites) completed this randomised, examiner-blinded, parallel-group study. A prophylaxis was performed at baseline. Gingival Severity Index (GSI; primary objective), Gingival Index (GI) and Plaque Index (PI) were assessed at baseline and after 6 weeks of treatment. Adverse events (AEs) were recorded throughout the study. Results Between treatment differences at week 6 demonstrated significantly lower GSI for the 0.2% CHX-alcohol and 0.2% CHX-alcohol-free groups compared to brushing alone (primary endpoint; treatment difference −0.061 [95% CI −0.081, −0.041] and −0.070 [95% CI −0.090, −0.050], respectively; both p <0.0001). There were also significant reductions in GI and PI for the 0.2% CHX-alcohol and 0.2% CHX-alcohol-free groups compared to brushing alone (all p <0.0001). The proportion of subjects reporting ≥1 treatment-related adverse events (TRAEs) was 27.8% (0.2% CHX-alcohol), 24.8% (0.2% CHX-alcohol-free) and 3.7% (brushing alone). Conclusions Chlorhexidine mouthrinse with or without alcohol as an adjunct to brushing with regular fluoride toothpaste significantly reduces bleeding scores, plaque and gingival inflammation compared to brushing alone. TRAEs are characteristic of those associated with the use of chlorhexidine and are similar for both mouthrinses. PMID:26271869

An economic evaluation of a chlorhexidine chip for treating chronic periodontitis: the CHIP (chlorhexidine in periodontitis) study.

PubMed

Henke, C J; Villa, K F; Aichelmann-Reidy, M E; Armitage, G C; Eber, R M; Genco, R J; Killoy, W J; Miller, D P; Page, R C; Polson, A M; Ryder, M I; Silva, S J; Somerman, M J; Van Dyke, T E; Wolff, L F; Evans, C J; Finkelman, R D

2001-11-01

The authors previously suggested that an adjunctive, controlled-release chlorhexidine, or CHX, chip may reduce periodontal surgical needs at little additional cost. This article presents an economic analysis of the CHX chip in general dental practice. In a one-year prospective clinical trial, 484 chronic periodontitis patients in 52 general practices across the United States were treated with either scaling and root planing, or SRP, plus any therapy prescribed by treating, unblinded dentists; or SRP plus other therapy as above but including the CHX chip. Economic data were collected from bills, case report forms and 12-month treatment recommendations from blinded periodontist evaluators. Total dental charges were higher for SRP + CHX chip patients vs. SRP patients when CHX chip costs were included (P = .027) but lower when CHX chip costs were excluded (P = .012). About one-half of the CHX chip acquisition cost was offset by savings in other charges. SRP + CHX chip patients were about 50 percent less likely to undergo surgical procedures than were SRP patients (P = .021). At the end of the trial, periodontist evaluators recommended similar additional procedures for both groups: SRP, about 46 percent; maintenance, about 37 percent; surgery, 56 percent for SRP alone and 63 percent for SRP + CHX chip. Adjunctive CHX chip use for general-practice patients with periodontitis increased costs but reduced surgeries over one year. At study's end, periodontists recommended similar additional surgical treatment for both groups. In general practice, routine use of the CHX chip suggests that costs will be partially offset by reduced surgery over at least one year.

Comparison of two shampoos for the treatment of canine Malassezia dermatitis: a randomised controlled trial.

PubMed

Maynard, L; Rème, C A; Viaud, S

2011-11-01

Two antimicrobial shampoos for treatment of canine Malassezia dermatitis (CMD) were compared in a prospective, randomised, single-blinded, field clinical trial. Sixty-seven dogs with pedal or generalised dermatitis associated with Malassezia overgrowth (MO) were treated with 3% chlorhexidine shampoo (3%CHX) or 2% miconazole-2% chlorhexidine shampoo (2%MIC/CHX) and evaluated for up to 6 weeks until cytological recovery. Pruritus, erythema, papules, greasy seborrhoea, scaling, malodour, excoriations, secondary hairloss, lichenification, hyperpigmentation and lesion extent were each scored on a 0-3 severity scale and combined making an aggregate score. Among 54 dogs with good treatment compliance, reduction of yeast counts by at least 88% was recorded in 21 of 22 dogs with 3%CHX and 30 of 32 dogs with 2%MIC/CHX. No significant difference was detected between products for yeast count reduction (P=0·592). Time to cytological recovery was not significantly different between groups (P=0·960). Lesion score was significantly reduced in both groups after treatment (72·5 ±25·7% with 3%CHX versus 78·7 ±22·3% with 2%MIC/CHX, P=0·309). Four dogs treated with chlorhexidine shampoo showed minor adverse effects. In this study, 3%CHX was clinically as effective as 2%MIC/CHX for treatment of CMD. © 2011 British Small Animal Veterinary Association.

The efficacy of 2% chlorhexidine gluconate in 70% alcohol compared with 10% povidone iodine in reducing blood culture contamination in pediatric patients.

PubMed

Tangsathapompong, Auchara; Banjongmanee, Pornumpa; Unrit, Kengkaj; Sritipsukho, Paskorn; Mungkornkaew, Narisara; Sajak, Sirinporn

2014-08-01

Blood culture is the gold standard for diagnosis of septicemia. However; false-positive blood cultures are associated with increased health care costs due to unnecessary treatment. To evaluate the efficacy of 2% chlorhexidine gluconate in 70% alcohol compared with 10% povidone iodine in reducing blood culture contamination inpediatricpatients. This is a prospective study of pediatric patients who were admitted at a tertiary-care hospital. Pediatric patients who neededpercutaneous blood cultures were recruitedfrom two general pediatric wards and the pediatric intensive care unit. The authors used 10% povidone iodine as an antiseptic in odd months and 2% chlorhexidine gluconate in 70% alcohol as an antiseptic in even months in obtaining the blood culture samples. There were 1,269 blood culture specimens taken from 821 patients. 654 specimens used 10%povidone iodine as an antiseptic and 619 specimens used 2% chlorhexidine gluconate in 70% alcohol as an antiseptic. The 10% povidone iodine group and the 2% chlorhexidine gluconate in 70% alcohol group had the risk of blood culture contamination of 3.21% (95%CI: 2.00%-4.87%) and 2.28% (95% CI: 1.25%-3.79%) respectively. The risk difference ofblood culture contamination was 0.93% (95% confidence interval: 0. 86-2.72%) with p = 0.31. The most common contamination organism was Coagulase negative staphylococci (68.57%). No adverse skin reactions were observed in both antiseptic solutions groups. Use of2% chlorhexidine gluconate in 70% alcohol as an antiseptic seems to reduce the risk of blood culture contamination compared to use of 10% povidone iodine. In addition, neither of the antiseptic solutions resulted in adverse skin reactions.

Synergistic bactericidal activity of chlorhexidine-loaded, silver-decorated mesoporous silica nanoparticles.

PubMed

Lu, Meng-Meng; Wang, Qiu-Jing; Chang, Zhi-Min; Wang, Zheng; Zheng, Xiao; Shao, Dan; Dong, Wen-Fei; Zhou, Yan-Min

2017-01-01

Combination of chlorhexidine (CHX) and silver ions could engender synergistic bactericidal effect and improve the bactericidal efficacy. It is highly desired to develop an efficient carrier for the antiseptics codelivery targeting infection foci with acidic microenvironment. In this work, monodisperse mesoporous silica nanoparticle (MSN) nanospheres were successfully developed as an ideal carrier for CHX and nanosilver codelivery through a facile and environmentally friendly method. The CHX-loaded, silver-decorated mesoporous silica nanoparticles (Ag-MSNs@CHX) exhibited a pH-responsive release manner of CHX and silver ions simultaneously, leading to synergistically antibacterial effect against both gram-positive Staphylococcus aureus and gram-negative Escherichia coli . Moreover, the effective antibacterial concentration of Ag-MSNs@CHX showed less cytotoxicity on normal cells. Given their synergistically bactericidal ability and good biocompatibility, these nanoantiseptics might have effective and broad clinical applications for bacterial infections.

Effect of digluconate chlorhexidine on bond strength between dental adhesive systems and dentin: A systematic review.

PubMed

Dionysopoulos, Dimitrios

2016-01-01

This study aimed to systematically review the literature for the effect of digluconate chlorhexidine (CHX) on bond strength between dental adhesive systems and dentin of composite restorations. The electronic databases that were searched to identify manuscripts for inclusion were Medline via PubMed and Google search engine. The search strategies were computer search of the database and review of reference lists of the related articles. Search words/terms were as follows: (digluconate chlorhexidine*) AND (dentin* OR adhesive system* OR bond strength*). Bond strength reduction after CHX treatments varied among the studies, ranging 0-84.9%. In most of the studies, pretreatment CHX exhibited lower bond strength reduction than the control experimental groups. Researchers who previously investigated the effect of CHX on the bond strength of dental adhesive systems on dentin have reported contrary results, which may be attributed to different experimental methods, different designs of the experiments, and different materials investigated. Further investigations, in particular clinical studies, would be necessary to clarify the effect of CHX on the longevity of dentin bonds.

Comparative study of 0.2% and 0.12% digluconate chlorhexidine mouth rinses on the level of dental staining and gingival indices.

PubMed

Najafi, Mohammad Hassan; Taheri, Morteza; Mokhtari, Majid Reza; Forouzanfar, Ali; Farazi, Fateme; Mirzaee, Mona; Ebrahiminik, Zahra; Mehrara, Reza

2012-05-01

Chlorhexidine (CHX) as a gold standard chemical agent appears to be the most effective antimicrobial agent for reduction of both plaque and gingivitis. The aim of this study was to compare the efficacy of two concentrations of digluconate chlorhexidine (CHX) solutions (0.12% and 0.20%) on gingival indices and the level of dental staining during 14 days. in this double-blind controlled clinical trial study 60 patients with moderate to severe gingivitis aged 17-56 years were randomly selected and divided to three groups: Group I (placebo) Group II (0.12% CHX), and Group III (0.2% CHX). Patients rinsed their mouthwashes twice a day after brushing. Before the examination and after 14 days plaque index, gingival index, bleeding index, and stain index were evaluated. The data were analyzed by "Mann-Whitney" test and P value was 0.05. the results showed that plaque index and gingival index significantly reduced in Groups II and III in comparison with the placebo group (P < 0.0001). However, the two concentrations did not differ significantly from each other (P = 0.552). Same results were observed in term of gingival bleeding index with this different that 0.2% CHX was significantly more efficient than 0.12% CHX (P < 0.0001). CHX mouthrinse, both concentrations, significantly increased the dental staining level (intensity and area) in comparison with the placebo group. Remarkable difference also was seen between 2 CHX concentrations so that the 0.2% CHX caused much more staining on the teeth than 0.12% CHX. based on the results of this study we can conclude that the lower concentrations of CHX should be prescribed, decreasing side effects, since higher concentrations do not seem to be more effective in controlling dental plaque and gingivitis.

Presence of antiseptic resistance genes in porcine methicillin-resistant Staphylococcus aureus.

PubMed

Wong, T Z; Zhang, M; O'Donoghue, M; Boost, M

2013-03-23

Numerous studies have documented the presence of methicillin-resistant Staphylococcus aureus (MRSA) in meat-producing animals, which has led to concern about its spread into the community. Disinfectants play an important role in reduction of contamination in both animal husbandry and food-preparation, helping control spread of organisms from foodstuffs, including raw meat. Plasmid-borne antiseptic resistance (AR) genes increasing tolerance to several disinfectants have been reported in S. aureus of human origin (qacA/B and smr) and from bovine, equine, and caprine staphylococcal isolates (qacG, qacH, and qacJ). This study investigated the presence of AR genes in porcine MRSA isolates. Plasmid DNA from 100 MRSA ST9 strains isolated from pig carcasses was amplified for the presence of AR genes. Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) to benzalkonium chloride (BC) and chlorhexidine gluconate (CHX) were determined in AR gene-positive isolates. qacG was present in 45 strains, eight of which also harbored smr. No strains carried qacA/B, qacH or qacJ. Presence of smr increased MICs to both BC and CHX and MBCs of CHX, but qacG presence only resulted in elevated MBC for CHX. This is the first report of AR genes from a porcine source. AR gene positivity has previously been associated with methicillin resistance and AR gene presence in these strains may increase their ability to persist in the environment. Improved implementation of hygiene measures during transportation and pre- and post-slaughter should be considered to prevent spread in the community. Copyright © 2012 Elsevier B.V. All rights reserved.

Antibacterial effect of chlorhexidine-cetrimide combination, Salvia officinalis plant extract and octenidine in comparison with conventional endodontic irrigants.

PubMed

Guneser, Mehmet Burak; Akbulut, Makbule Bilge; Eldeniz, Ayce Unverdi

2016-01-01

The aim of the present study was to compare the antimicrobial effect of sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), a CHX/cetrimide solution (CHX+CTR), octenidine hydrochloride (OCT) and Salvia officinalis plant extract against Enterococcus faecalis. Seventy decoronated single-rooted human teeth were infected and divided into 6 test (n=10) and 2 control groups (n=5) (negative, sterile samples and positive, infected samples). Following irrigants were then applied to test groups: 2.5% NaOCl, 5.25% NaOCl, CHX, CHX+CTR, S. officinalis extract and OCT. The dentin chips were obtained from inner root canal walls and analyzed by counting the number of colony forming units (CFU). The 2.5% NaOCl, 5.25% NaOCl, CHX and OCT groups presented no bacterial growth (CFU=0). S. officinalis and CHX+CTR groups reduced the number of E. faecalis cells but could not eliminate all. OCT may have potential as an endodontic irrigant in treatment of infected root canals.

A microleakage study of gutta-percha/AH Plus and Resilon/Real self-etch systems after different irrigation protocols

PubMed Central

PRADO, Maíra; SIMÃO, Renata Antoun; GOMES, Brenda Paula Figueiredo de Almeida

2014-01-01

The development and maintenance of the sealing of the root canal system is the key to the success of root canal treatment. The resin-based adhesive material has the potential to reduce the microleakage of the root canal because of its adhesive properties and penetration into dentinal walls. Moreover, the irrigation protocols may have an influence on the adhesiveness of resin-based sealers to root dentin. Objective The objective of the present study was to evaluate the effect of different irrigant protocols on coronal bacterial microleakage of gutta-percha/AH Plus and Resilon/Real Seal Self-etch systems. Material and Methods One hundred ninety pre-molars were used. The teeth were divided into 18 experimental groups according to the irrigation protocols and filling materials used. The protocols used were: distilled water; sodium hypochlorite (NaOCl)+eDTA; NaOCl+H3PO4; NaOCl+eDTA+chlorhexidine (CHX); NaOCl+H3PO4+CHX; CHX+eDTA; CHX+ H3PO4; CHX+eDTA+CHX and CHX+H3PO4+CHX. Gutta-percha/AH Plus or Resilon/Real Seal Se were used as root-filling materials. The coronal microleakage was evaluated for 90 days against Enterococcus faecalis. Data were statistically analyzed using Kaplan-Meier survival test, Kruskal-Wallis and Mann-Whitney tests. Results No significant difference was verified in the groups using chlorhexidine or sodium hypochlorite during the chemo-mechanical preparation followed by eDTA or phosphoric acid for smear layer removal. The same results were found for filling materials. However, the statistical analyses revealed that a final flush with 2% chlorhexidine reduced significantly the coronal microleakage. Conclusion A final flush with 2% chlorhexidine after smear layer removal reduces coronal microleakage of teeth filled with gutta-percha/AH Plus or Resilon/Real Seal SE. PMID:25025557

Effect of endodontic irrigating solutions on the microhardness and roughness of root canal dentin: an in vitro study.

PubMed

Patil, Chetan R; Uppin, Veerendra

2011-01-01

To evaluate the effect of widely used endodontic irrigating solutions on root dentin microhardness and surface roughness. One hundred twenty, non-carious extracted human permanent incisor teeth were selected. The crowns of the teeth were sectioned and the roots were separated longitudinally to get 240 specimens. These specimens were then divided into six groups according to the irrigating solutions used. The solutions used were 5% and 2.5% NaOCl solutions, 3% H2 O2 , 17% EDTA solution, 0.2% chlorhexidine gluconate, and distilled water. Then, the specimens were subjected to microhardness and roughness testing. The data were analyzed using ANOVA and Tukey's multiple comparison tests. The results of this study indicated that all irrigation solutions, except 0.2% chlorhexidine gluconate, decreased the microhardness of root dentin, and 3% H2 O2 and 0.2% chlorhexidine gluconate had no effect on surface roughness. Within the limitation of this study, it is concluded that 0.2% chlorhexidine gluconate seems to be an appropriate irrigation solution, because of its harmless effect on the microhardness and surface roughness of root canal dentin.

Evaluation and Comparison of the Antibacterial Activity against Streptococcus mutans of Grape Seed Extract at Different Concentrations with Chlorhexidine Gluconate: An in vitro Study.

PubMed

Swadas, Milan; Dave, Bhavna; Vyas, Soham M; Shah, Nupur

2016-01-01

Streptococcus mutans has been implicated as primary microorganisms which cause dental caries in humans. There has been an increased interest in the therapeutic properties of some medicinal plants and natural compounds which have demonstrated antibacterial activities. Grape is one of the plants of this group which contains tannin and polyphenolic compound. To evaluate and compare antibacterial activity of grape seed extract at different concentrations with chlorhexidine gluconate against S. mutans. Grape seeds were extracted with ethanol/water ratio of 70:30 volume/volume. The extracts were filtered through Whatman No. 1 filter paper until it becomes colorless. Streptococcus mutans strains were taken. To check the antimicrobial properties of grape seed extract at different concentration and chlorhexidine gluconate, they were added to S. mutans strain and incubated for 48 hours than colony-forming units/mL were checked. Grape seed extract at higher concentration were found to be more potent against S. mutans. Chlorhexidine gluconate was found to have most potent antibacterial action compared to all different concentrations of grape seed extract. Grape seed extract as a natural antimicrobial compound has inhibitory effect against S. mutans. Swadas M, Dave B, Vyas SM, Shah N. Evaluation and Comparison of the Antibacterial Activity against Streptococcus mutans of Grape Seed Extract at Different Concentrations with Chlorhexidine Gluconate: An in vitro Study. Int J Clin Pediatr Dent 2016;9(3):181-185.

Chlorhexidine Induces VanA-Type Vancomycin Resistance Genes in Enterococci

PubMed Central

Bhardwaj, Pooja; Ziegler, Elizabeth

2016-01-01

Chlorhexidine is a bisbiguanide antiseptic used for infection control. Vancomycin-resistant E. faecium (VREfm) is among the leading causes of hospital-acquired infections. VREfm may be exposed to chlorhexidine at supra- and subinhibitory concentrations as a result of chlorhexidine bathing and chlorhexidine-impregnated central venous catheter use. We used RNA sequencing to investigate how VREfm responds to chlorhexidine gluconate exposure. Among the 35 genes upregulated ≥10-fold after 15 min of exposure to the MIC of chlorhexidine gluconate were those encoding VanA-type vancomycin resistance (vanHAX) and those associated with reduced daptomycin susceptibility (liaXYZ). We confirmed that vanA upregulation was not strain or species specific by querying other VanA-type VRE. VanB-type genes were not induced. The vanH promoter was found to be responsive to subinhibitory chlorhexidine gluconate in VREfm, as was production of the VanX protein. Using vanH reporter experiments with Bacillus subtilis and deletion analysis in VREfm, we found that this phenomenon is VanR dependent. Deletion of vanR did not result in increased chlorhexidine susceptibility, demonstrating that vanHAX induction is not protective against chlorhexidine. As expected, VanA-type VRE is more susceptible to ceftriaxone in the presence of sub-MIC chlorhexidine. Unexpectedly, VREfm is also more susceptible to vancomycin in the presence of subinhibitory chlorhexidine, suggesting that chlorhexidine-induced gene expression changes lead to additional alterations in cell wall synthesis. We conclude that chlorhexidine induces expression of VanA-type vancomycin resistance genes and genes associated with daptomycin nonsusceptibility. Overall, our results indicate that the impacts of subinhibitory chlorhexidine exposure on hospital-associated pathogens should be further investigated in laboratory studies. PMID:26810654

A Scanning Electron Microscope Evaluation of Smear Layer Removal and Antimicrobial Action of Mixture of Tetracycline, Acid and Detergent, Sodium Hypochlorite, Ethylenediaminetetraacetic Acid, and Chlorhexidine Gluconate: An In vitro Study.

PubMed

Charlie, K M; Kuttappa, M A; George, Liza; Manoj, K V; Joseph, Bobby; John, Nishin K

2018-01-01

The main objective is to evaluate the efficiency in removal of smear layer of mixture of tetracycline, acid and detergent (MTAD), sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA) and chlorhexidine gluconate by scanning electron microscope (SEM) evaluation and also to evaluate the antimicrobial action of the same irrigants against standard culture strains of Enterococcus faecalis . This study included 60 extracted permanent teeth with single root canal. The sample was categorized into five groups with 12 teeth in each group. Root canals were enlarged till size 40 with K-files. One group was kept as control and irrigated only with saline. Other four groups used 5% NaOCl as irrigant during instrumentation and MTAD, 5% NaOCl, 17% EDTA, and 2% chlorhexidine gluconate as final rinse. Teeth were split and examined under SEM. To test the antibacterial action, the zone of inhibition method using agar plates was used. Obtained data were statistically analyzed by SPSS version 17 (SPSS Inc., Chicago, IL, USA). MTAD and 17% EDTA removed smear layer from all regions of the root canals. About 5% NaOCl and 2% chlorhexidine gluconate were ineffective in removing the smear layer. The mean zone of inhibition formed by the irrigants was in the following order; MTAD (40.5 mm), 2% chlorhexidine gluconate (29.375 mm), 17% EDTA (24.125 mm), 5% NaOCl (22.125 mm), and saline (zero). MTAD showed high smear layer removal efficacy, but no significant difference was found to that of 17% EDTA. As the dimensions of the zones of inhibition showed, MTAD has got highest antibacterial action against E. faecalis , followed by 2% chlorhexidine gluconate, 17% EDTA, and 5% NaOCl. However, the exact correlation of in vitro study results to clinical conditions is impossible due to the variables involved.

Cholorhexidine, octenidine or povidone iodine for catheter related infections: A randomized controlled trial.

PubMed

Bilir, Ayten; Yelken, Birgül; Erkan, Ayse

2013-06-01

Protection of the catheter site by antimicrobial agents is one of the most important factors in the prevention of infection. Povidone iodine and chlorhexidine gluconate are the most common used agents for dressing. The purpose of this study was to compare the effects of povidone iodine, chlorhexidine gluconate and octenidine hydrochloride in preventing catheter related infections. Patients were randomized to receive; 4% chlorhexidine gluconate, 10% povidone iodine or octenidine hydrochlorodine for cutaneous antisepsis. Cultures were taken at the site surrounding catheter insertion and at the catheter hub after removal to help identify the source of microorganisms. Catheter related sepsis was 10.5% in the povidone iodine and octenidine hydrochlorodine groups. Catheter related colonization was 26.3% in povidone iodine group and 21.5% in octenidine hydrochlorodine group. 4% chlorhexidine or octenidine hydrochlorodine for cutaneous disinfection before insertion of an intravascular device and for post-insertion site care can reduce the catheter related colonization.

Effectiveness of 1% versus 0.2% chlorhexidine gels in reducing alveolar osteitis from mandibular third molar surgery: A randomized, double-blind clinical trial

PubMed Central

Bravo-Pérez, Manuel; Sánchez-López, José D.; Muñoz-Soto, Esther; Romero-Olid, María N.; Baca-García, Pilar

2013-01-01

Purpose: Alveolar osteitis (AO) is the most common postoperative complication of dental extractions. The purpose of this study was to compare the effectiveness of 1% versus 0.2% chlorhexidine (CHX) gel in reducing postoperative AO after surgical extraction of mandibular third molars, and assess the impact of treatment on the Oral HealthRelated Quality of Life (OHRQoL). Material and Methods: This clinical study was a randomized, double-blind clinical trial. Eighty eight patients underwent surgical extraction of one retained mandibular third molar with the intra-alveolar application of 0.2% CHX gel. Afterwards, they were assigned to one of two groups: 1% CHX gel (n=42) or 0.2% CHX gel (n=46). The patients applied the gel twice a day to the wound for one week. All patients were evaluated for AO. Results: In the 0.2% CHX gel group, 13% of AO incidence was found, while in the 1% CHX gel group, AO incidence was 7%, a difference that was not statistically significant. Variables such as sensation of pain and inflammation at baseline and during one week, as well as OHRQoL of the patients at 24 hours and 7 days post-extraction, gave no statistically significant differences. Conclusions: There are no significant differences in AO after surgical extraction of mandibular third molars, when comparing applying 1% CHX gel twice a day for 7 days with 0.2% CHX gel. Key words:Alveolar osteitis, chlorhexidine gel, third molar. PMID:23722126

Measurements of chlorhexidine, p-chloroaniline, and p-chloronitrobenzene in saliva after mouth wash before and after operation with 0.2% chlorhexidine digluconate in maxillofacial surgery: a randomised controlled trial.

PubMed

Below, H; Assadian, O; Baguhl, R; Hildebrandt, U; Jäger, B; Meissner, K; Leaper, D J; Kramer, A

2017-02-01

Chlorhexidine gluconate is used to prevent the accumulation of dental plaque and gingivitis, infection of the surgical site, and ventilator-associated pneumonia in maxillofacial surgery, but it is not clear whether the metabolites of chlorhexidine are detectable in the patient's saliva at clinically relevant concentrations. Forty-three patients who had orofacial operations were randomised to use a 0.2% chlorhexidine gluconate (n=23), or an octenidine-based, chlorhexidine-free (n=20), mouthwash once preoperatively and three times daily for five postoperative days. After the first, 8.7 (23.3) mg/L chlorhexidine (0.7%-2.5% of the total amount used) was measured in saliva. The concentration increased to 15.2 (6.2) mg/L after the second rinse (first postoperative day), and peaked at 29.4 (11.2) mg/L on the fourth postoperative day. It remained detectable for up to 12hours after the last one, but was not detectable in serum or urine at any time. The potentially carcinogenic metabolite p-chloroaniline was detectable in saliva at higher concentrations in the chlorhexidine group (0.55mg/L) than the octenidine group (0.21mg/L), and p-chloronitrobenzene was detected in both groups in only minimal concentrations (0.001-0.21mg/L). Chlorhexidine gluconate mouthwashes do increase the concentration of p-chloroaniline, but a single use seems to be safe. Whether prolonged exposure over many years may have carcinogenic potential is still not clear. Based on the hitherto unknown kinetics of p-chloroaniline in saliva, the recent recommendation of the Federal Drug Administration (FDA) in the USA to limit the use of a chlorhexidine gluconate mouthwash to a maximum of six months seems to be justified. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.

Controlled release of chlorhexidine antiseptic from microporous amorphous silica applied in open porosity of an implant surface.

PubMed

Verraedt, Els; Braem, Annabel; Chaudhari, Amol; Thevissen, Karin; Adams, Erwin; Van Mellaert, Lieve; Cammue, Bruno P A; Duyck, Joke; Anné, Jozef; Vleugels, Jef; Martens, Johan A

2011-10-31

Amorphous microporous silica (AMS) serving as a reservoir for controlled release of a bioactive agent was applied in the open porosity of a titanium coating on a Ti-6Al-4V metal substrate. The pores of the AMS emptied by calcination were loaded with chlorhexidine diacetate (CHX) via incipient wetness impregnation with CHX solution, followed by solvent evaporation. Using this CHX loaded AMS system on titanium substrate sustained release of CHX into physiological medium was obtained over a 10 day-period. CHX released from the AMS coating was demonstrated to be effective in killing planktonic cultures of the human pathogens Candida albicans and Staphylococcus epidermidis. This surface modification of titanium bodies with AMS controlled release functionality for a bioactive compound potentially can be applied on dental and orthopaedic implants to abate implant-associated microbial infection. Copyright © 2011 Elsevier B.V. All rights reserved.

Influence of 2% chlorhexidine on pH, calcium release and setting time of a resinous MTA-based root-end filling material.

PubMed

Jacinto, Rogério Castilho; Linhares-Farina, Giane; Sposito, Otávio da Silva; Zanchi, César Henrique; Cenci, Maximiliano Sérgio

2015-01-01

The addition of chlorhexidine (CHX) to a resinous experimental Mineral Trioxide Aggregate (E-MTA) based root-end filling material is an alternative to boost its antimicrobial activity. However, the influence of chlorhexidine on the properties of this material is unclear. The aim of this study was to evaluate the influence of 2% chlorhexidine on the pH, calcium ion release and setting time of a Bisphenol A Ethoxylate Dimethacrylate/Mineral Trioxide Aggregate (Bis-EMA/MTA) based dual-cure experimental root-end filling material (E-MTA), in comparison with E-MTA without the addition of CHX and with conventional white MTA (W-MTA). The materials were placed in polyethylene tubes, and immersed in deionized water to determine pH (digital pH meter) and calcium ion release (atomic absorption spectrometry technique). The setting time of each material was analyzed using Gilmore needles. The data were statistically analyzed at a significance level of 5%. E-MTA + CHX showed an alkaline pH in the 3 h period of evaluation, the alkalinity of which decreased but remained as such for 15 days. The pH of E-MTA + CHX was higher than the other two materials after 7 days, and lower after 30 days (p < 0.05). All of the materials were found to release calcium ions throughout the 30 days of the study. The addition of CHX increased the calcium ion release of E-MTA to levels statistically similar to W-MTA. E-MTA showed shorter initial and final setting time, compared with W-MTA (p < 0.05). The addition of 2% CHX to MTA prevented setting of the material. The addition of CHX to E-MTA increased its pH and calcium ion release. However, it also prevented setting of the material.

Evaluation and Comparison of the Antibacterial Activity against Streptococcus mutans of Grape Seed Extract at Different Concentrations with Chlorhexidine Gluconate: An in vitro Study

PubMed Central

Dave, Bhavna; Vyas, Soham M; Shah, Nupur

2016-01-01

Introduction Streptococcus mutans has been implicated as primary microorganisms which cause dental caries in humans. There has been an increased interest in the therapeutic properties of some medicinal plants and natural compounds which have demonstrated antibacterial activities. Grape is one of the plants of this group which contains tannin and polyphenolic compound. Aim To evaluate and compare antibacterial activity of grape seed extract at different concentrations with chlorhexidine gluconate against S. mutans. Materials and methods Grape seeds were extracted with ethanol/water ratio of 70:30 volume/volume. The extracts were filtered through Whatman No. 1 filter paper until it becomes colorless. Streptococcus mutans strains were taken. To check the antimicrobial properties of grape seed extract at different concentration and chlorhexidine gluconate, they were added to S. mutans strain and incubated for 48 hours than colony-forming units/mL were checked. Results Grape seed extract at higher concentration were found to be more potent against S. mutans. Chlorhexidine gluconate was found to have most potent antibacterial action compared to all different concentrations of grape seed extract. Conclusion Grape seed extract as a natural antimicrobial compound has inhibitory effect against S. mutans. How to cite this article Swadas M, Dave B, Vyas SM, Shah N. Evaluation and Comparison of the Antibacterial Activity against Streptococcus mutans of Grape Seed Extract at Different Concentrations with Chlorhexidine Gluconate: An in vitro Study. Int J Clin Pediatr Dent 2016;9(3):181-185. PMID:27843246

Pulp tissue dissolution capacity of QMix 2in1 irrigation solution.

PubMed

Arslan, Dilara; Guneser, Mehmet Burak; Kustarci, Alper; Er, Kursat; Siso, Seyda Herguner

2015-01-01

The aim of this study was to evaluate the tissue dissolution efficacy of four root canal irrigation solutions (sodium hypochlorite [NaOCl], chlorhexidine gluconate [CHX], Octenidine [OCT], and QMix 2in1) on bovine pulp tissue. Fifty bovine pulp tissue samples, each weighing 6.55 mg, were prepared and randomly divided into four experimental groups and one control group (n = 10) according to the dissolution irrigants used: (1) 5.25% NaOCl group; (2) 2% CHX group; (3) OCT group; (4) QMix 2in1 group; and (5) control group (saline solution). These samples were then placed into special bovine dentin reservoir models and immersed for 1 h with each test solution (0.1 mL of each) at room temperature. The pulp samples were then blotted dry and weighed again. The percentage of weight loss was calculated. Statistically analyzed with one-way analysis of variance and post-hoc Tukey tests (P = 0.05). Saline solution did not dissolve the bovine pulp tissue. All groups, except OCT, dissolved pulp samples more effectively than the control group (P < 0.05). The highest tissue dissolution was observed in 5.25% NaOCl group (P < 0.05). No statistically significant difference was found between the tissue-dissolving effect between QMix 2in1 and those of 2% CHX. Within the limitations of this in vitro study, NaOCl exhibited the best tissue-dissolving effect out of all solutions tested. CHX and QMix 2in1 were able to dissolve pulp tissue but less than NaOCl. OCT and saline solutions could not exhibit significantly tissue-dissolving effectiveness. This study shown that QMix 2in1 has little capacity to dissolve pulp tissue therefore used alone is not sufficient for this purpose.

Pulp tissue dissolution capacity of QMix 2in1 irrigation solution

PubMed Central

Arslan, Dilara; Guneser, Mehmet Burak; Kustarci, Alper; Er, Kursat; Siso, Seyda Herguner

2015-01-01

Objective: The aim of this study was to evaluate the tissue dissolution efficacy of four root canal irrigation solutions (sodium hypochlorite [NaOCl], chlorhexidine gluconate [CHX], Octenidine [OCT], and QMix 2in1) on bovine pulp tissue. Materials and Methods: Fifty bovine pulp tissue samples, each weighing 6.55 mg, were prepared and randomly divided into four experimental groups and one control group (n = 10) according to the dissolution irrigants used: (1) 5.25% NaOCl group; (2) 2% CHX group; (3) OCT group; (4) QMix 2in1 group; and (5) control group (saline solution). These samples were then placed into special bovine dentin reservoir models and immersed for 1 h with each test solution (0.1 mL of each) at room temperature. The pulp samples were then blotted dry and weighed again. The percentage of weight loss was calculated. Statistically analyzed with one-way analysis of variance and post-hoc Tukey tests (P = 0.05). Results: Saline solution did not dissolve the bovine pulp tissue. All groups, except OCT, dissolved pulp samples more effectively than the control group (P < 0.05). The highest tissue dissolution was observed in 5.25% NaOCl group (P < 0.05). No statistically significant difference was found between the tissue-dissolving effect between QMix 2in1 and those of 2% CHX. Conclusions: Within the limitations of this in vitro study, NaOCl exhibited the best tissue-dissolving effect out of all solutions tested. CHX and QMix 2in1 were able to dissolve pulp tissue but less than NaOCl. OCT and saline solutions could not exhibit significantly tissue-dissolving effectiveness. This study shown that QMix 2in1 has little capacity to dissolve pulp tissue therefore used alone is not sufficient for this purpose. PMID:26430374

Chlorhexidine binding to mineralized versus demineralized dentin powder

PubMed Central

Kim, Jongryul; Uchiyama, Toshikazu; Carrilho, Marcela; Agee, Kelli A.; Mazzoni, Annalisa; Breschi, Lorenzo; Carvalho, Ricardo M.; Tjäderhane, Leo; Looney, Stephen; Wimmer, Courtney; Tezvergil-Mutluay, Arzu; Tay, Franklin R.; Pashley, David H.

2010-01-01

Objectives The purposes of this work were to quantitate the affinity and binding capacity of chlorhexidine (CHX) digluconate to mineralized vs. demineralized dentin powder, and to determine how much debinding would result from rinsing with water, ethanol, hydroxyethylmethacrylate (HEMA) or 0.5 M NaCl in water. Methods Dentin powder was made from coronal dentin of extracted human third molars. Standard amounts of dentin powder were tumbled with increasing concentrations of CHX (0–30 mM) for 30 min at 37 C. After centrifuging the tubes, the supernatant was removed and the decrease in CHX concentration quantitated by UV-spectroscopy. CHX-treated dentin powder was resuspended in one of the four debinding solutions for 3 min. The amount of debound CHX in the solvents was also quantitated by UV-spectroscopy. Results As the CHX concentration in the medium increased, the CHX binding to mineralized dentin powder also increased up to 6.8 μmoles/g of dry dentin powder. Demineralized dentin powder took up significantly (p<0.01) more CHX, reaching 30.1 μmoles CHX/g of dry dentin powder. Debinding of CHX was in the order: HEMA < ethanol < 0.05 M NaCl < water. The highest CHX binding to demineralized dentin occurred at 30 mM (1.5 wt%). Significance As CHX is not debound by HEMA, it may remain bound to demineralized dentin during resin-dentin bonding. This may be responsible for the long-term efficacy of CHX as an MMP inhibitor in resin-dentin bonds. PMID:20472280

In vitro susceptibility of gram-negative bacterial isolates to chlorhexidine gluconate.

PubMed

Mengistu, Y; Erge, W; Bellete, B

1999-05-01

To investigate the susceptibility of clinical isolates of gram-negative bacteria to chlorhexidine gluconate. Prospective laboratory study. Tikur Anbessa Hospital, Addis Ababa, Ethiopia. Clinical specimens from 443 hospital patients. Significant number of gram negative bacteria were not inhibited by chlorhexidine gluconate (0.02-0.05%) used for antisepsis. Four hundred and forty three strains of gram-negative bacteria were isolated from Tikur Anbessa Hospital patients. Escherichia coli (31.6%) and Klebsiella pneumoniae (23%) were the most frequently isolated bacteria followed by Proteus species (13.3%), Pseudomonas species (9.2%), and Citrobacter species (6.1%). Each organism was tested to chlorhexidine gluconate (CHG), minimum inhibitory concentration (MIC) ranging from 0.0001% to 1%w/v. All Salmonella species and E. coli were inhibited by CHG, MIC < or = 0.01%. Twenty nine per cent of Acinetobacter, 28% of K. pneumoniae and Enterobacter species and 19-25% of Pseudomonas, Proteus and Providencia species were only inhibited at high concentrations of CHG (> or = 0.1%). Our results showed that a significant number of the gram-negative bacterial isolates were not inhibited by CHG at the concentration used for disinfection of wounds or instruments (MIC 0.02-0.05% w/v). It is therefore important to select appropriate concentration of this disinfectant and rationally use it for disinfection and hospital hygiene. Continuing follow up and surveillance is also needed to detect resistant bacteria to chlorhexidine or other disinfectants in time.

In vitro and in vivo evaluations of glass-ionomer cement containing chlorhexidine for Atraumatic Restorative Treatment

PubMed Central

Duque, Cristiane; Aida, Kelly Limi; Pereira, Jesse Augusto; Teixeira, Gláucia Schuindt; Caldo-Teixeira, Angela Scarparo; Perrone, Luciana Rodrigues; Caiaffa, Karina Sampaio; Negrini, Thais de Cássia; de Castilho, Aline Rogéria Freire; Costa, Carlos Alberto de Souza

2017-01-01

Abstract Objectives: Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX. Material and Methods: For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (p<0.05). Results: Incorporation of 1.25% and 2.5% CHX improved the antimicrobial/anti-biofilm activity of GIC, without affecting F release and mechanical characteristics, but 2.5% CHX was cytotoxic. Survival rate of restorations using GIC with 1.25% CHX was similar to GIC. A significant reduction of MS levels was observed for KM+CHX group in children saliva and biofilm 7 days after treatment. Conclusions: The incorporation of 1.25% CHX increased the in vitro antimicrobial activity, without changing chemical-mechanical properties of GIC and odontoblast-like cell viability. This combination improved the in vivo short-term microbiological effect without affecting clinical performance of ART restorations. PMID:29069152

In vitro and in vivo evaluations of glass-ionomer cement containing chlorhexidine for Atraumatic Restorative Treatment.

PubMed

Duque, Cristiane; Aida, Kelly Limi; Pereira, Jesse Augusto; Teixeira, Gláucia Schuindt; Caldo-Teixeira, Angela Scarparo; Perrone, Luciana Rodrigues; Caiaffa, Karina Sampaio; Negrini, Thais de Cássia; Castilho, Aline Rogéria Freire de; Costa, Carlos Alberto de Souza

2017-01-01

Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX. For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (p<0.05). Incorporation of 1.25% and 2.5% CHX improved the antimicrobial/anti-biofilm activity of GIC, without affecting F release and mechanical characteristics, but 2.5% CHX was cytotoxic. Survival rate of restorations using GIC with 1.25% CHX was similar to GIC. A significant reduction of MS levels was observed for KM+CHX group in children saliva and biofilm 7 days after treatment. The incorporation of 1.25% CHX increased the in vitro antimicrobial activity, without changing chemical-mechanical properties of GIC and odontoblast-like cell viability. This combination improved the in vivo short-term microbiological effect without affecting clinical performance of ART restorations.

Corneal Injury from Presurgical Chlorhexidine Skin Preparation.

PubMed

Bever, Gregory J; Brodie, Frank L; Hwang, David G

2016-12-01

Chlorhexidine skin preparation has been shown to provide highly effective antimicrobial presurgical skin cleansing. However, there is a significant risk of ocular toxicity when it is used in periocular areas. We describe 2 cases of significant corneal damage resulting from 4% chlorhexidine gluconate preoperative skin cleanser, despite the use of protective occlusive dressing over the eyes. Because of the potential for severe corneal toxicity resulting from use of chlorhexidine, alternative agents such as 10% povidone-iodine should be considered for skin preparation near periocular areas whenever possible. If chlorhexidine gluconate must be employed near periocular areas, great care must be exercised to avoid contact with the eyes, and additional protective measures (e.g., absorbent eye pads along with tightly occlusive dressings) must be used whenever possible. Copyright © 2016 Elsevier Inc. All rights reserved.

Cholorhexidine, octenidine or povidone iodine for catheter related infections: A randomized controlled trial

PubMed Central

Bilir, Ayten; Yelken, Birgül; Erkan, Ayse

2013-01-01

Background: Protection of the catheter site by antimicrobial agents is one of the most important factors in the prevention of infection. Povidone iodine and chlorhexidine gluconate are the most common used agents for dressing. The purpose of this study was to compare the effects of povidone iodine, chlorhexidine gluconate and octenidine hydrochloride in preventing catheter related infections. Materials and Methods: Patients were randomized to receive; 4% chlorhexidine gluconate, 10% povidone iodine or octenidine hydrochlorodine for cutaneous antisepsis. Cultures were taken at the site surrounding catheter insertion and at the catheter hub after removal to help identify the source of microorganisms. Results: Catheter related sepsis was 10.5% in the povidone iodine and octenidine hydrochlorodine groups. Catheter related colonization was 26.3% in povidone iodine group and 21.5% in octenidine hydrochlorodine group. Conclusion: 4% chlorhexidine or octenidine hydrochlorodine for cutaneous disinfection before insertion of an intravascular device and for post-insertion site care can reduce the catheter related colonization. PMID:24250702

Effects of chlorhexidine, essential oils and herbal medicines (Salvia, Chamomile, Calendula) on human fibroblast in vitro.

PubMed

Wyganowska-Swiatkowska, Marzena; Urbaniak, Paulina; Szkaradkiewicz, Anna; Jankun, Jerzy; Kotwicka, Malgorzata

2016-01-01

Antiseptic rinses have been successfully used in inflammatory states of the gums and oral cavity mucosa. Antibacterial effects of chlorhexidine, essential oils and some herbs are well documented. Reaction of host tissue to these substances has much poorer documentation. The aim of the study was to analyse the influence of chlorhexidine (CHX), essential oil (EO: thymol, 0.064%; eucalyptol, 0.092%; methyl salicylate, 0.060%; menthol, 0.042%) mouth rinses and salvia, chamomile and calendula brews on fibroblast biology in vitro. The human fibroblast CCD16 line cells were cultured in incubation media which contained the examined substances. After 24 and 48 hours, the cell morphology, relative growth and apoptosis were evaluated. Exposure of fibroblasts to CHX, EO or salvia caused various changes in cell morphology. Cells cultured for 48 hours with CHX revealed a noticeably elongated shape of while cells cultured in high EO concentration or with salvia were considerably smaller and contracted with fewer projections. Chlorhexidine, EO and salvia reduced the fibroblast proliferation rate and stimulated cell death. Both reactions to EO were dose dependent. Cells exposure to chamomile or calendula brews did not change morphology or proliferation of fibroblasts. The results of this in vitro study showed that in contrast to chamomile and calendula, the brews of EO, CHX or salvia had a negative influence on fibroblast biology.

Effects of chlorhexidine, essential oils and herbal medicines (Salvia, Chamomile, Calendula) on human fibroblast in vitro

PubMed Central

Urbaniak, Paulina; Szkaradkiewicz, Anna; Jankun, Jerzy; Kotwicka, Malgorzata

2016-01-01

Antiseptic rinses have been successfully used in inflammatory states of the gums and oral cavity mucosa. Antibacterial effects of chlorhexidine, essential oils and some herbs are well documented. Reaction of host tissue to these substances has much poorer documentation. The aim of the study was to analyse the influence of chlorhexidine (CHX), essential oil (EO: thymol, 0.064%; eucalyptol, 0.092%; methyl salicylate, 0.060%; menthol, 0.042%) mouth rinses and salvia, chamomile and calendula brews on fibroblast biology in vitro. The human fibroblast CCD16 line cells were cultured in incubation media which contained the examined substances. After 24 and 48 hours, the cell morphology, relative growth and apoptosis were evaluated. Exposure of fibroblasts to CHX, EO or salvia caused various changes in cell morphology. Cells cultured for 48 hours with CHX revealed a noticeably elongated shape of while cells cultured in high EO concentration or with salvia were considerably smaller and contracted with fewer projections. Chlorhexidine, EO and salvia reduced the fibroblast proliferation rate and stimulated cell death. Both reactions to EO were dose dependent. Cells exposure to chamomile or calendula brews did not change morphology or proliferation of fibroblasts. The results of this in vitro study showed that in contrast to chamomile and calendula, the brews of EO, CHX or salvia had a negative influence on fibroblast biology. PMID:27536196

Antimicrobial effect of chlorhexidine digluconate in dentin: In vitro and in situ study.

PubMed

Borges, Fátima Maria Cavalcante; de Melo, Mary Anne Sampaio; Lima, Juliana Paiva Marques; Zanin, Iriana Carla Junqueria; Rodrigues, Lidiany Karla Azevedo

2012-01-01

The aim of this study was to evaluate a very short-term in vitro and in situ effect of 2% chlorhexidine-digluconate-based (CHX) cavity cleanser on the disinfection of dentin demineralized by cariogenic bacteria. Human dentin slabs were randomly allocated and used in 2 distinct phases, in vitro and in situ, for obtaining demineralized dentin. In vitro, the slabs (n=15) were immersed for 5 days in BHI broth inoculated with Streptococcus mutans CTT 3440. In situ, a double-blind design was conducted in one phase of 14 days, during which 20 volunteers wore palatal devices containing two human dental dentin slabs. On 5(th) day in vitro and 14(th) day in situ, the slabs were allocated to the two groups: Control group (5 μl of 0.9% NaCl solution) and CHX group (5 μl of 2% chlorhexidine digluconate solution, Cavity Cleanser™ BISCO, Schaumburg, IL, EUA), for 5 minutes. The microbiological analyses were performed immediately before and after the treatments. The log reductions means found for CHX treatment on tested micro organisms were higher when compared to Control group either in vitro or in situ conditions. Our results showed that CHX was effective in reducing the cultivable microbiota in contaminated dentin. Furthermore, although the use of chlorhexidine-digluconate-based cavity disinfectant did not completely eliminate the viable microorganisms, it served as a suitable agent to disinfect tooth preparations.

The comparative effects of 0.12% chlorhexidine and herbal oral rinse on dental plaque-induced gingivitis: A randomized clinical trial

PubMed Central

Bhate, Devaki; Jain, Sanjay; Kale, Rahul; Muglikar, Sangeeta

2015-01-01

Background: Chlorhexidine (CHX) is considered as a gold standard of antimicrobial rinses. Various herbal oral rinses are available in the market. However, little is known of its effectiveness. Aim: The aim of this study was to evaluate the clinical changes after the usage of herbal oral rinse and 0.12% CHX. Materials and Methods: In a randomized clinical trial, 76 patients with dental plaque-induced gingivitis were assigned to Group I (Herbal Oral Rinse - Hiora®) and 76 patients with dental plaque-induced gingivitis to Group II (0.12% Chlorhexidine-Peridex®). Gingival index and Plaque index scores were recorded at baseline and 21 days after scaling. Results: Intragroup comparison in both groups showed that plaque index and gingival index scores were statistically significant after 21 days as compared to baseline. Intergroup comparison showed that plaque index scores and gingival index scores were statistically significant in Group II as compared to Group I. Conclusion: When herbal oral rinse was compared to 0.12% CHX, 0.12% CHX mouth rinse effectively reduced the clinical symptoms of plaque-induced gingivitis. PMID:26392686

In vitro antibacterial activity of ethanolic extract of Morus alba leaf against periodontal pathogens.

PubMed

Gunjal, Shilpa; Ankola, Anil V; Bhat, Kishore

2015-01-01

Antibiotic resistance is a major problem with inadvertent usage. Thus, there is a need to search for new antimicrobial agents of herbal origin to combat antibiotic resistance. One such plant is Morus alba which has a long history of medicinal use in traditional Chinese medicine. To compare the antibacterial activity of ethanolic extract of M. alba leaves with chlorhexidine gluconate against Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, and Tannerella forsythia. Experimental in vitro study. Crude extract from the leaves of M. alba were prepared by Soxhlet extraction method by using ethanol as a solvent. Minimum inhibitory concentration (MIC) of the extract was assessed against A. actinomycetemcomitans, P. gingivalis and T. forsythia, and compared with that of chlorhexidine gluconate by broth dilution method. P. gingivalis was the most sensitive organism against the M. alba extract with an MIC value of 1.95 mg/ml; while T. forsythia and P. gingivalis both were most sensitive organisms against chlorhexidine gluconate with MIC values of 0.00781 mg/ml. M. alba possess good antibacterial activity against A. actinomycetemcomitans, P. gingivalis and T. forsythia and thus would be beneficial for the prevention and treatment of periodontal disease. However, chlorhexidine gluconate was found to be more effective when compared to M. alba.

Efficacy of Chlorhexidine, Xylitol, and Chlorhexidine + Xylitol against Dental Plaque, Gingivitis, and Salivary Streptococcus mutans Load: A Randomised Controlled Trial.

PubMed

Marya, Charu Mohan; Taneja, Pratibha; Nagpal, Ruchi; Marya, Vandana; Oberoi, Sukhvinder Singh; Arora, Dimple

To compare the antiplaque, antigingivitis and antibacterial efficacy of chlorhexidine (CHX), XYL and a mouthwash combining CHX and XYL against Streptococcus mutans (S. mutans). A parallel design, randomised controlled trial was conducted among 75 dental students. Participants were randomised into CHX, CHX+XYL and XYL-only groups using the lottery method. Subjects were instructed to use 10 ml of the provided mouthwash for 15 s twice daily for 3 weeks. All the outcome measures, gingival index (GI), plaque index (PI) and number of salivary S. mutans CFU were recorded at baseline and 3 weeks post intervention. Nonparametric tests were used for inferential statistics. All outcome variables (GI, PI scores and log10 salivary S. mutans counts) decreased significantly from baseline compared to post intervention among all three groups. Intergroup comparison demonstrated that reduction in GI was not significantly different among the three groups. The decrease in PI scores was found to be significantly higher in the XYL group, while the decrease in the log10 salivary S. mutans count was significantly higher in the CHX+XYL group. The present study provided sufficient data to suggest that all the three mouthwashes are effective against plaque, gingivitis and S. mutans load in saliva. Further investigations should be carried out to confirm the results and develop strategies for using such products to prevent tooth decay.

Antimicrobial effectiveness of intracanal medicaments on Enterococcus faecalis: chlorhexidine versus octenidine.

PubMed

de Lucena, J M V M; Decker, E M; Walter, C; Boeira, L S; Löst, C; Weiger, R

2013-01-01

To determine the viability of Enterococcus faecalis in infected human root dentine in vitro after exposure to root canal medicaments based on chlorhexidine and octenidine. Human root segments (n = 40) were infected with E. faecalis for 8 weeks. Root dentine samples (rd) collected at week 4 served as individual baseline values. At week 8, the root segments were randomly divided into four test groups (n = 10 each) for the placement of one of the following medicaments in the root canals: calcium hydroxide paste (CH), chlorhexidine gel (CHX-gel) (5.0%), chlorhexidine/gutta-percha points (CHX-GP) (active points(®) ; Roeko, Langenau, Germany) and octenidine gel (OCT-gel) (5.0%) followed by incubation for 4 weeks. The effect on E. faecalis viability was assessed by two fluorescent dyes (syto 9/propidium iodide) to determine the 'proportion of viable bacteria' (PVB%) and number of 'colony-forming units' (CFU). Mean values and 95% confidence intervals (CI) were calculated for PVB% and log CFU, and the difference between groups was established. Viable and dead bacterial cells were detected in all 'rd' samples at weeks 4 and 8. The treatment with CHX-gel, CHX-GP and OCT-gel resulted in significantly lower PVB% values with 15.4%, 3.5% and 0%, respectively. No growth (CFU) was recorded for these samples at week 12. When medicated by CH, the PVB% was increased without a corresponding change in CFUs. In contrast to calcium hydroxide, both CHX - and octenidine-based intracanal medicaments were effective in decreasing the viability of E. faecalis. OCT showed the most favourable results and may have potential as an endodontic medicament. © 2012 International Endodontic Journal.

A chlorhexidine-loaded biodegradable cellulosic device for periodontal pockets treatment.

PubMed

Tabary, Nicolas; Chai, Feng; Blanchemain, Nicolas; Neut, Christel; Pauchet, Lucile; Bertini, Sabrina; Delcourt-Debruyne, Elisabeth; Hildebrand, Hartmut Frederic; Martel, Bernard

2014-01-01

Absorbent points widely used in endodontic therapy were transformed into bioresorbable chlorhexidine delivery systems for the treatment of the periodontal pocket by preventing its recolonization by the subgingival microflora. These paper points (PPs) were first oxidized to promote their resorption, then grafted with β-cyclodextrin (CD) or maltodextrin (MD) in order to achieve sustained delivery of chlorhexidine. We investigated the oxidation step parameters through the time of reaction and the nitric and phosphoric acid ratios in the oxidizing mixture, and then the dextrin grafting step parameters through the time and temperature of reaction. A first selection of the appropriate functionalization parameters was undertaken in relation to the degradation profile kinetics of the oxidized (PPO) and oxidized-grafted samples (PPO-CD and PPO-MD). Samples were then loaded with chlorhexidine digluconate (digCHX), a widely used antiseptic agent in periodontal therapy. The release kinetics of digCHX from PPO-CD and PPO-MD samples were compared to PP, PPO and to PerioChip(®) (a commercial digCHX containing gelatine chip) in phosphate buffered saline (pH 7.4) by ultraviolet spectrophotometry. The cytocompatibility of the oxidized-grafted PP was demonstrated by cell proliferation assays. Finally, the disc diffusion test from digCHX loaded PPO-MD samples immersed in human plasma was developed on pre-inoculated agar plates with four common periodontal pathogenic strains: Fusobacterium nucleatum, Prevotella melaninogenica, Aggregatibacter actinomycetem comitans and Porphyromonas gingivalis. To conclude, the optimized oxidized-dextrin-grafted PPs responded to our initial specifications in terms of resorption and digCHX release rates and therefore could be adopted as a reliable complementary periodontal therapy. Copyright © 2013 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Is chlorhexidine-methacrylate as effective as chlorhexidine digluconate in preserving resin dentin interfaces?

PubMed

Abu Nawareg, Manar; Elkassas, Dina; Zidan, Ahmed; Abuelenain, Dalia; Abu Haimed, Tariq; Hassan, Ali H; Chiba, Ayaka; Bock, Thorsten; Agee, Kelli; Pashley, David H

2016-02-01

The aim of the current study was to evaluate the effect of 2% CHX and 2% CHX-methacrylate compared to the resin-dentin bonds created by a two-step etch-and-rinse adhesive system after 24h, 6min and 12min. Microtensile bond strengths and interfacial nanoleakage within resin-dentin interfaces created by Adper Single Bond 2, with or without CHX or CHX-methacrylate pre-treatment for 30s on acid-etched dentin surfaces, were evaluated after 24h, 6min and 12min of storage in distilled water at 37°C. Twelve months of storage resulted in a significant decrease in microtensile bond strength in the control group, and significant increases in silver nanoleakage. In contrast, Single Bond 2+CHX, and to a greater extent CHX-methacrylate, significantly reduced the rate of deterioration of resin-dentin interfaces over the 12min water storage period, in terms of bond strength. Similar to Single Bond 2+CHX, Single Bond+CHX-methacrylates reduced the degradation of resin-bonded interfaces over a 12 month storage period. Thus it can be concluded that Single Bond 2+CHX-methacrylate may be important to improve durability of bonded interfaces and therefore, prolong the life span of adhesive restorations. Although CHX primers have been shown to enhance the durability of etch-and-rinse adhesives, that protection is lost after 2h. The use of CHX-methacrylate should last much longer since it may copolymerize with adhesive monomers, unlike CHX. Copyright © 2015 Elsevier Ltd. All rights reserved.

Microscopic and Spectroscopic Analyses of Chlorhexidine Tolerance in Delftia acidovorans Biofilms

PubMed Central

Rema, Tara; Lawrence, John R.; Dynes, James J.; Hitchcock, Adam P.

2014-01-01

The physicochemical responses of Delftia acidovorans biofilms exposed to the commonly used antimicrobial chlorhexidine (CHX) were examined in this study. A CHX-sensitive mutant (MIC, 1.0 μg ml−1) was derived from a CHX-tolerant (MIC, 15.0 μg ml−1) D. acidovorans parent strain using transposon mutagenesis. D. acidovorans mutant (MT51) and wild-type (WT15) strain biofilms were cultivated in flow cells and then treated with CHX at sub-MIC and inhibitory concentrations and examined by confocal laser scanning microscopy (CLSM), scanning transmission X-ray microscopy (STXM), and infrared (IR) spectroscopy. Specific morphological, structural, and chemical compositional differences between the CHX-treated and -untreated biofilms of both strains were observed. Apart from architectural differences, CLSM revealed a negative effect of CHX on biofilm thickness in the CHX-sensitive MT51 biofilms relative to those of the WT15 strain. STXM analyses showed that the WT15 biofilms contained two morphochemical cell variants, whereas only one type was detected in the MT51 biofilms. The cells in the MT51 biofilms bioaccumulated CHX to a similar extent as one of the cell types found in the WT15 biofilms, whereas the other cell type in the WT15 biofilms did not bioaccumulate CHX. STXM and IR spectral analyses revealed that CHX-sensitive MT51 cells accumulated the highest levels of CHX. Pretreating biofilms with EDTA promoted the accumulation of CHX in all cells. Thus, it is suggested that a subpopulation of cells that do not accumulate CHX appear to be responsible for greater CHX resistance in D. acidovorans WT15 biofilm in conjunction with the possible involvement of bacterial membrane stability. PMID:25022584

Chlorhexidine stabilizes the adhesive interface: a 2 year in vitro study

PubMed Central

Breschi, Lorenzo; Mazzoni, Annalisa; Nato, Fernando; Carrilho, Marcela; Visintini, Erika; Tjäderhane, Leo; Ruggeri, Alessandra; Tay, Franklin R; De Stefano Dorigo, Elettra; Pashley, David H

2013-01-01

Objectives This study evaluated the role of endogenous dentin MMPs in auto-degradation of collagen fibrils within adhesive-bonded interfaces. The null hypotheses tested were that adhesive blends or chlorhexidine digluconate (CHX) application does not modify dentin MMPs activity and that CHX used as therapeutic primer does not improve the stability of adhesive interfaces over time. Methods Zymograms of protein extracts from human dentin powder incubated with Adper Scotchbond 1XT (SB1XT) on untreated or 0.2–2% CHX treated dentin were obtained to assay dentin MMPs activity. Microtensile bond strength and interfacial nanoleakage expression of SB1XT bonded interfaces (with or without CHX pre-treatment for 30s on the etched surface) were analyzed immediately and after 2 yr of storage in artificial saliva at 37°C. Results Zymograms showed that application of SB1XT to human dentin powder increases MMP-2 activity, while CHX pre-treatment inhibited all dentin gelatinolytic activity, irrespective from the tested concentration. CHX significantly lowered the loss of bond strength and nanoleakage seen in acid-etched resin-bonded dentin artificially aged for 2 yr. Significance The study demonstrates the active role of SB1XT in dentin MMP-2 activation and the efficacy of CHX inhibition of MMPs even if used at low concentration (0.2%). PMID:20045177

Chlorhexidine mouthwash reduces plaque and gingivitis.

PubMed

Herrera, David

2013-03-01

Medline, Embase and Cochrane Central Register of Controlled Trials (CENTRAL) databases were searched along with the reference lists of all selected studies. Only English language studies were included. Randomised controlled clinical trials comparing chlorhexidine (CHX) to placebo/control mouthrinses for oral hygiene in studies of at least four weeks duration were included. Screening, selection and data abstractions were conducted independently by two reviewers. Where possible meta-analysis of weighted mean differences was carried out using fixed or random effects models where appropriate. Thirty studies were included, with 13 studies contributing to the meta-analysis. The meta-analysis found significant differences favouring CHX for a range of indices; the Plaque Index Silness & Löe, Plaque-Index Quigley & Hein (PIQH), the Gingival Index (GI), Papillary BIeeding Index, Bleeding on Marginal Probing and the Lobene Stain Index. Relative to control, the reduction with CHX for plaque was 33% and for gingivitis 26%. CHX rinsing groups demonstrated significantly more staining. In gingivitis patients, CHX mouthrinses together with OH versus placebo, or control mouthrinse provide significant reductions in plaque and gingivitis scores, but a significant increase in staining score.

The effect of 1% chlorhexidine varnish and 40% xylitol solution on Streptococcus mutans and plaque accumulation in children.

PubMed

Simões Moraes, Renata; Modesto, Adriana; Regina Netto Dos Santos, Kátia; Drake, David

2011-01-01

The purpose of this study was to determine the effect of the association of 1% chlorhexidine varnish (CHX) and 40% xylitol solution (XYL) on Streptococcus mutans (SM) counts and plaque indices in 2- to 5-year-olds. Sixty-eight children were selected with medium levels (1 x 10³) to very high levels (>1 x 10⁵) of SM in the saliva. Subjects were divided into 4 groups of 17 children each: (1) CHX; (2) CHX+XYL; (3) XYL; and(4) 0.05% sodium fluoride (F). An assessment of SM levels and plaque indices was done on all children at baseline, 15 days, and at 1, 3, and 6 months. SM levels were determined by the spatula method. Although the reduction in SM counts in all groups was statistically significant, differences among groups were not observed, and the CHX and F groups seemed to show the greatest effect. Plaque reduction was observed in all groups, whereas statistically significant decreases among groups were not observed. One percent chlorhexidine varnish associated with 40% xylitol solution tested in the present study does not provide significant suppression of Streptococcus mutans counts and reduction of plaque accumulation at any follow-up time points.

The effects of sodium hypochlorite and chlorhexidine irrigants on the antibacterial activities of alkaline media against Enterococcus faecalis.

PubMed

Ma, Jinglei; Tong, Zhongchun; Ling, Junqi; Liu, Hongyan; Wei, Xi

2015-07-01

Sodium hypochlorite (NaOCl), chlorhexidine (CHX) and calcium hydroxide are common intracanal medicaments. The present study aimed to evaluate the effects of NaOCl and CHX on the antibacterial activities of alkaline media against Enterococcus faecalis. The survival rates of planktonic and biofilm E. faecalis were evaluated by plate counts after 1 min of pretreatment with NaOCl and CHX, and time-kill assays were then used to assess subsequent pH alkaline challenges. Dead and living cells in the E. faecalis biofilm were assessed with SYTO 9 and PI staining in combination with confocal laser scanning microscopy following exposure to NaOCl or CHX and subsequent alkaline challenges by common root canal irrigation and dressing procedures. One minute of pretreatment with 2% CHX, 0.2% CHX, or 5.25% NaOCl in combination with a subsequent alkaline challenge significantly decreased planktonic E. faecalis survival rates, but pretreatment with 1% NaOCl did not. The E. faecalis biofilm survival rates were reduced in the subsequent alkaline challenge following CHX pretreatment but gradually increased following NaOCl pretreatment. Similarly, CLSM analysis revealed that the greatest proportions of dead E. faecalis cells in the biofilms were presented in the CHX and alkaline treatment group. CHX might be more effective in improving the antibacterial activities of alkaline root canal medicaments against E. faecalis than NaOCl during routine root canal therapy procedures. Copyright © 2015 Elsevier Ltd. All rights reserved.

Inhibition of orally produced volatile sulfur compounds by zinc, chlorhexidine or cetylpyridinium chloride--effect of concentration.

PubMed

Young, Alix; Jonski, Grazyna; Rölla, Gunnar

2003-10-01

Zinc ions, chlorhexidine (CHX) and cetylpyridinium chloride (CPC) are all known to inhibit production of volatile sulfur compounds (VSCs). The objective was to examine the anti-VSC dose-response effects of each of the above agents. Oral malodor was induced in 13 test subjects using the cysteine challenge method. The oral VSC response to rinses with 6 mm l-cysteine (pH 7.2) before and 1, 2 and 3 h after rinsing with zinc ions (Zn2+: 0.1, 0.3 and 1.0%), CHX and CPC (0.025 and 0.2%) was measured. Mouth air was analysed for VSC by gas chromatography (GC) according to current methodology. Zinc had a marked dose- and time-dependent anti-VSC effect. Zinc at 1% concentration had a somewhat unpleasant taste, whereas the lowest concentration was found acceptable. Chlorhexidine maintained a moderate anti-VSC effect over time. At 3 h, 0.2% CHX was the most effective agent but tasted relatively unpleasant. Cetylpyridinium at a concentration of 0.2% was only marginally more effective than 0.025% CHX over the 3 h, while 0.025% CPC had no better anti-VSC effect than water at both 2 h and 3 h. It was concluded that the three test agents demonstrated different anti-VSC kinetics. Although Zn had the best anti-VSC effect at 1 h, 0.2% CHX was at least as effective as 1% Zn at 3 h, most likely as a result of its unique substantivity.

Does human saliva decrease the antimicrobial activity of chlorhexidine against oral bacteria?

PubMed

Abouassi, Thaer; Hannig, Christian; Mahncke, Katja; Karygianni, Lamprini; Wolkewitz, Martin; Hellwig, Elmar; Al-Ahmad, Ali

2014-10-10

Several studies have shown the antibacterial effectiveness of 0.2% chlorhexidine (CHX) in both in vitro and in vivo studies. In this way, CHX comes directly in contact with saliva. This in vitro study aimed at investigating the possible neutralizing effect of saliva on CHX. Saliva samples (12 ml) were collected from twenty healthy volunteers. The aerobic and anaerobic bacterial counts in saliva were determined on Colombia blood agar (CBA) and yeast cysteine agar (HCB), respectively. Saliva from each subject was divided among 4 experimental groups (3 ml/group). Samples were centrifuged at 4000 g for 10 min. The centrifuged salivary bacteria were incubated with the following solutions: 0.2% CHX in saliva, CHX in saliva with 7% ethanol, CHX in 0.9% NaCl, CHX in 0.9% NaCl with 7% ethanol. After exposure for 1 min or 3 min to these CHX solutions, the CHX was neutralized and the bacteria were cultivated, after which the number of colony forming units (aerobic and anaerobic) was determined. CHX reduced the CFU in all groups significantly (p = 0.0001). Therefore, CHX had a similar effect on both aerobic and anaerobic microorganisms. Significantly more bacteria survived the effect of CHX when kept in salivary solution. This effect from saliva could be compensated by the addition of ethanol. In the absence of saliva there was no significant difference observed in the effectiveness of CHX with respect to ethanol. Prolonging the exposure time to 3 min enhanced the effectiveness of CHX. The effect of saliva on the antimicrobial activity of CHX was weak albeit statistically significant. However, addition of 7% ethanol compensates this effect. The impact of saliva on the reduction of the antimicrobial efficacy of mouthrinses such as CHX needs to be taken into consideration with regard to improving their antibacterial properties.

"Nature cures:" An alternative herbal formulation as a denture cleanser.

PubMed

Sushma, R; Sathe, Tanuja Tanaji; Farias, Anand; Sanyal, Pronob Kumar; Kiran, Shashi

2017-01-01

Candida albicans is one of the microorganisms which harbor the oral cavity, especially in elderly. However, the incidence of existence of this increases in patients using removable dental prosthesis. There is therefore a need to test the anticandidal efficacy of these cost-effective, easily available products to be used as routine denture cleansers. (1) To evaluate antifungal properties of triphala churna on the heat cure denture base material. (2) To evaluate the antifungal effect of chlorhexidine gluconate on the heat cure denture base material. (3) To compare the antifungal effect of triphala churna and chlorhexidine gluconate with a control. (4) To evaluate which among triphala churna and chlorhexidine gluconate has a better antifungal property on the heat cure denture base material. Study population consisted of sixty dentures wearers from those attending the Outpatient Department of Prosthodontics of the School of Dentistry, Krishna Institute of Medical Sciences Deemed University, Karad. Swabs were collected from the dentures before and after the use of triphala and chlorhexidine. The swabs were cultured on Sabouraud dextrose agar and the total Candida counts were determined. Triphala as an antifungal is shown to have more efficacy than the conventional chlorhexidine mouthwash. Résumé Arrière-plan: Candida albicans est l'un des micro-organismes qui abritent la cavité buccale surtout chez les personnes âgées. Cependant, l'incidence de l'existence de cette augmentation chez les patients utilisant des prothèses dentaires amovibles. Il est donc nécessaire de tester l'efficacité anticancédique de ces produits rentables et faciles à utiliser pour être utilisés comme nettoyants de routine pour prothèses dentaires. Buts et Objectifs: (1) Évaluer les propriétés antifongiques de Triphala churna sur le matériau de base de la prothèse thermo-durcissable. (2) Évaluer l'effet antifongique du gluconate de chlorhexidine sur le matériau de base de la prothèse thermo-durcissable. (3) Comparer l'effet antifongique de Triphala churna et du gluconate de chlorhexidine avec un témoin. (4) Évaluer lequel parmi Triphala churna et le gluconate de chlorhexidine a une meilleure propriété antifongique sur le matériel de base de la prothèse de durcissement à chaud. Matériaux et Méthode: La population de l'étude était constituée de soixante porteurs de prothèses dentaires de ceux qui fréquentaient le Département de Prosthodontie de l'École des Sciences Dentaires de l'Institut Krishna des Sciences Médicales de l'Université de Karad. Des prélèvements ont été effectués sur les prothèses avant et après l'utilisation de Triphala et de chlorhexidine. On a cultivé les écouvillons sur de l'agar Sabouraud dextrose et on a déterminé le nombre total de candida. Triphala comme un anti fongique est démontré pour avoir plus d'efficacité que le lavage de la bouche classique chlorhexidine.

Evaluation of Shear Bond Strength of Total- and Self-etching Adhesive Systems after Application of Chlorhexidine to Dentin Contaminated with a Hemostatic Agent

PubMed Central

Sharafeddin, Farahnaz; Farhadpour, Hajar

2015-01-01

Statement of the Problem Hemostatic agents may influence the bond strength of different bonding agents. Also, chlorhexidine has shown positive effects on bond strength values and their combination effect has not been reported yet. Purpose The aim of this study was to evaluate the effect of contamination with a hemostatic agent on shear bond strength (SBS) of total- and self-etching adhesive systems and the effect of chlorhexidine application after removal of the hemostatic agent. Materials and Method In this experimental study, the occlusal enamel of each sixty caries-free mandibular molars was removed and their midcoronal dentin was exposed. The specimens were then mounted in auto-polymerizing resin 1mm apical to CEJ. Then, the specimens were divided into 6 groups (n=10) based on contamination with a hemostatic agent (H), application of chlorhexidine (CHX) and the adhesive system used; and then were classified as Group 1: Adper Single Bond (ASB); Group 2: H+ASB; Group 3: H+0.2% CHX+ASB; Group 4: Clearfil SE Bond (CSB); Group 5: H+CSB; Group 6: H+0.2% CHX+CSB. Then, composite resin rods (4×2 mm) were built up on the dentin surfaces and after thermocycling, the SBS (MPa) was evaluated. Statistical analysis was performed using two-way ANOVA and post hoc Tukey tests (p< 0.05). Results There were statistically significant differences between bond strength values of group 1 (ASB) and group 2 (H+ASB) (p< 0.001) and group 1 (ASB) and group 3 (H+CHX+ASB) (p< 0.001). Similarly, significant differences were seen between group 4 (CSB) and group 5 (H+CSB) (p< 0.001) and between group 4 (CSB) and group 6 (H+CHX+CSB) (p< 0.001). Conclusion Contamination with hemostatic agent reduced the SBS of both total- and self-etching adhesive systems. In addition, application of chlorhexidine after the removal of hemostatic agent had a negative effect on SBS of total- and self-etching adhesive systems. PMID:26331146

Cost-Effectiveness Analysis of a Transparent Antimicrobial Dressing for Managing Central Venous and Arterial Catheters in Intensive Care Units

PubMed Central

Bernatchez, Stéphanie F.; Ruckly, Stéphane; Timsit, Jean-François

2015-01-01

Objective To model the cost-effectiveness impact of routine use of an antimicrobial chlorhexidine gluconate-containing securement dressing compared to non-antimicrobial transparent dressings for the protection of central vascular lines in intensive care unit patients. Design This study uses a novel health economic model to estimate the cost-effectiveness of using the chlorhexidine gluconate dressing versus transparent dressings in a French intensive care unit scenario. The 30-day time non-homogeneous markovian model comprises eight health states. The probabilities of events derive from a multicentre (12 French intensive care units) randomized controlled trial. 1,000 Monte Carlo simulations of 1,000 patients per dressing strategy are used for probabilistic sensitivity analysis and 95% confidence intervals calculations. The outcome is the number of catheter-related bloodstream infections avoided. Costs of intensive care unit stay are based on a recent French multicentre study and the cost-effectiveness criterion is the cost per catheter-related bloodstream infections avoided. The incremental net monetary benefit per patient is also estimated. Patients 1000 patients per group simulated based on the source randomized controlled trial involving 1,879 adults expected to require intravascular catheterization for 48 hours. Intervention Chlorhexidine Gluconate-containing securement dressing compared to non-antimicrobial transparent dressings. Results The chlorhexidine gluconate dressing prevents 11.8 infections /1,000 patients (95% confidence interval: [3.85; 19.64]) with a number needed to treat of 85 patients. The mean cost difference per patient of €141 is not statistically significant (95% confidence interval: [€-975; €1,258]). The incremental cost-effectiveness ratio is of €12,046 per catheter-related bloodstream infection prevented, and the incremental net monetary benefit per patient is of €344.88. Conclusions According to the base case scenario, the chlorhexidine gluconate dressing is more cost-effective than the reference dressing. Trial Registration This model is based on the data from the RCT registered with www.clinicaltrials.gov (NCT01189682). PMID:26086783

Influence of chlorhexidine on dentin adhesive interface micromorphology and nanoleakage expression of resin cements.

PubMed

Stape, Thiago Henrique Scarabello; Menezes, Murilo De Sousa; Barreto, Bruno De Castro Ferreira; Naves, Lucas Zago; Aguiar, Flávio Henrique Baggio; Quagliatto, Paulo Sérgio; Martins, Luís Roberto Marcondes

2013-08-01

This study focused on adhesive interface morphologic characterization and nanoleakage expression of resin cements bonded to human dentin pretreated with 1% chlorhexidine (CHX). Thirty-two non-carious human third molars were ground flat to expose superficial dentin. Resin composite blocks were luted to the exposed dentin using one conventional (RelyX ARC) and one self-adhesive resin cement (RelyX U100), with/without CHX pretreatment. Four groups (n = 8) were obtained: control groups (ARC and U100); experimental groups (ARC/CHX and U100/CHX) were pretreated with 1% CHX prior to the luting process. After storage in water for 24 h, the bonded teeth were sectioned into 0.9 × 0.9 mm(2) sticks producing a minimum of 12 sticks per tooth. Four sticks from each tooth were prepared for hybrid layer evaluation by scanning electron microscope analysis. The remaining sticks were immersed in silver nitrate for 24 h for either nanoleakage evaluation along the bonded interfaces or after rupture. Nanoleakage samples were carbon coated and examined using backscattered electron mode. Well-established hybrid layers were observed in the groups luted with RelyX ARC. Nanoleakage evaluation revealed increase nanoleakage in groups treated with CHX for both resin cements. Group U100/CHX exhibited the most pronouncing nanoleakage expression along with porous zones adjacent to the CHX pretreated dentin. The results suggest a possible incompatibility between CHX and RelyX U100 that raises the concern that the use of CHX with self-adhesive cements may adversely affect resin-dentin bond. Copyright © 2013 Wiley Periodicals, Inc.

A 2-year in vitro evaluation of a chlorhexidine-containing acid on the durability of resin-dentin interfaces.

PubMed

Stanislawczuk, Rodrigo; Reis, Alessandra; Loguercio, Alessandro D

2011-01-01

This study evaluated the effect of 2% chlorhexidine-containing acid (Ac/CHX) and 2% chlorhexidine digluconate solution (CHX) on immediate (IM) and 2-year (2Y) resin-dentin bond strength (BS) and silver nitrate uptake (SNU) for two simplified etch-and-rinse adhesives. Forty-two caries-free extracted molars had a flat dentin surface exposed. In the control groups (groups 1), the surfaces were acid etched with conventional phosphoric acid and the adhesives Prime&Bond NT (PB) or Adper Single Bond 2 (SB) was applied after rinsing, drying and rewetting with water. In groups 2, Ac/CHX groups the adhesives were applied in a similar manner; however a 2% CHX-containing acid was previously applied. In groups 3, the adhesives were applied according to the control group; however the rewetting procedure was performed with an aqueous solution of 2% CHX for 60s. Composite build-ups were constructed incrementally and microtensile specimens (0.8mm(2)) were prepared for microtensile bond strength testing in the IM or 2Y periods at 0.5mm/min. For SNU, 2 bonded sticks from each tooth were coated with nail varnish, placed in the silver nitrate, polished down with SiC papers and analysed by EDX-SEM. The data from each adhesive was submitted to a two-way repeated measures ANOVA and Tukey's test (α=0.05). After 2Y, significant reductions of BS were observed for both adhesives in the control group (p<0.05). In Ac/CHX or CHX groups the BS remained stable for both systems. SNU was more evident in the control than in the experimental groups (p<0.05) both in IM and 2Y periods. The use of CHX in an aqueous solution or associated with the acid conditioner was effective to reduce the degradation of dentin bonds over a 2-year period. The addition of CHX digluconate in the acidic conditioner may be an excellent tool to increase the long-term stability of collagens fibrils within the hybrid layer against host-derived metalloproteinases without the need for additional steps for the bonding protocol. Copyright © 2010 Elsevier Ltd. All rights reserved.

The Two-Component System ChtRS Contributes to Chlorhexidine Tolerance in Enterococcus faecium.

PubMed

Guzmán Prieto, Ana M; Wijngaarden, Jessica; Braat, Johanna C; Rogers, Malbert R C; Majoor, Eline; Brouwer, Ellen C; Zhang, Xinglin; Bayjanov, Jumamurat R; Bonten, Marc J M; Willems, Rob J L; van Schaik, Willem

2017-05-01

Enterococcus faecium is one of the primary causes of nosocomial infections. Disinfectants are commonly used to prevent infections with multidrug-resistant E. faecium in hospitals. Worryingly, E. faecium strains that exhibit tolerance to disinfectants have already been described. We aimed to identify and characterize E. faecium genes that contribute to tolerance to the disinfectant chlorhexidine (CHX). We used a transposon mutant library, constructed in a multidrug-resistant E. faecium bloodstream isolate, to perform a genome-wide screen to identify genetic determinants involved in tolerance to CHX. We identified a putative two-component system (2CS), composed of a putative sensor histidine kinase (ChtS) and a cognate DNA-binding response regulator (ChtR), which contributed to CHX tolerance in E. faecium Targeted chtR and chtS deletion mutants exhibited compromised growth in the presence of CHX. Growth of the chtR and chtS mutants was also affected in the presence of the antibiotic bacitracin. The CHX- and bacitracin-tolerant phenotype of E. faecium E1162 was linked to a unique, nonsynonymous single nucleotide polymorphism in chtR Transmission electron microscopy showed that upon challenge with CHX, the Δ chtR and Δ chtS mutants failed to divide properly and formed long chains. Normal growth and cell morphology were restored when the mutations were complemented in trans Morphological abnormalities were also observed upon exposure of the Δ chtR and Δ chtS mutants to bacitracin. The tolerance to both chlorhexidine and bacitracin provided by ChtRS in E. faecium highlights the overlap between responses to disinfectants and antibiotics and the potential for the development of cross-tolerance for these classes of antimicrobials. Copyright © 2017 American Society for Microbiology.

Immobilization of antibacterial chlorhexidine on stainless steel using crosslinking polydopamine film: Towards infection resistant medical devices.

PubMed

Mohd Daud, Nurizzati; Saeful Bahri, Ihda Fithriyana; Nik Malek, Nik Ahmad Nizam; Hermawan, Hendra; Saidin, Syafiqah

2016-09-01

Chlorhexidine (CHX) is known for its high antibacterial substantivity and is suitable for use to bio-inert medical devices due to its long-term antibacterial efficacy. However, CHX molecules require a crosslinking film to be stably immobilized on bio-inert metal surfaces. Therefore, polydopamine (PDA) was utilized in this study to immobilize CHX on the surface of 316L type stainless steel (SS316L). The SS316L disks were pre-treated, modified with PDA film and immobilized with different concentrations of CHX (10mM-50mM). The disks were then subjected to various surface characterization analyses (ATR-FTIR, XPS, ToF-SIMS, SEM and contact angle measurement) and tested for their cytocompatibility with human skin fibroblast (HSF) cells and antibacterial activity against Escherichia coli and Staphylococcus aureus. The results demonstrated the formation of a thin PDA film on the SS316L surface, which acted as a crosslinking medium between the metal and CHX. CHX was immobilized via a reduction process that covalently linked the CHX molecules with the functional group of PDA. The immobilization of CHX increased the hydrophobicity of the disk surfaces. Despite this property, a low concentration of CHX optimized the viability of HSF cells without disrupting the morphology of adherent cells. The immobilized disks also demonstrated high antibacterial efficacy against both bacteria, even at a low concentration of CHX. This study demonstrates a strong beneficial effect of the crosslinked PDA film in immobilizing CHX on bio-inert metal, and these materials are applicable in medical devices. Specifically, the coating will restrain bacterial proliferation without suffocating nearby tissues. Copyright © 2016 Elsevier B.V. All rights reserved.

Does Para-chloroaniline Really Form after Mixing Sodium Hypochlorite and Chlorhexidine?

PubMed

Orhan, Ekim Onur; Irmak, Özgür; Hür, Deniz; Yaman, Batu Can; Karabucak, Bekir

2016-03-01

Mixing sodium hypochlorite (NaOCl) with chlorhexidine (CHX) forms a brown-colored precipitate. Previous studies are not in agreement whether this precipitate contains para-chloroaniline (PCA). Tests used for analysis may demonstrate different outcomes. Purpose of this study was to determine whether PCA is formed through the reaction of mixing NaOCl and CHX by using high performance liquid chromatography, proton nuclear magnetic resonance spectroscopy, gas chromatography, thin layer chromatography, infrared spectroscopy, and gas chromatography/mass spectrometry. To obtain a brown precipitate, 4.99% NaOCl was mixed with 2.0% CHX. This brown precipitate was analyzed and compared with signals obtained from commercially available 4.99% NaOCl, 2% solutions, and 98% PCA in powder form. Chromatographic and spectroscopic analyses showed that brown precipitate does not contain free PCA. This study will be a cutoff proof for the argument on PCA formation from reaction of CHX and NaOCl. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Determination of mutagenicity of the precipitate formed by sodium hypochlorite and chlorhexidine using the Ames test.

PubMed

Patil, Pranali; Aminoshariae, Anita; Harding, Jarrod; Montagnese, Thomas A; Mickel, Andre

2016-04-01

The aim of this study was to determine the direct mutagenic potential of any precipitate formed by combining sodium hypochlorite (NaOCl) and chlorhexidine (CHX). The precipitates formed by NaOCl and CHX were dissolved in 100% dimethyl sulfoxide and cultured with mutant Salmonella Typhimurium strains. The cells were observed for reverse mutation. The numbers of positive/mutated wells were statistically compared with those in the background plates using the two-sample proportion independent t-test. The precipitates were not found to be significantly more mutagenic than the background plates. Within the limitations of this study, the results suggest that the precipitates formed when sodium hypochlorite and chlorhexidine contact did not show mutagenic (and are therefore carcinogenic) potential. © 2015 Australian Society of Endodontology.

Influence of different final irrigation regimens and various endodontic filling materials on vertical root fracture resistance.

PubMed

Sungur, D D; Altundasar, E; Uzunoglu, E; Yilmaz, Z

2016-01-01

The aim of this study was to evaluate the influence of different endodontic materials and final irrigation regimens on vertical root fracture (VRF) resistance. Eighty human teeth were prepared then assigned into two groups (n = 40) according to the final irrigations. G1: 5 mL, 5.25% sodium hypochlorite (NaOCl), G2: 5 mL, 2% chlorhexidine gluconate (CHX). Each group was assigned into four subgroups according to the obturation system used (n = 10): A: iRoot SP/single gutta-percha cone (SGP), B: Only iRoot SP, C: Mineral trioxide aggregate (MTA)-Fillapex/SGP, D: AH26/SGP. The specimens were embedded in acrylic molds and subjected to compressive loading at a rate of 1 mm min until VRF occurred. Data were analyzed via three-way ANOVA tests. The statistically significant difference was found among groups (P < 0.05). The G1A and G1B and G1D revealed significantly higher-VRF values than G1C (P = 0.023). The roots filled with MTA-Fillapex revealed lower-VRF values than the other subgroups (P < 0.05). Groups irrigated with NaOCl had significantly lower-VRF values than the groups irrigated with CHX (P < 0.05). Final irrigation regimens could alter VRF resistance of root canals filled with different obturation technique and root canal sealers.

Effects of chlorhexidine (gel) application on bacterial levels and orthodontic brackets during orthodontic treatment.

PubMed

Al-Bazi, Samar M; Abbassy, Mona A; Bakry, Ahmed S; Merdad, Leena A; Hassan, Ali H

2016-01-01

The objectives of this study were to evaluate the effects of applying 0.50% chlorhexidine (CHX) gel using the dental drug delivery system (3DS) on salivary Streptococcus mutans (S. mutans) and on the surface topography of metal and ceramic orthodontic brackets. The study involved 20 orthodontic patients with high levels of salivary S. mutans. The patients were treated with professional mechanical tooth cleaning followed by application of 0.50% CHX using individual trays (3DS). Salivary S. mutans levels were repeatedly measured 1, 2, 4, and 8 weeks post-treatment. In vitro study utilized forty ceramic and metallic brackets that were immersed in 0.50% CHX gel for 10 min, whereas another untreated forty brackets served as controls. The frictional resistances of stainless steel wires to the brackets before and after CHX treatment were recorded using a universal testing machine. Scanning electron microscopy was used to compare changes in the surface topography of brackets. Statistical analyses were used to determine the effect of CHX on bacterial count and to evaluate the effect of CHX on frictional resistance. According to the results of this study, S. mutans levels were reduced significantly (P < 0.05). There were no significant changes in the frictional resistance and surface topography of brackets before or after application of CHX. (J Oral Sci 58, 35-42, 2016).

Antimicrobial Activity of a Novel Vascular Access Film Dressing Containing Chlorhexidine Gluconate.

PubMed

Wibaux, Anne; Thota, Priyaleela; Mastej, Jozef; Prince, Daniel L; Carty, Neal; Johnson, Peter

2015-01-01

Covering insertion sites with chlorhexidine impregnated dressings has been proven to be clinically effective in reducing catheter related blood stream infections (CR-BSI). Two chlorhexidine gluconate (CHG)-impregnated dressings are commercially available, a polyurethane foam disk and a film dressing containing a chlorhexidine gluconate-impregnated gel pad. While both have demonstrated efficacy in clinical settings, the major drawback of high cost and impaired IV insertion site visibility limits their usage. A new, simple film dressing containing CHG within its adhesive layer is now available. The objective of this study was to test the in vitro antimicrobial efficacy of the new dressing in comparison to the CHG-impregnated gel dressing. Quantitative aliquots of suspensions (concentration of 1.0x106 to 5.0x106 cfu/sample) of clinically relevant challenge organisms (Staphylococcus species, gram-negative bacilli, Candida albicans) were incubated in contact with the new CHG-containing film dressing, a placebo version of the same (negative control) and the commercially available CHG-impregnated gel dressing (positive control). Serial dilutions of the surviving organisms were quantified using the pour plate after 1, 3, 5, and 7 days of incubation in order to calculate an antimicrobial log10 reduction for each organism/dressing combination at each point in time. The new CHG-containing film dressing delivered greater than 5.0 log10 reduction throughout the 7 days on all aerobic gram-negative bacilli and Staphylococcus species tested. As of day 1 the CHG-containing film dressing provided greater than 5.0 log10 reduction on Candida albicans. There were no statistically significant differences in the log10 reduction between the two dressings tested. The new CHG-containing film dressing was found to be as effective as the chlorhexidine gluconate-impregnated gel dressing on clinically relevant microbes.

The antibacterial activity of chlorhexidine digluconate against Streptococcus mutans biofilms follows sigmoidal patterns.

PubMed

Lee, Dae-Woo; Jung, Ji-Eun; Yang, Yeon-Mi; Kim, Jae-Gon; Yi, Ho-Keun; Jeon, Jae-Gyu

2016-10-01

The aim of this study was to determine the pattern of the antibacterial activity of chlorhexidine digluconate (CHX) against mature Streptococcus mutans biofilms. Streptococcus mutans biofilms were formed on saliva-coated hydroxyapatite discs and then treated with 0-20% CHX, once, three times, or five times (1 min per treatment) during the period of mature biofilm formation (beyond 46 h). After the treatments, the colony-forming unit (CFU) counts of the treated biofilms were determined. The pH values of the spent culture medium were also determined to investigate the change in pH resulting from the antibacterial activity of CHX. The relationships between the concentration of CHX and the CFU counts and the concentration of CHX and culture medium pH, relative to the number of treatments performed, were evaluated using a sigmoidal curve-fitting procedure. The changes in CFU counts and culture medium pH followed sigmoidal curves and were dependent on the concentration of CHX (R 2 = 0.99). The sigmoidal curves were left-shifted with increasing number of treatments. Furthermore, the culture-medium pH of the treated biofilms increased as their CFU counts decreased. The lowest CHX concentration to increase culture-medium pH above the critical pH also decreased as the number of treatments increased. These results may provide fundamental information for selecting the appropriate CHX concentrations to treat S. mutans biofilms. © 2016 Eur J Oral Sci.

Effect of chlorhexidine/thymol and fluoride varnishes on dental biofilm formation in vitro.

PubMed

Takeuchi, Yasuo; Guggenheim, Bernhard; Filieri, Anna; Baehni, Pierre

2007-12-01

This study evaluated the effect of chlorhexidine/thymol (CHX/T) and fluoride (F) varnishes on biofilm formation in vitro. Hydroxyapatite discs coated with varnish were first immersed in saline for 0, 3, 7 or 14 d, then immersed in pasteurized saliva. The discs were incubated for 20 h with a bacterial suspension containing Actinomyces naeslundii, Fusobacterium nucleatum, Streptococcus oralis, and Veillonella dispar. Uncoated discs were used as controls. Growth of bacteria on the discs was evaluated by culture and by scanning electron microscopy (SEM). Bacterial vitality was examined by fluorescence staining. In the CHX/T-treated group, bacterial accumulation was delayed, and the total number of bacteria was significantly lower than in the controls. In the F-treated group, the total number of bacteria did not differ from the control, although the number of S. oralis was lower. Bacterial vitality in the CHX/T and F groups did not differ from that in the controls. The total number of bacteria on the CHX/T-treated discs immersed in saline was significantly higher than that on the non-immersed discs. Biofilm development was inhibited by the CHX/T varnish but not by the F varnish. The effect of the CHX/T varnish decreased following the immersion of discs in saline.

Effect of chlorhexidine digluconate on different cell types: a molecular and ultrastructural investigation.

PubMed

Giannelli, M; Chellini, F; Margheri, M; Tonelli, P; Tani, A

2008-03-01

Although several studies have shown that chlorhexidine digluconate (CHX) has bactericidal activity against periodontal pathogens and exerts toxic effects on periodontal tissues, few have been directed to evaluate the mechanisms underlying its adverse effects on these tissues. Therefore, the aim of the present study was to investigate the in vitro cytotoxicity of CHX on cells that could represent common targets for its action in the surgical procedures for the treatment of periodontitis and peri-implantitis and to elucidate its mechanisms of action. Osteoblastic, endothelial and fibroblastic cell lines were exposed to various concentrations of CHX for different times and assayed for cell viability and cell death. Also analysis of mitochondrial membrane potential, intracellular Ca2+ mobilization and reactive oxygen species (ROS) generation were done in parallel, to correlate CHX-induced cell damage with alterations in key parameters of cell homeostasis. CHX affected cell viability in a dose and time-dependent manners, particularly in osteoblasts. Its toxic effect consisted in the induction of apoptotic and autophagic/necrotic cell deaths and involved disturbance of mitochondrial function, intracellular Ca2+ increase and oxidative stress. These data suggest that CHX is highly cytotoxic in vitro and invite to a more cautioned use of the antiseptic in the oral surgical procedures.

The antifungal properties of chlorhexidine digluconate and cetylpyrinidinium chloride on oral Candida.

PubMed

Fathilah, A R; Himratul-Aznita, W H; Fatheen, A R N; Suriani, K R

2012-07-01

C. tropicalis and C. krusei have emerged as virulent species causing oral infections. Both have developed resistance to commonly prescribed azole antifungal agents. The study aimed to determine the effect of mouth rinses containing chlorhexidine digluconate (CHX), cetylpyridinium chloride (CPC) and their combination (CHX-CPC) on the growth of these strains. The minimal inhibition concentrations (MIC) of the mouth rinses were determined. The growth curves of the strains produced under the mouth rinse-treated and untreated conditions, as well as alterations to the morphology of the growth colonies and cells following the treatments were compared and analysed. The MICs of CPC compared to CHX mouth rinses were found to be lower for both Candida sp. In the mixed formulation, CPC doubled the inhibitory effect of CHX towards both Candida sp., while CHX quadrupled the activity of CPC towards C. tropicalis. The growth colonies also appeared coarse, wrinkled and dried. The profound effects shown may suggest the fungicidal activities of the mouth rinses incorporated with CHX, CPC or their combination on both C. tropicalis and C. krusei. Gargling using mouth rinses with such fungicidal activity would enhance a rapid reduction in the candidal population of patients with fungal infection. Copyright © 2012 Elsevier Ltd. All rights reserved.

Comparison of the effectiveness in bacterial decontamination between chlorhexidine gluconate and povidone-iodine solution in foot and ankle: a pilot study.

PubMed

Rugpolmuang, Likit; Thanabodeethada, Roongroj; Riansuwan, Kongkhet

2012-09-01

The decontamination for foot and ankle surgery should be considered as a special preparation due to higher rate of bacterial contamination. The footwear and humidity is also the issue of interest especially in tropical country. The contamination before surgery should be reduced to avoid the infection. The effectiveness of antiseptics and special condition for the foot and ankle surgery should be elucidated for better medical care. The twenty volunteers were included in the present study. In group 1, the foot was scrubbed with 7.5% Povidone-lodine and painted with 10% Povidone-lodine solution. In group II, the foot was scrubbed with Chlorhexidine gluconate scrub and painted with 2% Chlorhexidine gluconate in 70% alcohol. At the beginning and end of the preparation, specimens were taking from all toes, nailfold, interdigital web spaces. These samples were sent for aerobic bacterial cultures. The results were interpreted as positive or negative cultivation and the number of bacterial colonies. All of the samples from 40 feet were collected; In Group I, positive culture was 5 samples (25%). In Group II, positive culture was 2 samples (10%) (p = 0.2). The Chlorhexidine gluconate and Povidone-lodine are effective in reduction the number of bacterial colonization. The steps of preparation before surgery also play an important role in eliminating the pathogenic bacteria. Both antiseptics were found no significant different in efficacy of pathogenic bacteria reduction.

Comparative evaluation of antibacterial property and substantivity of chlorhexidine containing dentifrices with sodium lauryl sulfate and Tween as surfactants: an in vivo study.

PubMed

Venu, V; Prabhakar, A R; Basappa, N

2013-01-01

The aim of the study was to determine the antibacterial property and substantivity of chlorhexidine containing dentifrices with sodium lauryl sulfate (SLS) and Tween as surfactants. It is a double-blind cross over the study, a total of 20 children within their mixed dentition period (7-13 year) having Streptococci mutans count more than 10(6) were selected for the main study. Three types of chlorhexidine containing dentifrices were used with a washout period of 1 week. Out of the three toothpastes, one was without surfactant and other two toothpastes contained SLS and Tween as surfactants respectively. 20 volunteers brushed for 1 min during the study day with their assigned toothpaste. Saliva samples were collected before brushing, immediately after brushing and 1, 3, 5, and 7 hand sent for microbial analysis. The culture carried out by inoculating saliva sample onto Mitis salivarius agar for selective isolation of S. mutans followed by counting of colony forming unit. Group I and III (Chlorhexidine and CHX + Tween) had shown statistically significant reduction in bacterial count until 7 h when compared to their baseline values ( P < 0.001). Group II toothpaste (CHX + SLS) had shown significant reduction in bacterial count until 3 h only. On inter group comparison, Group III had shown good amount of percentage reduction in bacterial count when compared to other groups. CHX + Tween toothpaste had shown statistically significant reduction in antibacterial activity and substantivity than other groups. These findings show chlorhexidine containing toothpaste with non-ionic surfactant will be able to maintain the antibacterial property and substantivity of chlorhexidine.

Chlorhexidine-loaded hydroxyapatite microspheres as an antimicrobial delivery system and its effect on in vivo osteo-conductive properties.

PubMed

Soriano-Souza, Carlos Alberto; Rossi, Andre L; Mavropoulos, Elena; Hausen, Moema A; Tanaka, Marcelo N; Calasans-Maia, Mônica D; Granjeiro, Jose M; Rocha-Leão, Maria Helena M; Rossi, Alexandre M

2015-04-01

Hydroxyapatite (HA) has been investigated as a delivery system for antimicrobial and antibacterial agents to simultaneously stimulate bone regeneration and prevent infection. Despite evidence supporting the bactericidal efficiency of these HA carriers, few studies have focused on the effect of this association on bone regeneration. In this work, we evaluated the physico-chemical properties of hydroxyapatite microspheres loaded with chlorhexidine (CHX) at two different concentrations, 0.9 and 9.1 μgCHX/cm2 HA, and characterized their effects on in vitro osteoblast viability and bone regeneration. Ultraviolet-visible spectroscopy, scanning and transmission electron microscopy associated with energy-dispersive X-ray spectroscopy and electron energy loss spectroscopy were used to characterize the association of CHX and HA nanoparticles. The high CHX loading dose induced formation of organic CHX plate-like aggregates on the HA surface, whereas a Langmuir film was formed at the low CHX surface concentration. Quantitative evaluation of murine osteoblast viability parameters, including adhesion, mitochondrial activity and membrane integrity of cells exposed to HA/CHX extracts, revealed a cytotoxic effect for both loading concentrations. Histomorphological analysis upon implantation into the dorsal connective tissues and calvaria of rats for 7 and 42 days showed that the high CHX concentration induced the infiltration of inflammatory cells, resulting in retarded bone growth. Despite a strong decrease in in vitro cell viability, the low CHX loading dose did not impair the biocompatibility and osteoconductivity of HA during bone repair. These results indicate that high antimicrobial doses may activate a strong local inflammatory response and disrupt the long-term osteoconductive properties of CHX-HA delivery systems.

Effect of 2% chlorhexidine digluconate on bond strength of a glass-fibre post to root dentine.

PubMed

Wang, L; Pinto, T A; Silva, L M; Araújo, D F G; Martins, L M; Hannas, A R; Pedreira, A P R V; Francisconi, P A S; Honório, H M

2013-09-01

To assess the immediate influence of dentine bonding systems (DBS) associated with 2% chlorhexidine digluconate (CHX) on glass-fibre post-bond strength to root dentine, in terms of coronal, middle and apical thirds. Sixty bovine roots were root filled and randomly assigned to 1 of 6 groups (n = 10): SBMP (3-step etch-and-rinse system, Scotchbond Multi-Purpose), SB (2-step etch-and-rinse system, Single Bond 2), SE (2-step self-etching system, Clearfil SE Bond) and SBMP-CHX, SB-CHX and SE-CHX, respectively, associated with CHX. For all groups, a glass-fibre post was luted with a dual-cure resin cement, RelyX ARC. After 7-day storage, specimens were subjected to the push-out test. Failure modes were analysed under optical microscopy (40x). Bond strength values were statistically analysed by two-way anova and Bonferroni tests (P < 0.05). The effect of DBS was significant (P < 0.05), and SE reached higher bond strength in comparison with the other DBS tested. CHX association did not show improvement with any DBS (P > 0.05); rather, it negatively affected SE, which was detected for all thirds. There was no difference between thirds (P > 0.05), except for the SE-CHX, which presented lower values for the apical third (P < 0.05). Adhesive cement/dentine adhesive failure was predominant for all groups. CHX did not influence the failure mode for any DBS (P > 0.05). The performance of the dentine bonding systems was material dependent. CHX did not improve immediate bond strength; however, CHX negatively affected the bond strength of the self-etching system, especially in the third apical. © 2013 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Comparison of the efficacy of chlorhexidine varnish and chip in the treatment of chronic periodontitis

PubMed Central

Jagadish Pai, B. S.; Rajan, Smitha Anitha; Srinivas, M.; Padma, R.; Suragimath, Girish; Walvekar, Amit; Goel, Saakshi; Kamath, Vinesh

2013-01-01

Background: The purpose of this study was to clinically evaluate the benefits of sub gingival chlorhexidine (CHX) varnish and biodegradable CHX chip application used as an adjunct to scaling and root planning (SRP) as combined therapy and also to compare the effect of combined therapy with SRP alone. Materials and Methods: Fifteen patients with at least three sites with a probing pocket depth (PPD) of 5-8 mm were considered. Following baseline evaluation, all three sites were subjected for SRP. After completing SRP, each site was randomly subjected for CHX varnish, CHX chip application and the 3rd site was left without any medication as a control. Clinical parameters such as sulcus bleeding index, plaque index, bleeding on probing (BOP), PPD, and clinical attachment level (CAL) were recorded at baseline, 1 month and 3 months post-operatively. Results: All three groups presented with an improvement in clinical parameters compared to baseline. The mean reduction in PPD was 2.4 mm in SRP sites, 2.5 mm in SRP + CHX varnish sites and 2.8 mm in SRP + CHX chip sites. The mean gain in CAL was 2.4 mm in SRP sites, 2.3 mm in SRP + CHX varnish sites and 2.8 mm SRP + CHX chip sites. Interpretation and Conclusion: The present study indicated that application of CHX varnish and placement of CHX chip as an adjunct to SRP produced a clinically significant reduction in the PPD, BOP and a gain in CAL at 30th day and 90th day from baseline when compared to SRP alone. The results though were not statistically significant. PMID:24015002

Comparative Evaluation of the Efficacy of Probiotic, Herbal and Chlorhexidine Mouthwash on Gingival Health: A Randomized Clinical Trial

PubMed Central

Dodamani, Arun Suresh; Karibasappa, Gundabaktha; Khairnar, Mahesh Ravindra; Naik, Rahul Gaybarao; Jadhav, Harish Chaitram

2017-01-01

Introduction Due to inherent limitations of Chlorhexidine (CHX), search for an effective and potentially safe anti-plaque agent has led to emergence of alternative products. Aim The present study evaluated the comparative efficacy of probiotic, herbal and CHX mouthwashes on gingival health of healthy individuals. Materials and Methods The present study was randomized parallel group controlled trial. A group of 45 healthy subjects in the age group of 18-21 years received complete supragingival scaling at baseline and study variables viz., Oral Hygiene Index – Simplified (OHI-S), Plaque Index (PI) and Gingival Index (GI) were recorded. Subjects were then randomly divided into three groups (15 in each group) and were randomly intervened with three different mouthwashes i.e., HiOra mouthwash, CHX mouthwash and Probiotic mouthwash. Variables were again recorded on the seventh and 14th day after use of mouthwashes and data obtained was subjected to statistical analysis. Results There was no significant difference in the efficacy of CHX, HiOra regular and probiotic mouthwashes on plaque accumulation, gingival health and oral hygiene status. Conclusion Herbal and probiotic mouthwashes can prove to be effective alternatives to CHX with minimal side effects. PMID:28511500

Assessment of cytogenetic and cytotoxic effects of chlorhexidine digluconate on cultured human lymphocytes.

PubMed

Arabaci, Taner; Türkez, Hasan; Çanakçi, Cenk Fatih; Özgöz, Mehmet

2013-09-01

The aim of this study was to assess the genetic and cellular toxicity of Chlorhexidine digluconate (CHX) on peripheral human lymphocytes in vitro. Micronucleus assay was used to investigate the genotoxicity, while the cell viability and proliferation were evaluated by Trypan blue exclusion test and Nuclear Division Index in control and CHX-treated (0.05, 0.1, 0.2, 0.4, 0.5 mg/ml) human blood cultures. A dose-dependent toxic effect was found depending on CHX incubation on the genetic and cell viability of the lymphocytes. Micronucleus frequency was found to be statistically higher at 0.5 mg/ml concentration compared to lower doses and the control group (p < 0.05). A significant reduction was shown in the cell viability and cell proliferation of the exposed lymphocytes at the concentrations of 0.4 and 0.5 mg/ml (p < 0.05), while no significant toxicity was found at lower concentrations compared to control (p > 0.05). This study showed dose-dependent genotoxic and cytotoxic effects of CHX on human lymphocytes in vitro. It should be considered during periodontal irrigation or novel CHX products at lower concentrations should be manufactured for clinical usage.

Electrochemical monitoring of chlorhexidine digluconate effect on polyelectrolyte immobilized bacteria and kinetic cell adhesion.

PubMed

Borghol, N; Mora, L; Sakly, N; Lejeune, P; Jouenne, T; Jaffrézic-Renault, N; Othmane, A

2011-01-10

The electrochemical impedance spectroscopy (EIS) technique has been used as a sensitive method to explore the effect of antibacterial molecules on immobilized bacteria and biofilm formation. In this work, we describe the electrochemical spectroscopy as a powerful method to monitor the effect of chlorhexidine digluconate (CHX-Dg) on polyelectrolyte immobilized Escherichia coli K12 MG1655 and the kinetics of cell adhesion on gold electrodes. The experimental impedance data were modeled with a Zview program to find the best equivalent electrical circuit and analyse its parameter's properties. Polyelectrolyte multilayer formation on the electrode surface and bacteria immobilization greatly increased the electron-transfer resistance (R(et)) and reduced the constant phase element (CPE(dl)). The effect of CHX-Dg was studied in a 0.5 x 10⁻⁴ mmol l⁻¹ to 0.5 mmol l⁻¹ range. The relation between the evolution of R(et) and CHX-Dg concentration was found to be negatively correlated. When CHX-Dg was added, the electrochemical monitoring of the bacterial kinetic adhesion showed that the electrode's capacity (C(P)) variation remained stable, demonstrating that the addition of CHX-Dg in the broth inhibited bacterial adhesion. © 2010 Elsevier B.V. All rights reserved.

Characterization of Chlorhexidine-Loaded Calcium-Hydroxide Microparticles as a Potential Dental Pulp-Capping Material.

PubMed

Priyadarshini, Balasankar M; Selvan, Subramanian T; Narayanan, Karthikeyan; Fawzy, Amr S

2017-06-22

This study explores the delivery of novel calcium hydroxide [Ca(OH)₂] microparticles loaded with chlorhexidine (CHX) for potential dental therapeutic and preventive applications. Herein, we introduce a new approach for drug-delivery to deep dentin-surfaces in the form of drug-loaded microparticles. Unloaded Ca(OH)₂ [Ca(OH)₂/Blank] and CHX-loaded/Ca(OH)₂ microparticles were fabricated by aqueous chemical-precipitation technique. The synthesized-microparticles were characterized in vitro for determination of surface-morphology, crystalline-features and thermal-properties examined by energy-dispersive X-ray scanning and transmission electron-microscopy (EDX-SEM/TEM), Fourier-transform infrared-spectroscopy (FTIR), X-ray diffraction (XRD), thermogravimetric analysis (TGA) and differential scanning-calorimetry (DSC). Time-related pH changes, initial antibacterial/biofilm-abilities and cytotoxicity of CHX-loaded/Ca(OH)₂ microparticles were evaluated. Microparticles were delivered to dentin-surfaces with subsequent SEM examination of treated dentin-substrates. The in vitro and ex vivo CHX-release profiles were characterized. Ca(OH)₂/Blank were hexagonal-shaped with highest z -average diameter whereas CHX-inclusion evidenced micro-metric spheres with distinguishable surface "rounded deposits" and a negative-shift in diameter. CHX:Ca(OH)₂/50 mg exhibited maximum encapsulation-efficiency with good antibacterial and cytocompatible properties. SEM examination revealed an intact layer of microparticles on exposed dentin-surfaces with retention of spherical shape and smooth texture. Microparticles loaded on dentin-surfaces showed prolonged release of CHX indicating substantial retention on dentin-substrates. This study validated the inherent-applicability of this novel drug-delivery approach to dentin-surfaces using micro-metric CHX-loaded/Ca(OH)₂ microparticles.

Effect of Different Concentrations of Chlorhexidine in Glass-ionomer Cements on In Vivo Biocompatibility.

PubMed

Lacerda-Santos, Rogério; Sampaio, Gêisa Aiane de Morais; Moura, Mirella de Fátima Liberato; Carvalho, Fabiola Galbiatti de; Santos, Antonielson Dos; Pithon, Matheus Melo; Alves, Polliana Muniz

To examine whether a difference exists between the in vivo biocompatibility of glass-ionomer cements (GICs) containing chlorhexidine (CHX) in different concentrations. Eighty-four male Wistar rats were distributed into 7 groups (n = 12) and received subcutaneous implants of small tubes containing different materials, as follows: Ketac control (K), Ketac-CHX 10% (K10), Ketac-CHX 18% (K18), Resilience control (R), Resilience-CHX 10% (R10), Resilience-CHX 18% (R18), Control (polyethylene). The animals were then sacrificed on post-insertion days 7, 15 and 30, and tissues were examined under an optical microscope for inflammatory infiltrate, edema, necrosis, granulation tissue, multinucleated giant cells, and collagen fibers. The results were statistically analyzed using Kruskal-Wallis and Dunn's tests (p < 0.05). Groups K18 and R18 showed larger areas of intense inflammatory infiltrate, with significant differences between group C and groups K18 and R18 (p = 0.007) at 7 days, and between groups C and K18 (p = 0.017) at 15 days. In terms of tissue repair, groups K18 and R18 demonstrated a lower quantity of collagen fibers with significant differences from group C (p = 0.019) at 7 days, and between group K18 and group C (p = 0.021) at 15 days. The 18% concentration of CHX was shown to have a toxic effect. The 10% concentration of CHX was shown to be suitable for tissue contact. The addition of CHX to the glass-ionomer cements is a highly promising method for obtaining of an antibacterial GIC for use in clinical practice.

Mechanical properties and modeling of drug release from chlorhexidine-containing etch-and-rinse adhesives.

PubMed

Stanislawczuk, Rodrigo; Reis, Alessandra; Malaquias, Pamela; Pereira, Fabiane; Farago, Paulo Vitor; Meier, Marcia Margarete; Loguercio, Alessandro D

2014-04-01

To evaluate the effects of chlorhexidine (CHX) addition in different concentrations into simplified etch-and-rinse adhesives on the ultimate tensile strength (UTS), water sorption (WS), solubility (SO) and the rate of CHX release over time. We added CHX diacetate to Ambar [AM] (FGM) and XP Bond [XP] (Dentsply) in concentrations of 0, 0.01, 0.05, 0.1 and 0.2 wt%. For UTS (n=10 for each group), adhesive specimens were constructed in an hourglass shape metallic matrix with cross-sectional area of 0.8 mm(2). Half of specimens were tested after 24 h and the other half after 28 days of water storage in tension of 0.5 mm/min. For WS and SO (n=10 for each group), adhesive discs (5.8 mm×1.0 mm) were prepared into a mold. After desiccation, we weighed and stored the cured adhesive specimens in distilled water for evaluation of the WS, SO and the cumulative release of CHX over a 28-day period. For CHX release (n=10 for each group), spectrophotometric measurements of storage solution were performed to examine the release kinetics of CHX. We subjected data from each test to ANOVA and Tukey' test (α=0.05). XP Bond adhesive showed significantly more WS and SO and lower UTS than Ambar. In general, the addition of CHX did not alter WS, SO and UTS of the adhesives. XP showed a higher CHX release than AM (p<0.05) in all concentrations and the final amount of CHX release was directly proportional to the initial CHX concentration added to the adhesives. After 28 days of water storage, approximately 20% of CHX was released from XP and 8.0-12.0% from AM. Addition of CHX to commercial adhesive is a feasible method to provide a controlled release of CHX over time without jeopardizing WS, SO and UTS of the adhesives. Manufacturers should consider adding CHX to commercial adhesives to provide a controlled release of CHX over time. Copyright © 2014 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

Effects of EDTA gel preconditioning of periodontally affected human root surfaces on chlorhexidine substantivity - an SEM study.

PubMed

Gamal, Ahmed Y; Mailhot, Jason M

2007-09-01

Infection control is an important requirement during the early stages of periodontal healing. This study was performed to assess the preconditioning effect of EDTA gel on chlorhexidine (CHX) substantivity to periodontally involved root surfaces. Eighty patients with severe chronic periodontitis were enrolled in this study. Following cause-related therapy, patients were divided randomly into four groups. Each group consisted of 20 subjects with one tooth that was diagnosed as hopeless and designated for extraction. In group 1 (G1), selected periodontal pockets were filled with a placebo gel in a silica base for 2 minutes. Exposed roots in group 2 (G2) were etched for 2 minutes with a neutral EDTA conditioning agent, followed by pocket fill with the placebo gel. Pockets in group 3 (G3) were filled with 0.12% CHX digluconate gel in a silica base. Exposed roots in group 4 (G4) were etched for 2 minutes with a neutral EDTA conditioning agent, followed by pocket fill with the CHX gel. Four teeth from each group were extracted immediately and at 3, 12, 24, and 48 hours for SEM evaluation. G1 and G2 specimens showed no evidence of silica adherent to any of the examined root surfaces. At 3 hours following CHX gel application, G3 specimens showed marked reduction in CHX-coated silica. At 24 and 48 hours following EDTA and CHX gel application, G4 specimens demonstrated adherent CHX-coated silica particles despite the reclogging of the tubule orifices. EDTA and CHX gel root conditioning is a valuable regimen that improves CHX substantivity to periodontally involved root surfaces.

Effects of mouthrinses with chlorhexidine and zinc ions combined with fluoride on the viability and glycolytic activity of dental plaque.

PubMed

Giertsen, E; Scheie, A A

1995-10-01

Inhibition of plaque acidogenicity by a mouthrinse with chlorhexidine (CHX) or zinc ions has been ascribed to a prolonged bacteriostasis due to substantive properties of the agents. The present aim was to study the effects of mouthrinses with CHX and Zn ions combined with fluoride on the viability and glycolytic activity of dental plaque in order to assess the bacteriostatic versus possible bactericidal effects. Following 2 d of plaque accumulation, 4 groups of 10 students rinsed with either 12 mM NaF (F), 0.55 mM CHX diacetate+F (F-CHX), 10 mM Zn acetate+F (F-Zn), or with the three agents in combination (F-CHX-Zn). Plaque samples were collected before and 90 min after mouthrinsing. Thereafter, the in vivo plaque pH response to sucrose was monitored in each student using touch microelectrodes. F-CHX and F-CHX-Zn reduced the in vivo pH fall significantly as compared with F, whereas F-Zn exerted a non-significant inhibition. Pooled pre- and post-rinse plaque samples were used to measure the pH fall during fermentation of [14C]-glucose, and the glycolytic profiles were analyzed by HPLC. Bacterial viability was assessed by counting the colony-forming units (CFU). All mouthrinses except F reduced glucose consumption and acid formation and thus the pH fall. F-CHX reduced the CFU equal to the reduction of glucose consumption, indicating that inhibition of plaque acidogenicity was due to a bactericidal rather than a bacteriostatic effect. F and F-Zn did not reduce the CFU, thus F-Zn decreased glucose metabolism without affecting plaque viability. F-CHX-Zn reduced both the CFU and glucose metabolism of surviving plaque microorganisms.

The properties of chlorhexidine and undesired effects of its use in endodontics.

PubMed

Bernardi, Anarela; Teixeira, Cleonice Silveira

2015-01-01

The purpose of this article was to review the literature on the properties of chlorhexidine (CHX) and the adverse effects that may occur from its use in endodontics. In addition, adverse effects that may result from its use, such as dark staining of teeth, chemical interaction with sodium hypochlorite and formed flocculate, biologic hazards, and interactions with the filling material were evaluated. Relevant publications on the use CHX in endodontics were thoroughly reviewed from the literature published between the years 2007 and 2014. The authors conducted an electronic search using the English language databases Medline and PubMed. According to the reviewed studies, it was concluded that CHX has proven antimicrobial activity, excellent substantivity, low surface tension, and low cytotoxicity and genotoxicity that depend on the dose and exposed area. There is scientific evidence showing the possibility of tooth staining and formation of brown precipitate when its use is associated with sodium hypochlorite. On the other hand, it is not well established that its use interferes with the quality of endodontic fillings. With respect to the biologic risks, the degradation of CHX may generate para-chloroaniline and free radicals, which are harmful to the vital tissues. There is no established consensus on the potential risk of CHX. The final considerations of this review will encourage researchers to seek scientific evidence demonstrating the safety of the use and applicability of CHX in endodontic therapy.

Chlorhexidine-induced apoptosis or necrosis in L929 fibroblasts: A role for endoplasmic reticulum stress

DOE Office of Scientific and Technical Information (OSTI.GOV)

Faria, Gisele; Cardoso, Cristina R.B.; Department of Biological Sciences, Federal University of Triangulo Mineiro, Uberaba, Minas Gerais

Chlorhexidine (CHX), widely used as antiseptic and therapeutic agent in medicine and dentistry, has a toxic effect both in vivo and in vitro. The intrinsic mechanism underlying CHX-induced cytotoxicity in eukaryotic cells is, however, still unknown. A recent study from our laboratory has suggested that CHX may induce death in cultured L929 fibroblasts via endoplasmic reticulum (ER) stress. This hypothesis was further tested by means of light and electron microscopy, quantification of apoptosis and necrosis by flow cytometry, fluorescence visualization of the cytoskeleton and endoplasmic reticulum, and evaluation of the expression of 78-kDa glucose-regulated protein 78 (Grp78), a marker ofmore » activation of the unfolded protein response (UPR) in cultured L929 fibroblasts. Our finding showing increased Grp 78 expression in CHX-treated cells and the results of flow cytometry, cytoskeleton and endoplasmic reticulum fluorescence visualization, and scanning and transmission electron microscopy allowed us to suggest that CHX elicits accumulation of proteins in the endoplasmic reticulum, which causes ER overload, resulting in ER stress and cell death either by necrosis or apoptosis. It must be pointed out, however, that this does not necessarily mean that ER stress is the only way that CHX kills L929 fibroblasts, but rather that ER stress is an important target or indicator of cell death induced by this drug.« less

Chlorhexidine markedly potentiates the oxidants scavenging abilities of Candida albicans.

PubMed

Ginsburg, I; Koren, E; Feuerstein, O; Zogakis, I P; Shalish, M; Gorelik, S

2015-10-01

The oxidant scavenging ability (OSA) of catalase-rich Candida albicans is markedly enhanced by chlorhexidine digluconate (CHX), polymyxin B, the bile salt ursodeoxycholate and by lysophosphatidylcholine, which all act as detergents facilitating the penetration of oxidants and their intracellular decomposition. Quantifications of the OSA of Candida albicans were measured by a highly sensitive luminol-dependent chemiluminescence assay and by the Thurman's assay, to quantify hydrogen peroxide (H2O2). The OSA enhancing activity by CHX depends to some extent on the media on which candida grew. The OSA of candida treated by CHX was modulated by whole human saliva, red blood cells, lysozyme, cationic peptides and by polyphenols. Concentrations of CHX, which killed over 95 % of Candida albicans cells, did not affect the cells' abilities to scavenge reactive oxygen species (ROS). The OSA of Candida cells treated by CHX is highly refractory to H2O2 (50 mM) but is strongly inhibited by hypochlorous acid, lecithin, trypan blue and by heparin. We speculate that similarly to catalase-rich red blood cells, Candida albicans and additional catalase-rich microbiota may also have the ability to scavenge oxidants and thus can protect catalase-negative anaerobes and facultative anaerobes cariogenic streptococci against peroxide and thus secure their survival in the oral cavity.

Antimicrobial Activity of a Novel Vascular Access Film Dressing Containing Chlorhexidine Gluconate

PubMed Central

Wibaux, Anne; Thota, Priyaleela; Mastej, Jozef; Prince, Daniel L.; Carty, Neal; Johnson, Peter

2015-01-01

Background Covering insertion sites with chlorhexidine impregnated dressings has been proven to be clinically effective in reducing catheter related blood stream infections (CR-BSI). Two chlorhexidine gluconate (CHG)-impregnated dressings are commercially available, a polyurethane foam disk and a film dressing containing a chlorhexidine gluconate-impregnated gel pad. While both have demonstrated efficacy in clinical settings, the major drawback of high cost and impaired IV insertion site visibility limits their usage. A new, simple film dressing containing CHG within its adhesive layer is now available. The objective of this study was to test the in vitro antimicrobial efficacy of the new dressing in comparison to the CHG-impregnated gel dressing. Methods Quantitative aliquots of suspensions (concentration of 1.0x106 to 5.0x106 cfu/sample) of clinically relevant challenge organisms (Staphylococcus species, gram-negative bacilli, Candida albicans) were incubated in contact with the new CHG-containing film dressing, a placebo version of the same (negative control) and the commercially available CHG-impregnated gel dressing (positive control). Serial dilutions of the surviving organisms were quantified using the pour plate after 1, 3, 5, and 7 days of incubation in order to calculate an antimicrobial log10 reduction for each organism/dressing combination at each point in time. Results The new CHG-containing film dressing delivered greater than 5.0 log10 reduction throughout the 7 days on all aerobic gram-negative bacilli and Staphylococcus species tested. As of day 1 the CHG-containing film dressing provided greater than 5.0 log10 reduction on Candida albicans. There were no statistically significant differences in the log10 reduction between the two dressings tested. Conclusion The new CHG-containing film dressing was found to be as effective as the chlorhexidine gluconate-impregnated gel dressing on clinically relevant microbes. PMID:26599087

Characterization of Chlorhexidine-Loaded Calcium-Hydroxide Microparticles as a Potential Dental Pulp-Capping Material

PubMed Central

Priyadarshini, Balasankar M.; Selvan, Subramanian T.; Narayanan, Karthikeyan; Fawzy, Amr S.

2017-01-01

This study explores the delivery of novel calcium hydroxide [Ca(OH)2] microparticles loaded with chlorhexidine (CHX) for potential dental therapeutic and preventive applications. Herein, we introduce a new approach for drug-delivery to deep dentin-surfaces in the form of drug-loaded microparticles. Unloaded Ca(OH)2 [Ca(OH)2/Blank] and CHX-loaded/Ca(OH)2 microparticles were fabricated by aqueous chemical-precipitation technique. The synthesized-microparticles were characterized in vitro for determination of surface-morphology, crystalline-features and thermal-properties examined by energy-dispersive X-ray scanning and transmission electron-microscopy (EDX-SEM/TEM), Fourier-transform infrared-spectroscopy (FTIR), X-ray diffraction (XRD), thermogravimetric analysis (TGA) and differential scanning-calorimetry (DSC). Time-related pH changes, initial antibacterial/biofilm-abilities and cytotoxicity of CHX-loaded/Ca(OH)2 microparticles were evaluated. Microparticles were delivered to dentin-surfaces with subsequent SEM examination of treated dentin-substrates. The in vitro and ex vivo CHX-release profiles were characterized. Ca(OH)2/Blank were hexagonal-shaped with highest z-average diameter whereas CHX-inclusion evidenced micro-metric spheres with distinguishable surface “rounded deposits” and a negative-shift in diameter. CHX:Ca(OH)2/50 mg exhibited maximum encapsulation-efficiency with good antibacterial and cytocompatible properties. SEM examination revealed an intact layer of microparticles on exposed dentin-surfaces with retention of spherical shape and smooth texture. Microparticles loaded on dentin-surfaces showed prolonged release of CHX indicating substantial retention on dentin-substrates. This study validated the inherent-applicability of this novel drug-delivery approach to dentin-surfaces using micro-metric CHX-loaded/Ca(OH)2 microparticles. PMID:28952538

Prospective, randomised, controlled study evaluating early modification of oral microbiota following admission to the intensive care unit and oral hygiene with chlorhexidine.

PubMed

Tuon, Felipe Francisco; Gavrilko, Oleg; Almeida, Saulo de; Sumi, Eigi Ricardo; Alberto, Thiago; Rocha, Jaime Luis; Rosa, Edvaldo Antonio

2017-03-01

Chlorhexidine (CHX) is the most commonly used oral hygiene product for the prevention of ventilator-associated pneumonia (VAP) in patients undergoing mechanical ventilation (MV). The change in dental plaque (DP) microbiota following CHX use in patients under MV has not been described previously. The aim of this study was to evaluate the incidence of pathogenic bacteria associated with VAP and the coverage of DP within the oral cavity in patients administered CHX. This was a prospective, randomised, controlled, double-blind study in patients (n=16) under MV who were mouth-rinsed with either CHX or placebo. Microbiology samples were collected from the oral mucosa (OM) and DP after admission to the ICU and on Days 3, 5, 7 and 10. Minimum inhibitory concentrations (MICs) and minimum bactericidal concentrations (MBCs) of CHX were determined. Upon admission, the occurrence of multidrug-resistant (MDR) bacteria, including carbapenem-resistant Klebsiella pneumoniae, was reported. The CHX group had a lower incidence of methicillin-resistant Staphylococcus aureus (MRSA) compared with the placebo group for the OM (RR=0.51, 95% CI 0.27-0.98; P=0.011). There was high agreement between the culture results of OM and DP (κ=0.825). VAP developed in six patients. The species identified following tracheal aspiration of VAP patients were similar to those found in the OM for four cases. The strains showed low MICs and MBCs for CHX (<0.039mg/mL). Although DP is rapidly colonised by MDR bacteria, use of 2% CHX reduced the incidence of S. aureus colonisation. Copyright © 2017 International Society for Chemotherapy of Infection and Cancer. Published by Elsevier Ltd. All rights reserved.

Effects of curcumin on crevicular levels of IL-1β and CCL28 in experimental gingivitis.

PubMed

Pulikkotil, S J; Nath, S

2015-09-01

Curcumin has anti-inflammatory properties. The aim of this study was to compare interleukin-1β (IL-1β) and chemokine (C-C motif) ligand 28 (CCL28) levels following a topical application of curcumin (CRM), chlorhexidine (CHX) and chlorhexidine-metronidazole (CHX-MTZ) in an experimental gingivitis human model. Sixty systemically healthy selected subjects were randomly assigned to one of three topical antigingivitis gels. Each gel was applied twice daily for 10 minutes as the sole method of oral hygiene for 29 days on the test quadrant only. Modified gingival index (MGI), plaque index (PI), bleeding on probing (BOP) and probing depth (PD) were assessed at baseline, 29 days and 60 days. Estimation of IL-1β and CCL28 levels in gingival crevicular fluid was done at baseline and at 29 days. The increase of IL-1β in the CRM (14.52 ± 16.6 pg/ml) and CHX-MTZ (31.63 ± 15.96) groups was significantly less than that of the CHX group (70.55 ± 38.81). Similar results were also observed for CCL28 (CRM: 8.12 ± 8.78 pg/ml; CHX-MTZ: 12.81 ± 18.68; CHX: 41.15 ± 22.82). All groups had a significant increase in MGI, PI and BOP at 29 days. The anti-inflammatory potential of topical curcumin was similar to CHX-MTZ but superior to CHX in affecting IL-1β and CCL28 levels. © 2015 Australian Dental Association.

Influence of 2% chlorhexidine digluconate on bond strength of a glass-fibre post luted with resin or glass-ionomer based cement.

PubMed

de Araújo, Diana Ferreira Gadelha; Chaves, Larissa Pinceli; Bim, Odair; Pimentel Garcia, Fernanda Cristina; Ishikiriama, Sérgio Kiyoshi; Honório, Heitor Marques; Wang, Linda

2014-06-01

This study evaluated the influence of 2% chlorhexidine digluconate (CHX) on the bond strength (BS) of a glass-fibre post to the root canal, regarding the cements (dual-cured resin or resin-modified glass-ionomer cement), the root thirds and the time of storage. Eighty bovine roots were selected and endodontically treated, before being randomly assigned to the following groups according to the luting protocol: ARC (RelyX ARC); ARC+CHX; RL (RelyX Luting 2); and RL+CHX. After 24 h of luting, the roots were sliced to obtain 1 mm-thick slices. Half of each group was submitted to either 7-day or 6-month storage in artificial saliva (n=10). The specimens were subjected to push-out tests with a crosshead speed of 0.5 mm/min. The data were analysed with four-way ANOVA and Tukey's test (P≤0.05). The failure modes were analysed with a digital microscope (50× and 200×). ARC yielded a significantly higher BS compared to RL (P<0.001). Despite CHX exerted a significant effect; it depends on the interaction with the luting cement and time (P<0.001). Thus, CHX decreased the values of BS to those of ARC after 6 months (P<0.001). On the 7th day of storage, the ARC+CHX presented higher BS to the cervical and middle thirds compared to RL+CHX (P=0.012). Time solely was not a significant factor (P=0.081). Adhesive cement-dentine type and mixed failures were predominant modes for the ARC groups. For the RL groups, the main failures were adhesive cement-post and mixed modes. Glass-fibre posts luted with RelyX ARC dual-cure resin cement exhibited higher BS than those luted with RelyX Luting 2 resin-modified glass-ionomer cement. Furthermore, CHX was not effective to improve the BS and negatively affected the BS of RelyX ARC after 6 months of storage. The use of chlorhexidine solution seems not to improve the bond strength of fibre posts to root canals, disregarding the composition of the luting cement. Copyright © 2014 Elsevier Ltd. All rights reserved.

Cutaneous antimicrobial preparation prior to intravenous catheterization in healthy dogs: clinical, microbiological, and histopathological evaluation.

PubMed

Coolman, B R; Marretta, S M; Kakoma, I; Wallig, M A; Coolman, S L; Paul, A J

1998-12-01

The purpose of this study was to determine the effects of a one-minute chlorhexidine gluconate skin preparation protocol prior to cephalic vein catheterization. Twenty-three healthy beagle dogs had one leg aseptically prepared and the opposite leg served as a control. Twenty-six- and 77-hour time groups were studied. Chlorhexidine-treated legs had significantly lower cutaneous bacterial counts than the control legs prior to catheter insertion and prior to catheter withdrawal for both time groups. Control legs developed significantly more dermatitis than the treated legs after 77 h. A one-minute preparation with 4% chlorhexidine gluconate was an effective method for sustained reduction of cutaneous bacterial counts at peripheral intravenous catheter insertion points in dogs. Increased cutaneous bacterial counts were associated with significantly more microscopic dermatitis in untreated legs after 77 h of catheterization.

Evaluation of penetration depth of 2% chlorhexidine digluconate into root dentinal tubules using confocal laser scanning microscope.

PubMed

Vadhana, Sekar; Latha, Jothi; Velmurugan, Natanasabapathy

2015-05-01

This study evaluated the penetration depth of 2% chlorhexidine digluconate (CHX) into root dentinal tubules and the influence of passive ultrasonic irrigation (PUI) using a confocal laser scanning microscope (CLSM). Twenty freshly extracted anterior teeth were decoronated and instrumented using Mtwo rotary files up to size 40, 4% taper. The samples were randomly divided into two groups (n = 10), that is, conventional syringe irrigation (CSI) and PUI. CHX was mixed with Rhodamine B dye and was used as the final irrigant. The teeth were sectioned at coronal, middle and apical levels and viewed under CLSM to record the penetration depth of CHX. The data were statistically analyzed using Kruskal-Wallis and Mann-Whitney U tests. The mean penetration depths of 2% CHX in coronal, middle and apical thirds were 138 µm, 80 µm and 44 µm in CSI group, respectively, whereas the mean penetration depths were 209 µm, 138 µm and 72 µm respectively in PUI group. Statistically significant difference was present between CSI group and PUI group at all three levels (p < 0.01 for coronal third and p < 0.001 for middle and apical thirds). On intragroup analysis, both groups showed statistically significant difference among three levels (p < 0.001). Penetration depth of 2% CHX into root dentinal tubules is deeper in coronal third when compared to middle and apical third. PUI aided in deeper penetration of 2% CHX into dentinal tubules when compared to conventional syringe irrigation at all three levels.

A comparative, randomized, controlled study on clinical efficacy and dental staining reduction of a mouthwash containing Chlorhexidine 0.20% and Anti Discoloration System (ADS).

PubMed

Marrelli, Massimo; Amantea, Massimiliano; Tatullo, Marco

2015-01-01

A good control of bacterial plaque is an essential factor for the success of periodontal therapy, therefore it is the main objective that the clinician together with the patient must get to have a healthy periodontium. The plaque control with mouthwashes is the most important home therapy as it helps to reduce the formation of plaque between the mechanical removal with a toothbrush. Authors analyzed the clinical data from a trial carried out with 3 different mouthwashes containing 0.2% Chlorhexidine (CHX). In addition, the ADS (Anti Discoloration System - Curaden Healthcare) was tested in comparison with the other mouthwashes without this system. We tested antiplaque activity showed by 3 of the most commercialized mouthwashes, moreover, we tested the ability in reducing the dental staining related to the oral assumption of Chlorhexidine. Our results demonstrated the clinical efficacy of the 3 mouthwashes with CHX. Particularly performing was the anti discoloration system (Curaden Healthcare), with a clinical detection of dental stainings significantly less than the others tested. This study demonstrated the clinical efficacy of ADS system in the reduction of tooth staining, without a loss of antiplaque activity with respect to the competing mouthwashes containing CHX.

Effectiveness of a Chlorhexidine Digluconate 0.12% and Cetylpyridinium Chloride 0.05% Solution in eliminating Candida albicans Colonizing Dentures: A Randomized Clinical in vivo Study.

PubMed

Aoun, Georges; Cassia, Antoine; Berberi, Antoine

2015-06-01

Effective denture hygiene is important for patients suffering from denture stomatitis (DS). This study aimed to evaluate the efficacy of a solution containing 0.12% chlorhexidine (CHX) digluconate and 0.05% cetylpyridinium chloride (CPC) in eliminating Candida albicans colonizing dentures. Forty denture wearers (11 men, 29 women; age range 40 to 80 years) with clinical evidence of DS were randomly divided into two groups, one test and one control. The dentures of the test group were treated by immersion in a solution of 0.12% CHX and 0.05% CPC while those of the control group were immersed in distilled water. Swabs were collected from the fitting surfaces of the upper dentures prior and post cleaner use and examined mycologically. Reduction in the number of colony-forming units (CFU) of Candida albicans after immersion of the dentures in a solution of 0.12% CHX and 0.05% CPC was significantly greater than that of the control group. A solution of 0.12% CHX and 0.05% CPC tested as a product of disinfection of the acrylic dentures showed significant results after immersion of 8 night hours for 4 days.

Synthesis, characterization, and efficacy of antimicrobial chlorhexidine hexametaphosphate nanoparticles for applications in biomedical materials and consumer products

PubMed Central

Barbour, Michele E; Maddocks, Sarah E; Wood, Natalie J; Collins, Andrew M

2013-01-01

Chlorhexidine (CHX) is an antimicrobial agent that is efficacious against gram-negative and -positive bacteria and yeasts. Its mechanism of action is based on cell membrane disruption and, as such, it does not promote the development of bacterial resistance, which is associated with the widespread use of antibiotics. In this manuscript, we report the development of novel antimicrobial nanoparticles (NPs) based on a hexametaphosphate salt of CHX. These are synthesized by instantaneous reaction between equimolar aqueous solutions of CHX digluconate and sodium hexametaphosphate, under room temperature and pressure. The reaction results in a stable colloid composed of highly negatively charged NPs (−50 mV), of size 20–160 nm. The NPs adhere rapidly to specimens of glass, titanium, and an elastomeric wound dressing, in a dose-dependent manner. The functionalized materials exhibit a gradual leaching of soluble CHX over a period of at least 50 days. The NP colloid is efficacious against methicillin-resistant Staphylococcus aureus (MRSA) and Pseudomonas aeruginosa in both planktonic and biofilm conditions. These NPs may find application in a range of biomedical and consumer materials. PMID:24092973

Antimicrobial action of chlorhexidine digluconate in self-ligating and conventional metal brackets infected with Streptococcus mutans biofilm

PubMed Central

Dias, Ana Paula; Paschoal, Marco Aurélio Benini; Diniz, Rafael Soares; Lage, Lucas Meneses; Gonçalves, Letícia Machado

2018-01-01

Objectives The objectives of this study were to assess the adherence of Streptococcus mutans biofilms grown over conventional ligature (CL) or self-ligating (SL) metal brackets and their bacterial viability after 0.12% chlorhexidine (CHX) digluconate treatment. Materials and methods The sample consisted of 48 metallic orthodontic brackets divided randomly into two groups: CL (n=24) and SL brackets (n=24). S. mutans biofilms were grown over the bracket surface (96 h) and treated with CHX (positive control) or 0.9% phosphate-buffered saline (PBS) (negative control) for 1 min each. Quantitative analysis was assessed by colony-forming units, and fluorescence microscopy was performed aiming to illustrate the outcomes. The tests were done in triplicate at three different times (n=9). Data were analyzed using ANOVA and Tukey test (P<0.05). Results There were significant differences in brackets’ biofilm formation, being CL largely colonized compared with SL, which was observed by colony-forming unit counting (P<0.05) and microcopy images. Significant reduction in the viability of S. mutans was found in both brackets treated with CHX compared to PBS (P<0.05). Conclusion The antimicrobial activities of CHX were similar for CL and SL brackets (P>0.05). In conclusion, a lower colonization was achieved in SL brackets and S. mutans biofilms were susceptible to CHX treatment to both studied brackets. PMID:29719422

Antimicrobial action of chlorhexidine digluconate in self-ligating and conventional metal brackets infected with Streptococcus mutans biofilm.

PubMed

Dias, Ana Paula; Paschoal, Marco Aurélio Benini; Diniz, Rafael Soares; Lage, Lucas Meneses; Gonçalves, Letícia Machado

2018-01-01

The objectives of this study were to assess the adherence of Streptococcus mutans biofilms grown over conventional ligature (CL) or self-ligating (SL) metal brackets and their bacterial viability after 0.12% chlorhexidine (CHX) digluconate treatment. The sample consisted of 48 metallic orthodontic brackets divided randomly into two groups: CL (n=24) and SL brackets (n=24). S. mutans biofilms were grown over the bracket surface (96 h) and treated with CHX (positive control) or 0.9% phosphate-buffered saline (PBS) (negative control) for 1 min each. Quantitative analysis was assessed by colony-forming units, and fluorescence microscopy was performed aiming to illustrate the outcomes. The tests were done in triplicate at three different times (n=9). Data were analyzed using ANOVA and Tukey test ( P <0.05). There were significant differences in brackets' biofilm formation, being CL largely colonized compared with SL, which was observed by colony-forming unit counting ( P <0.05) and microcopy images. Significant reduction in the viability of S. mutans was found in both brackets treated with CHX compared to PBS ( P <0.05). The antimicrobial activities of CHX were similar for CL and SL brackets ( P >0.05). In conclusion, a lower colonization was achieved in SL brackets and S. mutans biofilms were susceptible to CHX treatment to both studied brackets.

Caries lesion remineralization with fluoride toothpastes and chlorhexidine - effects of application timing and toothpaste surfactant

PubMed Central

Almohefer, Sami A.; Levon, John A.; Gregory, Richard L.

2018-01-01

Abstract Habitual toothbrushing with fluoridated toothpaste followed by rinsing with antibacterial mouthwashes is a method to maintain good oral hygiene and to diminish the occurrence and severity of dental caries and periodontal disease. However, our understanding of how antimicrobial agents in mouthwashes affect fluoride-mediated caries lesion remineralization is still poor. Objective: The objectives of this in vitro study were a) to determine the effects of the waiting period of chlorhexidine (CHX) rinsing after fluoride toothpaste use and b) to further determine the effect of the type of toothpaste surfactant [sodium dodecyl sulfate (SDS) or cocamidopropyl betaine (CAPB)] on caries lesion remineralization associated with CHX rinsing. Material and Methods: Caries lesions were formed in bovine enamel specimens and assigned to 10 treatment groups (n=18) based on Vickers surface microhardness (VHN). Lesions were then pH-cycled for 10 days with daily regimen comprised of twice daily toothpaste slurry treatments (1150 ppm fluoride, with SDS or CAPB), followed by CHX solution treatments [0, 15, 30 or 60 minutes following slurry treatment or no CHX treatment (negative control)]. VHN was measured again and the extent of lesion remineralization calculated (∆VHN). Results: ∆VHN with SDS-toothpaste was significantly lower than with CAPB-toothpaste, indicating more remineralization for the CAPB-toothpaste. ∆VHN with 0-minute waiting time was significantly lower than with 30-minute waiting time and with negative control. Conclusions: The absence of CHX as an adjunct to fluoride toothpastes led to greater remineralization of enamel lesions compared with the immediate use of CHX treatment for both SDS- and CAPB-toothpastes. CAPB-toothpastes indicated significantly greater remineralization than SDS-toothpastes, and can be suggested for patients at high risk of caries. A 30-minute waiting time for CHX treatment is recommended after brushing.

Chlorhexidine diminishes the loss of bond strength over time under simulated pulpal pressure and thermo-mechanical stressing.

PubMed

Campos, Edson Alves; Correr, Gisele Maria; Leonardi, Denise Piotto; Barato-Filho, Flares; Gonzaga, Carla Castiglia; Zielak, João César

2009-02-01

The purpose of this study was to investigate the effects of chlorhexidine (CHX) digluconate at 0.2% and 2% on dentin bonding durability of etch-and-rinse and self-etch adhesive systems. In this study were used 24 extracted non-carious human third-molars. The occlusal surfaces of the molar crowns were removed with a low-speed diamond saw to expose flat dentin surfaces. The tested materials were Single-Bond (SB) (two-step etch-and-rinse adhesive) and Clearfil Tri S Bond (CTSB) (all-in-one self-etch adhesive) used in association or not with CHX at 0.2% and 2%. The bonding systems were applied according to manufacturer's instructions and followed by composite application (Z250). For each condition, half of the specimens was immediately submitted to microtensile test and half of them was submitted to long-term storage of 6 months under simulated pulpal pressure and thermo-mechanical stressing before testing. The data were analyzed using Two-Way ANOVA and Tukey post hoc test (alpha=0.05). Failure patterns of the specimens were observed using scanning electron microscopy. The falling % in bond strength over the 6-month period was: SB control-43.64%; SB/0.2%CHX-23.79%; SB/2%CHX-26.42%; CTSB control-40.94%; CTSB/0.2%CHX-37.07%; CTSB/2%CHX-22.14%. The fracture modes were predominantly adhesive, mainly in the specimens of terminal groups. CXH digluconate at 2% was able to diminish loss of microtensile bond strength over time associated to both etch-and-rinse and self-etch adhesives. Lower concentration of CHX (0.2%) was not able to diminish the loss of bond strength over time when associated to the self-etch adhesive CTSB.

Antimicrobial activity of short- and medium-term applications of polyhexamethylene biguanide, chlorhexidine digluconate and calcium hydroxide in infected immature bovine teeth in vitro.

PubMed

Zaugg, Lucia K; Zitzmann, Nicola U; Hauser-Gerspach, Irmgard; Waltimo, Tuomas; Weiger, Roland; Krastl, Gabriel

2014-08-01

To compare the antimicrobial activity of polyhexamethylene biguanide (Prontosan wound gel, Pr) and chlorhexidine digluconate (CHX) after short- and medium-term application with the disinfection ability of calcium hydroxide (Ca) in a model using immature bovine teeth. Sixty immature bovine roots were infected with Enterococcus faecalis and randomly assigned to six groups (n = 10). Disinfectants were applied into the root canal for 10 min (CHX-10 min and Pr-10 min) or 7 days (CHX-7d, Pr-7d and Ca-7d(g) ). In the negative control group (Co-n), no disinfectant was used. Dentine samples were collected, and the total count of bacteria and colony-forming units were determined. The log10 -transformed Colony-forming units (CFU) data were analysed using a Kruskal-Wallis test with post hoc Wilcoxon multiple-comparison tests. The application of disinfectants led to a significant reduction in CFUs in all groups compared with group Co-n. When compared to Ca-7d(g) , CHX-7d (P = 0.290), CHX-10 min (P = 0.963) and Pr-7d (P = 0.095) revealed no significant differences. Pr-10 min had a significantly higher CFU value than Ca-7d(g) (P = 0.0004), CHX-10 min (P = 0.0009) and Pr-7d (P = 0.0006). Within the limitations of this study, sufficient antimicrobial effect may be reached by a short-term application of CHX. For the application of 1% Prontosan wound gel, a medium-term use (7 day) is required, while short-term use (10 min) is less effective. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effect of chlorhexidine and ethanol on push-out bond strength of fiber posts under cyclic loading.

PubMed

Cecchin, Doglas; Giacomin, Mateus; Farina, Ana Paula; Bhering, Cláudia Lopes; Mesquita, Marcelo Ferraz; Ferraz, Caio Cezar

2014-02-01

To investigate the effects of pretreatment with 2% chlorhexidine in a gel base (CHX) and 100% ethanol (EtOH) on the bond strength between fiber posts relined with resin composite and root dentin under cyclic loading. Forty bovine incisor roots were divided into four groups after phosphoric acid etching: group 1 (control), irrigation with physiological saline solution; group 2, 5 min pretreatment with CHX; group 3, 1 min pretreatment with EtOH; group 4, 5 min pretreatment with CHX followed by 1 min with EtOH. Fiber posts relined with resin composite were cemented with RelyX ARC and the etch-and-rinse adhesive system Scotchbond Multi-Purpose. Each group was randomly divided into two subgroups: 24 h of storage (immediate groups) and cyclic loading (loading groups) with 250,000 cycles in a controlled chewing simulator. All roots were sectioned transversely and push-out tests were performed. Failure modes were observed and the bond strength means were analyzed using ANOVA and Tukey's test (a = 0.05). The mean values for the bond strength test (MPa) in immediate groups were: group 1, 5.44 ± 1.48; group 2, 5.57 ± 1.41; group 3, 5.49 ± 1.48; group 4, 5.57 ± 1.42. Immediate groups showed similar bond strength values (p > 0.05). In the cyclic loading groups, the bond strength values were: group 1, 2.80 ± 0.79; group 2, 4.02 (1.30); group 3, 4.50 ± 1.67; group 4, 4.97 ± 2.00. After cyclic loading, a significant decrease in the control group was observed (p < 0.05), while CHX pretreatment resulted in intermediate values (p < 0.05) and EtOH alone or associated with CHX preserved the bond strength values (p > 0.05). Chlorhexidine and/or ethanol pretreatment preserved the bond strength of the fiber post after cyclic loading.

The long-term effect of a zinc acetate and chlorhexidine diacetate containing mouth rinse on intra-oral halitosis-A randomized clinical trial.

PubMed

Erovic Ademovski, Seida; Mårtensson, Carina; Persson, Gösta Rutger; Renvert, Stefan

2017-10-01

To evaluate the long-term effects of a zinc acetate and chlorhexidine diacetate mouth rinse (Zn/CHX) on intra-oral halitosis. Forty-six adults with intra-oral halitosis were randomized into a 6-month, double-blind, placebo-controlled clinical study. The presence of intra-oral halitosis was evaluated at baseline, 3 and 6 months after treatment by assessment of organoleptic score (OLS) and by total volatile sulphur compounds (T-VSC), hydrogen sulphide (H 2 S) and methyl mercaptan (MM) concentrations in exhaled air. A Zn/CHX mouth rinse provided significantly better control of intra-oral halitosis than a placebo mouth rinse. At 3 and 6 months, individuals rinsing with the Zn/CHX rinse presented with reductions of the OLS, T-VSC (p < .01, respectively), H 2 S (p < .001), and MM (p < .01) in subjects' exhaled air. At 6 months, 68.2% of individuals using the Zn/CHX rinse experienced a 1 or 2 category improvement in OLS compared with 19.1% of placebo-treated subjects. 91% of subjects in the Zn/CHX group were categorized as being effectively treated for intra-oral halitosis (i.e. H 2 S < 112 ppb), compared to 43% in the placebo group. Zn/CHX mouth rinse provides effective long-term efficacy against intra-oral halitosis, assessed both objectively and subjectively. With regular rinsing, the effect was sustained for 6 months. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Controlled release of chlorhexidine digluconate using β-cyclodextrin and microfibrillated cellulose.

PubMed

Lavoine, Nathalie; Tabary, Nicolas; Desloges, Isabelle; Martel, Bernard; Bras, Julien

2014-09-01

This study aims to develop a high-performance delivery system using microfibrillated cellulose (MFC)-coated papers as a controlled release system combined with the well-known drug delivery agent, β-cyclodextrin (βCD). Chlorhexidine digluconate (CHX), an antibacterial molecule, was mixed with a suspension of MFC or a βCD solution or mixed with both the substances, before coating onto a cellulosic substrate. The intermittent diffusion of CHX (i.e., diffusion interrupted by the renewal of the release medium periodically) was conducted in an aqueous medium, and the release mechanism of CHX was elucidated by field emission gun-scanning electron microscopy, SEM, NMR, and Fourier transform infrared analyses. According to the literature, both βCD and MFC are efficient controlled delivery systems. This study indicated that βCD releases CHX more gradually and over a longer period of time compared to MFC, which is mainly due to the ability of βCD to form an inclusion complex with CHX. Furthermore from the release study, a complementary action when the two compounds were combined was deduced. MFC mainly affected the burst effect, while βCD primarily controlled the amount of CHX released over time. In this paper, two different types of controlled release systems are proposed and compared. Depending on the final application, the use of βCD alone would release low amounts of active molecules over time (slow delivery), whereas the combination of β-cyclodextrin and MFC would be more suitable for the release of higher amounts of active molecules over time (rapid delivery). Copyright © 2014 Elsevier B.V. All rights reserved.

Management of Chronic Periodontitis Using Chlorhexidine Chip and Diode Laser-A Clinical Study.

PubMed

Jose, Kachapilly Arun; Ambooken, Majo; Mathew, Jayan Jacob; Issac, Annie Valayil; Kunju, Ajithkumar Parachalil; Parameshwaran, Renjith Athirkandathil

2016-04-01

The use of adjuncts like chlorhexidine local delivery and diode laser decontamination have been found to improve the clinical outcomes of scaling and root planing in non-surgical periodontal therapy in patients with chronic periodontitis. To evaluate the effects of diode laser and chlorhexidine chip as adjuncts to scaling and root planing in the management of chronic periodontitis. The objective is to evaluate the outcome of chlorhexidine chip and diode laser as adjuncts to scaling and root planing on clinical parameters like Plaque Index, Gingival Index, probing pocket depth and clinical attachment level. Department of Periodontics. Randomized clinical trial with split mouth design. Fifteen chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were included in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Results were statistically analysed using paired T test, one-way ANOVA, Tukey's HSD test and repeated measure ANOVA. Post-treatment, the test and control sites showed a statistically significant reduction in PI, GI, PPD, and CAL. After three months, a mean PPD reduction of 1.47±0.52 mm in control group, 1.40±0.83 mm in diode laser group, 2.67±0.62 mm in CHX group, and 2.80± 0.77 mm in combination group was seen. The mean gain in CAL were 1.47±0.52 mm in the control group, 1.40±0.83 mm in diode laser group, 2.67± 0.49 mm in CHX group and 2.67± 0.82 mm in combination group respectively. The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. Chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis.

Management of Chronic Periodontitis Using Chlorhexidine Chip and Diode Laser-A Clinical Study

PubMed Central

Ambooken, Majo; Mathew, Jayan Jacob; Issac, Annie Valayil; Kunju, Ajithkumar Parachalil; Parameshwaran, Renjith Athirkandathil

2016-01-01

Introduction The use of adjuncts like chlorhexidine local delivery and diode laser decontamination have been found to improve the clinical outcomes of scaling and root planing in non-surgical periodontal therapy in patients with chronic periodontitis. Aim To evaluate the effects of diode laser and chlorhexidine chip as adjuncts to scaling and root planing in the management of chronic periodontitis. The objective is to evaluate the outcome of chlorhexidine chip and diode laser as adjuncts to scaling and root planing on clinical parameters like Plaque Index, Gingival Index, probing pocket depth and clinical attachment level. Study and Design Department of Periodontics. Randomized clinical trial with split mouth design. Materials and Methods Fifteen chronic periodontitis patients having a probing pocket depth of 5mm-7mm on at least one interproximal site in each quadrant of the mouth were included in the study. After initial treatment, four sites in each patient were randomly subjected to scaling and root planing (control), chlorhexidine chip application (CHX chip group), diode laser (810 nm) decontamination (Diode laser group) or combination of both (Diode laser and chip group). Plaque Index (PI), Gingival Index (GI), probing pocket depth (PPD) and clinical attachment level (CAL) were assessed at baseline, one month and three months. Statistical analysis Results were statistically analysed using paired T test, one-way ANOVA, Tukey’s HSD test and repeated measure ANOVA. Results Post-treatment, the test and control sites showed a statistically significant reduction in PI, GI, PPD, and CAL. After three months, a mean PPD reduction of 1.47±0.52 mm in control group, 1.40±0.83 mm in diode laser group, 2.67±0.62 mm in CHX group, and 2.80± 0.77 mm in combination group was seen. The mean gain in CAL were 1.47±0.52 mm in the control group, 1.40±0.83 mm in diode laser group, 2.67± 0.49 mm in CHX group and 2.67± 0.82 mm in combination group respectively. The differences in PPD reduction and CAL gain between control group and CHX chip and combination groups were statistically significant (p<0.05) at three months, whereas, the diode laser group did not show any significant difference from the control group. Conclusion Chlorhexidine local delivery alone or in combination with diode laser decontamination is effective in reducing probing pocket depth and improving clinical attachment levels when used as adjuncts to scaling and root planing in non-surgical periodontal therapy of patients with chronic periodontitis. PMID:27190958

Comparison of alcoholic chlorhexidine and povidone-iodine cutaneous antiseptics for the prevention of central venous catheter-related infection: a cohort and quasi-experimental multicenter study.

PubMed

Pages, Justine; Hazera, Pascal; Mégarbane, Bruno; du Cheyron, Damien; Thuong, Marie; Dutheil, Jean-Jacques; Valette, Xavier; Fournel, François; Mermel, Leonard A; Mira, Jean-Paul; Daubin, Cédric; Parienti, Jean-Jacques

2016-09-01

Compare the effectiveness of different cutaneous antiseptics in reducing risk of catheter-related infection in intensive care unit (ICU) patients. We compared the risk of central venous catheter-related infection according to four-step (scrub, rinse, dry, and disinfect) alcoholic 5 % povidone-iodine (PVI-a, n = 1521), one-step (disinfect) alcoholic 2 % chlorhexidine (2 % CHX-a, n = 1116), four-step alcoholic <1 % chlorhexidine (<1 % CHX-a, n = 357), and four-step aqueous 10 % povidone-iodine (PVI, n = 368) antiseptics used for cutaneous disinfection and catheter care during the 3SITES multicenter randomized controlled trial. Within this cohort, we performed a quasi-experimental study (i.e., before-after) involving the four ICUs which switched from PVI-a to 2 % CHX-a. We used propensity score matching (PSM, n = 776) and inverse probability weighting treatment (IPWT, n = 1592). The end point was the incidence of catheter-related infection (CRI) defined as catheter-related bloodstream infection (CRBSI) or a positive catheter tip culture plus clinical sepsis on catheter removal. In the cohort analysis and compared with PVI-a, the incidence of CRI was lower with 2 % CHX-a [adjusted hazard ratio (aHR), 0.51; 95 % confidence interval (CI) (0.28-0.96), p = 0.037] and similar with <1 % CHX-a [aHR, 0.73; (0.36-1.48), p = 0.37] and PVI [aHR, 1.50; 95 % CI (0.85-2.64), p = 0.16] after controlling for potential confounders. In the quasi-experimental study and compared with PVI-a, the incidence of catheter-related infection was again lower with 2 % CHX-a after PSM [HR, 0.35; 95 % CI (0.15, 0.84), p = 0.02] and in the IPWT analysis [HR, 0.31; 95 % CI (0.14, 0.70), p = 0.005]. The incidence of CRBSI or adverse event was not significantly different between antiseptics in all analyses. In comparison with PVI-a, the use of 2 % CHX-a for cutaneous disinfection of the central venous catheter insertion site and maintenance catheter care was associated with a reduced risk of catheter infection, while the benefit of <1 % CHX-a was uncertain. NCT01479153.

Coronal leakage of four intracanal medications after exposure to human saliva in the presence of a temporary filling material.

PubMed

Verissimo, Rebeca Dibe; Gurgel-Filho, Eduardo Diogo; De-Deus, Gustavo; Coutinho-Filho, Tauby; de Souza-Filho, Francisco Jose

2010-01-01

To determine the time required for the recontamination of root canals medicated with four different materials. A total of 60 intact, caries-free, human single-rooted teeth with straight roots were selected for this study. After chemo-mechanical preparation they must be changed in the specimens into seven groups: 10 teeth medicated with calcium hydroxide (Ca(OH) 2) + Camphorated paramonochlorophanol (CPMC) (G.1); 10 medicated with 2.5% Sodium hypochlorite (NaOCL) (G.2); 10 medicated with 2% Chlorhexidine gluconate (CHX) in gel (G.3); 10 medicated with 2% CHX in gel + Ca(OH) 2 (G.4); 10 without intracanal medicament and sealed with a coronal temporary filling (G.5). Five teeth were without intracanal medicament and coronally unsealed, used as the positive control group (PC) (G.6) and 5 teeth with intact crowns used as the negative control group (NC) (G.7). Glass vials with rubber stoppers were adjusted for use. The medicaments were prepared and injected into the root canals using sterile plastic syringes. An apparatus was used to evaluate for 30 days leakage. The chamber was filled with 3 ml of human saliva and Brain Heart Infusion (BHI) broth, incubated at 37 degrees C and checked daily for the appearance of turbidity in the BHI broth. Recontamination was detected after an average time of 2.6 days in group 2, 15.9 days in group 3, 30 days in group 1, 27.6 days in group 4, 2.9 days in group 5, 1 day in the positive control, and there was no contamination in the negative control group. The NaOCl group showed the highest worst average of recontamination; on the other hand, high averages were also shown by Ca(OH) 2 + CPMC and Ca(OH) 2 + 2% CHX in gel.

Implant decontamination with 2% chlorhexidine during surgical peri-implantitis treatment: a randomized, double-blind, controlled trial.

PubMed

de Waal, Y C M; Raghoebar, G M; Meijer, H J A; Winkel, E G; van Winkelhoff, A J

2015-09-01

The objective of this randomized, double-blind, controlled trial was to evaluate the clinical, radiographic, and microbiological effects of implant surface decontamination with a 2% chlorhexidine (CHX) solution in comparison with a 0.12% chlorhexidine + 0.05% cetylpyridinium chloride (CPC) solution during resective surgical peri-implantitis treatment. Forty-four patients (108 implants) with peri-implantitis were treated with resective surgical treatment consisting of bone re-contouring, surface debridement and chemical decontamination, and apically repositioned flap. Patients were randomly allocated to decontamination with a 2% CHX solution (test group) or 0.12% CHX + 0.05% CPC (control group). Clinical and radiographic parameters were recorded before treatment (baseline), and at 3, 6, and 12 months after treatment. Microbiological parameters were recorded during surgery. Multilevel analysis showed no significant differences in bleeding, suppuration, probing pocket depth, and radiographic bone loss between control and test group over three follow-up measurements (3, 6, and 12 months) from baseline. Both decontamination procedures resulted in significant reductions in anaerobic bacterial counts on the implant surface, but no significant difference was noted between control and test group (mean log 3.37 ± 2.34 vs. 3.65 ± 2.87, P = 0.99). The use of a 2% CHX solution for implant surface decontamination during resective peri-implantitis therapy does not lead to improved clinical, radiographic, or microbiological results compared with a 0.12% CHX + 0.05% CPC solution. Overall, the additional use of CHX reduces anaerobic bacterial load on the implant surface better than mechanical debridement alone, but does not seem to enhance clinical treatment outcomes (ClinicalTrials.gov number NCT01852253). © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparative effect of a new mouthrinse containing chlorhexidine, triclosan and zinc on volatile sulphur compounds: a randomized, crossover, double-blind study.

PubMed

Mendes, L; Coimbra, J; Pereira, A L; Resende, M; Pinto, M G

2016-08-01

The aims of this study were to compare the volatile sulphur compounds (VSC)-reducing effect of two commercial mouthrinses using a morning bad breath model and to assess the role of mechanical plaque control (MPC) when performed previously to mouthrinse use. Eleven volunteers with good oral health were enrolled in a double-blind, randomized, six-step crossover design study with a 7-day washout period. Two commercial mouthrinses were tested using a saline solution (NaCl 0.9%) as a negative control: one mouthrinse contained 0.05% chlorhexidine, 0.05% cetylpyridinium chloride and 0.14% zinc lactate (CHX-CPC-Zn), while the other contained 0.05% chlorhexidine, 0.15% triclosan and 0.18% zinc pidolate (CHX-triclosan-Zn). A portable sulphide monitor (Halimeter(®) ) was used for VSC quantification. Measurements were made at baseline, and 1, 3 and 5 h after rinsing. Significant differences were detected by analysis of variance. No significant differences between groups were detected at baseline. We were unable to demonstrate a significant influence of mechanical plaque control on the reduction of VSC levels when performed before mouthrinse use (P = 0.631). Both mouthrinses effectively lowered VSC levels in all test intervals (P < 0.05). No statistically significant differences were found between mouthrinses in any of the test intervals (P = 0.629, 0.069 and 0.598 at 1, 3 and 5 h). This study demonstrated that CHX-CPC-Zn and CHX-triclosan-Zn have significant and similar effects in reducing VSC levels, which persist for at least 5 h. Such effects were independent of previous MPC, which failed to improve on the results of mouthrinse use alone. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effects of two different post-surgical protocols including either 0.05 % chlorhexidine herbal extract or 0.1 % chlorhexidine on post-surgical plaque control, early wound healing and patient acceptance following standard periodontal surgery and implant placement.

PubMed

Laugisch, Oliver; Ramseier, Christoph A; Salvi, Giovanni E; Hägi, Tobias T; Bürgin, Walter; Eick, Sigrun; Sculean, Anton

2016-11-01

The aim of this study was to compare early wound healing, tooth staining and patient acceptance with two different post-surgical maintenance protocols. Forty patients scheduled for flap surgery to treat periodontal pockets or accommodate dental implants were randomly assigned to receive the following two different post-surgical maintenance protocols: (a) 2 weeks rinsing with a 0.05 % chlorhexidine digluconate (CHX)/herbal extract combination (test) or (b) a 0.1 % CHX solution (control). Early wound healing was evaluated clinically and immunologically. Tooth staining and patient acceptance were assessed by means of visual analogue scale (VAS). Both groups presented with comparable wound healing profiles. No statistically significant differences were observed between the two protocols regarding early wound healing and plaque index (p > 0.05). However, in the control group, statistically significantly more patients felt discomfort due to tooth staining (p = 0.0467). Compared with patients from the test group, patients in the control group reported statistically significant more irritation of taste at week 1 (p = 0.0359) and at week 2 (p = 0.0042). The present findings indicate that the two CHX protocols resulted in comparable healing and inhibition of plaque formation. Tooth staining and subjective discomfort related to irritation of taste were more frequent in the control group. A post-operative protocol including 0.05 % CHX/herbal extract may have the potential to improve patient compliance during post-operative maintenance.

Combined and independent cytotoxicity of sodium hypochlorite, ethylenediaminetetraacetic acid and chlorhexidine.

PubMed

Vouzara, T; Koulaouzidou, E; Ziouti, F; Economides, N

2016-08-01

To evaluate the capacity of commonly used root canal irrigants to induce cytotoxic effects, when applied singly or in combination. The hypothesis tested was that the irrigants were less cytotoxic when applied in combination than independently. MRC5 cells were grown as monolayer cultures at 37 °C in an atmosphere containing 5% CO2 in air and 100% relative humidity. Cells were exposed to sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA), chlorhexidine (CHX) and their combinations (NaOCl/EDTA, NaOCl/CHX, EDTA/CHX) in serial dilutions. Growth medium was Dulbecco's modified Eagle's medium supplemented with 10% foetal bovine serum and antibiotics and was used as control. The effect on cell survival was estimated after 6 and 24 h of exposure by means of the sulforhodamine B assay, in reference to controls. Dose-response curves were plotted, and 50% inhibitory doses (IC50 ) were subjected to statistical analysis (anova and post hoc comparison test; P < 0.05). Analysis of cell survival and interaction of the irrigants was performed using CalcuSyn dose effect analyzer software to calculate a combination index (CI). The tested irrigants were cytotoxic in dose- and time-dependent manner. CHX was the most cytotoxic irrigant tested, followed by NaOCl, whilst EDTA was the least cytotoxic irrigant tested. The difference between CHX and NaOCl was significant (P < 0.05) as well as between NaOCl and EDTA (P < 0.05). Based on CalcuSyn modelling, a mainly antagonistic effect was recorded with NaOCl/CHX and NaOCl/EDTA combinations. The combination EDTA/CHX had an additive to antagonistic effect. CHX was significantly more cytotoxic than NaOCl and EDTA. NaOCl was significantly more cytotoxic than EDTA. The combined action of irrigants did not produce a significant increase in their cytotoxicity. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Effect of addition of lycopene to calcium hydroxide and chlorhexidine as intracanal medicament on fracture resistance of radicular dentin at two different time intervals: An in vitro study.

PubMed

Madhusudhana, Koppolu; Archanagupta, Kasamsetty; Suneelkumar, Chinni; Lavanya, Anumula; Deepthi, Mandava

2015-01-01

Long-term use of intracanal medicaments such as calcium hydroxide (CH) reduces the fracture resistance of dentin. The present study was undertaken to evaluate the fracture resistance of radicular dentin on long-term use of CH, chlorhexidine (CHX) with lycopene (LP). To compare the fracture resistance of radicular dentin when intracanal medicaments such as CH, CHX with LP were used for 1-week and 1-month time interval. Sixty single-rooted extracted human permanent premolars were collected, and complete instrumentation was done. Samples were divided into three groups based on intracanal medicament used. Group 1 - no medicament was placed (CON), group 2 - mixture of 1.5 g of CH and 1 ml of 2% CHX (CHCHX), group 3 - mixture of 1.5 g of CH, 1 ml of CHX and 1 ml of 5% LP solution (CHCHXLP). After storage period of each group for 1-week and 1-month, middle 8 mm root cylinder was sectioned and tested for fracture resistance. Results were analyzed using paired t-test. At 1-month time interval, there was a statistically significant difference in fracture resistance between CHCHX and CHCHXLP groups. Addition of LP has not decreased the fracture resistance of radicular dentin after 1-month.

Inhibition of early biofilm formation by glass-ionomer incorporated with chlorhexidine in vivo: a pilot study.

PubMed

Du, X; Huang, X; Huang, C; Frencken, J E; Yang, T

2012-03-01

This pilot study investigated the antibiofilm effects of glass-ionomer cements (GICs) and resin-modified glass-ionomer cements (RMGICs) incorporated with chlorhexidine (CHX) in vivo. Experimental GICs and RMGICs containing 2% CHX were obtained by mixing CHX with the powder of GICs (CHXGIC) and RMGICs (CHXRMGIC). Four groups of specimens were prepared in a standardized size. After polishing and sterilization, they were bonded to the buccal surface of the molars in the first and second quadrant of volunteers and left untouched for 4 hours and 24 hours, respectively. The bacterial vitality of plaque was then analysed by confocal laser scanning microscopy (CLSM). The bacterial morphology and biofilm accumulation were determined by scanning electron microscopy (SEM). The pH value of biofilm was assessed by Plaque Indicator Kits. CLSM analysis revealed that bacterial vitality of the biofilm on CHXGIC and CHXRMGIC was significantly lower than that on GIC and RMGIC. SEM analysis indicated that the morphology of bacteria on CHXGIC and CHXRMGIC was irregular. The pH value of biofilm on the experimental materials presented no statistically significant difference. Twenty-four hour bacterial vitality on GICs and RMGICs with CHX are lower in micro-organisms than on conventional GICs and RMGICs. © 2012 Australian Dental Association.

Evaluation of Persistent Antimicrobial Effects of an Antimicrobial Formulation

PubMed Central

Ferrara, Michael S.; Courson, Ron; Paulson, Daryl S.

2011-01-01

Context: Community-acquired methicillin-resistant Staphylococcus aureus (MRSA) is becoming more prevalent in healthy athletic populations. Various preventive measures have been proposed, but few researchers have evaluated the protective effects of a prophylactic application of a commercially available product. Objective: To compare the persistent antimicrobial properties of a commercially available antimicrobial product containing 4% chlorhexidine gluconate (Hibiclens) with those of a mild, nonmedicated soap (Dr. Bronner's Magic Soap). Design: Cross-sectional study. Setting: Microbiology laboratory, contract research organization. Patients or Other Participants: Twenty healthy human volunteers. Intervention(s): The test and control products were randomly assigned and applied to both forearms of each participant. Each forearm was washed for 2 minutes with the test or control product, rinsed, and dried. At, 1, 2, and 4 hours after application, each forearm was exposed to MRSA for approximately 30 minutes. Main Outcome Measure(s): Differences in numbers of MRSA recovered from each forearm, test and control, at each postapplication time point were compared. Results: Fewer MRSA (P < .0001) were recovered from the forearms treated with the test product (4% chlorhexidine gluconate) than from the forearms treated with the control product (nonmedicated soap). Conclusions: The 4% chlorhexidine gluconate product demonstrated persistent bactericidal activity versus MRSA for up to 4 hours after application. PMID:22488188

The effect of adjunctive chlorhexidine mouthrinse on GCF MMP-8 and TIMP-1 levels in gingivitis: a randomized placebo-controlled study.

PubMed

Türkoğlu, Oya; Becerik, Sema; Tervahartiala, Taina; Sorsa, Timo; Atilla, Gül; Emingil, Gülnur

2014-05-20

The aim of the present study was to evaluate the effect of adjunctive chlorhexidine (CHX) mouthrinse on gingival crevicular fluid (GCF) MMP-8 and TIMP-1 levels in plaque-associated gingivitis. A total of 50 gingivitis patients were included in the present study. In addition to daily plaque control, CHX group rinsed with CHX, while placebo group rinsed with placebo mouthrinse for 4 weeks. GCF samples were collected, and clinical parameters including plaque index, papillary bleeding index, calculus index and pocket depth were recorded at baseline and 4 weeks. GCF MMP-8 and TIMP-1 levels were determined by immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA), respectively. In both groups, GCF MMP-8 levels of anterior and posterior sites at four weeks were not different from baseline (p > 0.05). There were no significant differences in GCF MMP-8 levels between the study groups at four weeks (p > 0.05). GCF TIMP-1 levels of anterior and posterior sites at four weeks were higher compared to baseline in both groups (p < 0.05). There was no significant difference in GCF TIMP level between the study groups at four weeks (p > 0.05). CHX usage had no significant effects on the GCF MMP-8 and TIMP-1 levels in plaque-associate gingivitis. However, daily plaque control resulted in the increase of GCF TIMP-1 levels regardless of CHX usage.

The effect of adjunctive chlorhexidine mouthrinse on GCF MMP-8 and TIMP-1 levels in gingivitis: a randomized placebo-controlled study

PubMed Central

2014-01-01

Background The aim of the present study was to evaluate the effect of adjunctive chlorhexidine (CHX) mouthrinse on gingival crevicular fluid (GCF) MMP-8 and TIMP-1 levels in plaque-associated gingivitis. Methods A total of 50 gingivitis patients were included in the present study. In addition to daily plaque control, CHX group rinsed with CHX, while placebo group rinsed with placebo mouthrinse for 4 weeks. GCF samples were collected, and clinical parameters including plaque index, papillary bleeding index, calculus index and pocket depth were recorded at baseline and 4 weeks. GCF MMP-8 and TIMP-1 levels were determined by immunofluorometric assay (IFMA) and enzyme-linked immunosorbent assay (ELISA), respectively. Results In both groups, GCF MMP-8 levels of anterior and posterior sites at four weeks were not different from baseline (p > 0.05). There were no significant differences in GCF MMP-8 levels between the study groups at four weeks (p > 0.05). GCF TIMP-1 levels of anterior and posterior sites at four weeks were higher compared to baseline in both groups (p < 0.05). There was no significant difference in GCF TIMP level between the study groups at four weeks (p > 0.05). Conclusions CHX usage had no significant effects on the GCF MMP-8 and TIMP-1 levels in plaque-associate gingivitis. However, daily plaque control resulted in the increase of GCF TIMP-1 levels regardless of CHX usage. PMID:24886536

Evaluation of the antigingivitis effect of a chlorhexidine mouthwash with or without an antidiscoloration system compared to placebo during experimental gingivitis.

PubMed

Li, Wen; Wang, Ren E; Finger, Martin; Lang, Niklaus P

2014-02-01

The aim of the present study was to evaluate the effectiveness of chlorhexidine (CHX) with an antidiscoloration system (ADS) on stain, plaque accumulation, and gingivitis. A randomized, controlled clinical trial was conducted in 26 students. After a preparatory period, the students were randomly assigned to either group P (placebo), group T1 (0.12% CHX without an ADS), or group T2 (0.12% CHX with an ADS). During the 3-week experimental period, all mechanical oral hygiene was abolished. Rinsing with 10 mL mouthwash or placebo was performed twice daily under supervision. The parameters assessed on days 0, 7, 14, and 21 included the Discoloration Index (DI), Plaque Index (PII), and Gingival Index (GI). There were no significant mean differences in the DI, PII, or GI between groups T2 and P. Significant mean differences existed in the DI between groups T2 and T1 on days 14 and 21. Significant mean differences existed in the PI between groups T2 and T1 on days 7, 14, and 21. Likewise, significant mean differences existed in the GI between groups T2 and T1 on days 14 and 21. CHX with an ADS did not prevent plaque or gingivitis development. In fact, the CHX mouthwash with an ADS showed no superior effect over placebo on oral hygiene or the prevention of gingivitis. © 2013 Wiley Publishing Asia Pty Ltd.

Mouthwash overdose

MedlinePlus

... are: Chlorhexidine gluconate Ethanol (ethyl alcohol) Hydrogen peroxide Methyl salicylate ... amounts of alcohol (drunkenness). Swallowing large amounts of methyl salicylate and hydrogen peroxide may also cause serious stomach ...

Interaction between chlorhexidine digluconate and EDTA.

PubMed

Rasimick, Brian J; Nekich, Michelle; Hladek, Megan M; Musikant, Barry L; Deutsch, Allan S

2008-12-01

The combination of chlorhexidine and EDTA produces a white precipitate. The aim of this study was to determine if the precipitate involves the chemical degradation of chlorhexidine. The precipitate was produced and redissolved in a known amount of dilute trifluoroacetic acid. The amount of chlorhexidine and EDTA present in the dissolved precipitate was determined by reverse-phase high performance liquid chromatography (HPLC) with ultraviolet detection at 288 nm. More than 90% of the precipitate's mass was found to be EDTA or chlorhexidine. The remainder is suspected to be water, gluconate, and sodium. Parachloroaniline, a potentially carcinogenic decomposition product of chlorhexidine, was not detected in the precipitate (the limit of detection was 1%). The molar ratio of chlorhexidine to EDTA in the precipitate was about 1.6 to 1. Based on the results, chlorhexidine forms a salt with EDTA rather than undergoing a chemical reaction.

Removal of Escherichia coli and Enterococcus faecalis after Hand Washing with Antimicrobial and Nonantimicrobial Soap and Persistence of These Bacteria in Rinsates.

PubMed

Pérez-Garza, J; García, S; Heredia, N

2017-10-01

Food handlers are important sources of contamination in the agricultural environment. This study was conducted (i) to evaluate the activity of antimicrobial soaps against Escherichia coli and Enterococcus faecalis using a hand washing model with soiled hands and (ii) to determine the survival and persistence of these bacteria in rinsates. Sterilized agricultural soil from tomato and pepper farms was inoculated with E. coli or E. faecalis at 10 3 or 10 6 CFU/g. Decontaminated hands were placed in contact with contaminated soil for 2 min and were then washed with soaps with or without antimicrobial compounds (citric extracts, chloroxylenol, triclosan, or chlorhexidine gluconate). As the control, hands were washed with sterile distilled water. The levels of bacteria remaining on the hands and recovered from the rinsates were determined using a membrane filtration method and selective media. Antimicrobial soaps removed levels of E. coli similar to those removed by distilled water and nonantimicrobial soap on hands contaminated with E. coli at 10 3 CFU/g. However, when hands were contaminated with E. coli at 10 6 CFU/g, more E. coli was removed with the chlorhexidine gluconate soap. When hands were contaminated with E. faecalis at 10 3 CFU/g, bacteria were removed more effectively with soaps containing chloroxylenol or chlorhexidine gluconate. When hands were contaminated with E. faecalis at 10 6 CFU/g, all of the antimicrobial soaps were more effective for removing the bacteria than were distilled water and nonantimicrobial soap. E. coli grew in all of the hand washing rinsates except that containing triclosan, whereas E. faecalis from the 10 6 CFU/g treatments grew in rinsates containing chlorhexidine gluconate and in the distilled water rinsates. Washing with antimicrobial soap was more effective for reducing bacteria on soiled hands than was washing with water or nonantimicrobial soap. However, persistence or growth of bacteria in these rinsates poses health risks.

Residual antibacterial activity of chlorhexidine and MTAD in human root dentin in vitro.

PubMed

Mohammadi, Zahed; Shahriari, Shahriar

2008-03-01

The purpose of this in vitro study was to compare the antimicrobial substantivity of BioPure MTAD, 2% chlorhexidine (CHX) and 2.6% sodium hypochlorite (NaOCl) in human root dentin. One hundred and ten dentin tubes prepared from human maxillary incisors were infected in vitro for 14 days with Enterococcus faecalis. The specimens were divided into five groups as follows: CHX; BioPure MTAD; NaOCl; infected dentin tubes (positive control); and sterile dentin tubes (negative control). Dentin chips were collected with round burs into Brain Heart Infusion (BHI) broth. After culturing, the number of colony-forming units (CFU) was counted. In all experimental groups, CFU was minimum after treatment (day 0), and the results obtained were significantly different from each other at any time period (P < 0.05). After treatment, the NaOCI group and BioPure MTAD group showed the lowest and highest number of CFU, respectively. In each group, the number of CFUs increased significantly by time-lapse (P < 0.05). In conclusion, the substantivity of BioPure MTAD was significantly greater than CHX and NaOCl.

In vitro chlorhexidine release from alginate based microbeads for periodontal therapy

PubMed Central

Reske, Thomas; Böhmer, Femke; Hornung, Anne; Grabow, Niels; Lang, Hermann

2017-01-01

Periodontitis is one of the most common infectious diseases globally that, if untreated, leads to destruction of the tooth supporting tissues and finally results in tooth loss. Evidence shows that standard procedures as mechanical root cleaning could be supported by further treatment options such as locally applied substances. Due to gingival crevicular fluid flow, substances are commonly washed out off the periodontal pockets. The evaluation of administration techniques and the development of local drug releasing devices is thus an important aspect in periodontal research. This study describes the development and examination of a new alginate based, biodegradable and easily applicable drug delivery system for chlorhexidine (CHX). Different micro beads were produced and loaded with CHX and the release profiles were investigated by high performance liquid chromatography (HPLC). The in vitro-demonstrated release of CHX from alginate based beads shows comparable releasing characteristics as clinically approved systems. Yet many characteristics of this new delivery system show to be favourable for periodontal therapy. Easy application by injection, low production costs and multifunctional adaptions to patient related specifics may improve the usage in routine care. PMID:28973028

Chlorhexidine susceptibilities of mutans streptococcal serotypes and ribotypes.

PubMed

Grönroos, L; Mättö, J; Saarela, M; Luoma, A R; Luoma, H; Jousimies-Somer, H; Pyhälä, L; Asikainen, S; Alaluusua, S

1995-04-01

The susceptibilities of 379 clinical mutans streptococcal isolates to chlorhexidine (CHX) were tested by agar dilution according to the standards of the National Committee for Clinical Laboratory Standards. Isolates were obtained from saliva samples of 34 young mothers who had high or moderate salivary levels of mutans streptococci at baseline. Samples were collected on three occasions, before childbirth, when each child was 6 months old, and 1 year later. Of these isolates, 50% were inhibited at 1 microgram of CHX per ml, 90% were inhibited at 2.0 micrograms/ml, and all were inhibited at 4.0 micrograms/ml. The MICs for Streptococcus mutans isolates (serotypes c, e, and f) were lower than those for Streptococcus sobrinus isolates (serotypes d and g). In some subjects, the MICs for isolates of the same serotype were different. This phenomenon was studied by ribotyping isolates (n = 45) from selected subjects (n = 7). It was found that if there were intraindividual differences in the MICs for isolates of the same serotype, then the ribotypes of these isolates were different. In order to decrease the mutans streptococcal infection risk for children, 24 mothers (test group) brushed their teeth periodically with a gel that contained 0.3% CHX digluconate and 0.2% NaF, pH 5.8, between the second and third sampling occasions. The gel was used twice a day for the first 10 days of each month. Development of resistant strains during CHX-NaF gel use was not detected. The serotype distribution of isolates from the test group after 1 year of periodic CHX-NaF gel use did not differ from that at baseline. Periodic CHX-NaF gel brushing did not lead to lower salivary mutans streptococcal counts.

Free Active Chlorine in Sodium Hypochlorite Solutions Admixed with Octenidine, SmearOFF, Chlorhexidine, and EDTA.

PubMed

Krishnan, Unni; Saji, Sreeja; Clarkson, Roger; Lalloo, Ratilal; Moule, Alex J

2017-08-01

The therapeutic effects of sodium hypochlorite (NaOCl) solutions are dependent on the levels of free available chlorine (FAC). Mixing these solutions with irrigants can result in significant reductions in FAC. Although the effect of some irrigants on FAC is known, the effect of other commonly used irrigants is not. Thus, the therapeutic ramifications of the concurrent use of these on the efficiency of NaOCl solutions is not known. Aliquots of 5.2% (w/v) NaOCl solutions were admixed in proportions of 90:10, 80:20, and 50:50 with the following irrigants: octenidine dihydrochloride (OCT); SmearOFF (Vista Dental Products, Racine, WI), 17% EDTA; and 0.2%, 2%, and 5% chlorhexidine (CHX) solutions. Changes in FAC were measured by iodometric titration. Statistical differences between means were determined using a post hoc Tukey analysis test after an analysis of variance. OCT appeared not to affect FAC and was significantly different than all other irrigants, except for 90:10 and 80:20 mixtures of low concentration (0.2%) CHX. CHX solutions showed a marked concentration- and mixture proportion-dependent detrimental effect on FAC. The reduction of FAC between different concentrations of CHX was statistically significant in 80:20 and 50:50 proportions, with 50:50 mixtures of 5% CHX having the greatest influence. Mixtures containing even small proportions of SmearOFF or EDTA exhibited significant losses in FAC. OCT has little effect on FAC and can be used concurrently with NaOCl solutions. Higher concentrations of CHX significantly affect FAC. Their combined use with NaOCl solutions should be avoided. EDTA and SmearOFF should not be mixed with NaOCl solutions. Copyright © 2017 American Association of Endodontists. All rights reserved.

Chlorhexidine susceptibilities of mutans streptococcal serotypes and ribotypes.

PubMed Central

Grönroos, L; Mättö, J; Saarela, M; Luoma, A R; Luoma, H; Jousimies-Somer, H; Pyhälä, L; Asikainen, S; Alaluusua, S

1995-01-01

The susceptibilities of 379 clinical mutans streptococcal isolates to chlorhexidine (CHX) were tested by agar dilution according to the standards of the National Committee for Clinical Laboratory Standards. Isolates were obtained from saliva samples of 34 young mothers who had high or moderate salivary levels of mutans streptococci at baseline. Samples were collected on three occasions, before childbirth, when each child was 6 months old, and 1 year later. Of these isolates, 50% were inhibited at 1 microgram of CHX per ml, 90% were inhibited at 2.0 micrograms/ml, and all were inhibited at 4.0 micrograms/ml. The MICs for Streptococcus mutans isolates (serotypes c, e, and f) were lower than those for Streptococcus sobrinus isolates (serotypes d and g). In some subjects, the MICs for isolates of the same serotype were different. This phenomenon was studied by ribotyping isolates (n = 45) from selected subjects (n = 7). It was found that if there were intraindividual differences in the MICs for isolates of the same serotype, then the ribotypes of these isolates were different. In order to decrease the mutans streptococcal infection risk for children, 24 mothers (test group) brushed their teeth periodically with a gel that contained 0.3% CHX digluconate and 0.2% NaF, pH 5.8, between the second and third sampling occasions. The gel was used twice a day for the first 10 days of each month. Development of resistant strains during CHX-NaF gel use was not detected. The serotype distribution of isolates from the test group after 1 year of periodic CHX-NaF gel use did not differ from that at baseline. Periodic CHX-NaF gel brushing did not lead to lower salivary mutans streptococcal counts. PMID:7785991

Effect of modified nonequilibrium plasma with chlorhexidine digluconate against endodontic biofilms in vitro.

PubMed

Du, Tianfeng; Shi, Qi; Shen, Ya; Cao, Yingguang; Ma, Jingzhi; Lu, Xinpei; Xiong, Zilan; Haapasalo, Markus

2013-11-01

Nonequilibrium plasma has been reported to effectively kill Enterococcus faecalis in endodontic biofilm compared with chlorhexidine digluconate (CHX). The purpose of this study was to evaluate the antimicrobial in vitro activity of modified nonequilibrium plasma with CHX against E. faecalis and multispecies biofilms on bovine dentin discs. Sterile bovine dentin discs were incubated with E. faecalis or a mixture of bacteria from human dental root canal infections to form 1- and 3-week-old biofilms. The specimens were subjected to nonequilibrium plasma, modified nonequilibrium plasma with CHX, and 2% CHX for 2- and 5-minute exposure. After treatment, the biofilms were stained with viability dyes and examined by confocal laser scanning microscopy and 3-dimensional reconstruction analysis. The proportions of bacterial cells killed by the treatments were calculated. The 3-dimensional reconstruction images showed that 1- and 3-week-old biofilms adhered to bovine dentin discs. The proportions of dead cells increased significantly with the longer exposure in each treatment group (P < .05). Modified nonequilibrium plasma was the most effective in killing bacteria in E. faecalis and multispecies biofilms at both 2 and 5 minutes (P < .05). No significant difference was detected between nonequilibrium plasma and CHX groups (P > .05). Significantly more cells were killed in 1-week-old biofilms than in 3-week-old biofilms in all groups (P < .05). The modified nonequilibrium plasma killed more bacteria than conventional nonequilibrium plasma and 2% CHX in E. faecalis and multispecies endodontic biofilms in vitro and thus shows promise as an additional tool in infection control during endodontic treatment. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Inhibition of de novo plaque growth by a new 0.03 % chlorhexidine mouth rinse formulation applying a non-brushing model: a randomized, double blind clinical trial.

PubMed

Mor-Reinoso, Carolina; Pascual, Andres; Nart, Jose; Quirynen, Marc

2016-09-01

The aim of this study was to investigate the plaque inhibitory effect of a new 0.03 % chlorhexidine digluconate (CHX) and 0.05 % cetylpyridinium chloride (CPC) mouthrinse formulation and to explore patients' experience and side effects after its use. This short-term, randomized, double blind, parallel, clinical trial enrolled 150 periodontally healthy patients. These volunteers were randomly allocated to one of following mouthrinse groups (n = 50/group): 0.12 % CHX + 0.05 % CPC (Perio-Aid® Treatment alcohol-free), 0.03 % CHX + 0.05 % CPC new test formulation or to the placebo group. Clinical parameters (plaque, gingival, and stain indexes) and microbiological samples were taken at baseline, before supragingival cleaning, and after 4 days of undisturbed plaque growth, rinsing twice/day with one of the mouthrinses. Plaque reduction was similar for the 0.12 % CHX (-0.52 ± 0.55) and 0.03 % CHX (-0.47 ± 0.49) groups. Both showed significant reductions in plaque accumulation compared to the placebo (p < 0.001). The new formulation had less of a negative impact on taste perception when compared to the 0.12 % CHX solution. The new CHX mouthrinse was also able to control bacterial loads and reduce some periodontopathogens. This study indicated that the new 0.03 % CHX + 0.05 % CPC formulation exerted clinical efficacy similar to that achieved by an already-marketed 0.12 % CHX + 0.05 % CPC mouthrinse, but with slightly fewer side effects. Lower CHX mouthrinse formulations could be effective in the inhibition of plaque regrowth with reduced unpleasant subjective side effects.

Evaluation of Compatibility of a Gum Mastic Liquid Adhesive and Liquid Adhesive Remover With an Alcoholic Chlorhexidine Gluconate Skin Preparation.

PubMed

Ryder, Marcia; Duley, Collette

The compatibility of a 2% chlorhexidine gluconate/70% isopropyl alcohol (CHG/IPA) skin preparation with a gum mastic liquid adhesive (GMLA) and liquid adhesive remover (LAR) was assessed in healthy volunteers. Twenty subjects completed test material combination with microbial sampling at 3- and 7-day time points. Mean log10 reductions from baseline for normal flora were assessed. There was no significant difference in reduction of normal flora on skin prepped with CHG/IPA versus skin prepped with CHG/IPA followed by GMLA or LAR. The conclusion of the study was that the use of GMLA or LAR with CHG/IPA does not affect the antiseptic effectiveness of CHG/IPA.

Evaluation of Compatibility of a Gum Mastic Liquid Adhesive and Liquid Adhesive Remover With an Alcoholic Chlorhexidine Gluconate Skin Preparation

PubMed Central

Duley, Collette

2017-01-01

The compatibility of a 2% chlorhexidine gluconate/70% isopropyl alcohol (CHG/IPA) skin preparation with a gum mastic liquid adhesive (GMLA) and liquid adhesive remover (LAR) was assessed in healthy volunteers. Twenty subjects completed test material combination with microbial sampling at 3- and 7-day time points. Mean log10 reductions from baseline for normal flora were assessed. There was no significant difference in reduction of normal flora on skin prepped with CHG/IPA versus skin prepped with CHG/IPA followed by GMLA or LAR. The conclusion of the study was that the use of GMLA or LAR with CHG/IPA does not affect the antiseptic effectiveness of CHG/IPA. PMID:28683004

Chlorhexidine mouthwash and sodium lauryl sulphate dentifrice: do they mix effectively or interfere?

PubMed

Elkerbout, T A; Slot, D E; Bakker, E W P; Van der Weijden, G A

2016-02-01

What is the effectiveness of a chlorhexidine (CHX) mouthwash used in combination with a sodium lauryl sulphate (SLS) dentifrice on the parameters of plaque and gingivitis? MEDLINE-PubMed, Cochrane-CENTRAL, EMBASE and other electronic databases were searched up to July 2014. The inclusion criteria were (randomized) controlled clinical trials, subjects ≥18 years of age with good general health. Papers evaluating the effect of CHX mouthwash used in combination with SLS dentifrice or a dentifrice slurry compared with CHX mouthwash as a single oral hygiene intervention or in combination with an SLS-free dentifrice were included. From the eligible studies, data were extracted, and a meta-analysis was performed when feasible. Independent screening of 83 unique papers resulted in four eligible publications, with nine comparisons. The meta-analysis showed that when an SLS dentifrice was used as a slurry rinse, the interference on the plaque-inhibiting effect of a CHX mouthwash was significantly decreased (MD 0.33; P ≤ 0.00001; 95% CI: <0.24; 0.42>). No significant difference was observed when SLS dentifrice was applied as a paste in combination with CHX mouthwash (MD 0.08; P = 0.42; 95% CI: <-0.26; 0.11>). Descriptive and subgroup analyses support these findings. Moreover, the observed effect for the dentifrice paste occurred regardless of the order of use. This review demonstrates that when CHX mouthwash is recommended, it can be used in combination with an SLS dentifrice without any interference regarding its inhibiting effect on dental plaque, regardless of the order of use. Consequently, the collective evidence indicates that the combined use of dentifrice and CHX mouthwash is not contraindicated. However, this recommendation has been graded as moderate taking into account a potential publication bias because three of the four included studies emerged from the same research group. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Efficacy of umbilical cord cleansing with a single application of 4% chlorhexidine for the prevention of newborn infections in Uganda: study protocol for a randomized controlled trial.

PubMed

Nankabirwa, Victoria; Tylleskär, Thorkild; Tumuhamye, Josephine; Tumwine, James K; Ndeezi, Grace; Martines, José C; Sommerfelt, Halvor

2017-07-12

Yearly, nearly all the estimated worldwide 2.7 million neonatal deaths occur in low- and middle-income countries. Infections, including those affecting the umbilical cord (omphalitis), are a significant factor in approximately a third of these deaths. In fact, the odds of all-cause mortality are 46% higher among neonates with omphalitis than in those without. Five large randomized controlled trials in Asia and Sub-Saharan Africa (SSA) have examined the effect of multiple cord stump applications with 4% chlorhexidine (CHX) for at least 7 days on the risk of omphalitis and neonatal death. These studies, all community-based, show that multiple CHX applications reduced the risk of omphalitis. Of these trials, only one study from South Asia (the Bangladeshi study) and none from Africa examined the effect of a single application of CHX as soon as possible after birth. In this Bangladeshi trial, CHX led to a reduction in the risk of mild-moderate omphalitis and neonatal death. It is important, in an African setting, to explore the effect of a single application among health-facility births. A single application is programmatically much simpler to implement than daily applications for 7 days. Therefore, our study compares umbilical cord cleansing with a single application of 4% CHX at birth with dry cord care among Ugandan babies born in health facilities, on the risk of omphalitis and severe neonatal illness. The CHX study is a facility-based, individually randomized controlled trial that will be conducted among 4760 newborns in Uganda. The primary outcomes are severe illness and omphalitis during the neonatal period. Analysis will be by intention-to-treat. This study will provide novel evidence, from a Sub-Saharan African setting, of the effect of umbilical cord cleansing with a single application of 4% CHX at birth and identify modifiable risk factors for omphalitis. ClinicalTrials.gov, identifier: NCT02606565 . Registered on 12 November 2015.

The influence of different types of brackets and efficacy of two chlorhexidine mouthwashes on oral hygiene and the incidence of white spot lesions in adolescents during the orthodontic therapy.

PubMed

Jurišić, Sanja; Kozomara, Davorin; Jurić, Hrvoje; Verzak, Željko; Jurišić, Gordan

2016-12-01

To detect the effect of two different types of brackets (ceramic and stainless steel) and investigate the effectiveness of two chlorhexidine mouthwashes 0.2% (CHX) on oral hygiene status and incidence of white spot lesions (WSLs) in adolescents wearing fixed orthodontic appliance. One hundred and twenty subjects (aged 11 to 18 years, mean age 14.5 years) were divided into six equal groups according to brackets type and to different mouthwashes: Group 1: metal brackets and conventional CHX, Group 2: metal brackets and CHX with anti-discoloration system (CHX-ADS), Group 3: ceramic brackets and conventional CHX, Group 4: ceramic brackets and CHX-ADS, Group 5: metal brackets and water correction flavors mouthwash (placebo), Group 6: ceramic brackets and placebo. Four weeks after the placement of fixed orthodontic appliance the subjects were provided with three different mouthwashes for use during the next two weeks. Assessment was carried out according to oral hygiene index-simplified (OHI-S) and WSL index performed: prior to placement of the appliance (baseline), four weeks, six weeks, eighteen weeks, and thirty weeks after the placement. The data were then subjected to statistical analysis. Group 4 showed reduction in the OHI-S scores when compared to the Group 5 (in the 6 th week), and Group 6 (in the 6 th and 18 th week), which was statistically significant, P<0.05. Group 4 showed decrease in the WSLs scores when compared to the Group 1 (in the 4 th , 6 th , 18 th and 30 th week), Group 5 (in the 18 th and 30 th week) and Group 6 (in the 6 th , 18 th and 30 th week), which was statistically significant, P<0.05. The ceramic brackets and the usage of CHX-ADS resulted in better oral hygiene status and lower incidence of WSLs.

Mesenchymal stromal cell and osteoblast responses to oxidized titanium surfaces pre-treated with λ = 808 nm GaAlAs diode laser or chlorhexidine: in vitro study.

PubMed

Chellini, Flaminia; Giannelli, Marco; Tani, Alessia; Ballerini, Lara; Vallone, Larissa; Nosi, Daniele; Zecchi-Orlandini, Sandra; Sassoli, Chiara

2017-08-01

Preservation of implant biocompatibility following peri-implantitis treatments is a crucial issue in odontostomatological practice, being closely linked to implant re-osseointegration. Our aim was to assess the responses of osteoblast-like Saos2 cells and adult human bone marrow-mesenchymal stromal cells (MSCs) to oxidized titanium surfaces (TiUnite ® , TiU) pre-treated with a 808 ± 10 nm GaAlAs diode laser operating in non-contact mode, in continuous (2 W, 400 J/cm 2 ; CW) or pulsed (20 kHz, 7 μs, 0.44 W, 88 J/cm 2 ; PW) wave, previously demonstrated to have a strong bactericidal effect and proposed as optional treatment for peri-implantitis. The biocompatibility of TiU surfaces pre-treated with chlorhexidine digluconate (CHX) was also evaluated. In particular, in order to mimic the in vivo approach, TiU surfaces were pre-treated with CHX (0.2%, 5 min); CHX and rinse; and CHX, rinse and air drying. In some experiments, the cells were cultured on untreated TiU before being exposed to CHX. Cell viability (MTS assay), proliferation (EdU incorporation assay; Ki67 confocal immunofluorescence analysis), adhesion (morphological analysis of actin cytoskeleton organization), and osteogenic differentiation (osteopontin confocal immunofluorescence analysis; mineralized bone-like nodule formation) analyses were performed. CHX resulted cytotoxic in all experimental conditions. Diode laser irradiation preserved TiU surface biocompatibility. Notably, laser treatment appeared even to improve the known osteoconductive properties of TiU surfaces. Within the limitations of an in vitro experimentation, this study contributes to provide additional experimental basis to support the potential use of 808 ± 10 nm GaAlAs diode laser at the indicated irradiation setting, in the treatment of peri-implantitis and to discourage the use of CHX.

Influence of the Culture Medium in Dose-Response Effect of the Chlorhexidine on Streptococcus mutans Biofilms

PubMed Central

de Queiroz, Vanessa Salvadego; Ccahuana-Vásquez, Renzo Alberto; Tedesco, Alcides Fabiano; Lyra, Luzia; Cury, Jaime Aparecido; Schreiber, Angélica Zaninelli

2016-01-01

The aim of this study was to evaluate the influence of culture medium on dose-response effect of chlorhexidine (CHX) on Streptococcus mutans UA159 biofilm and validate the use of the cation-adjusted-Müller-Hinton broth (MH) for the evaluation of antibacterial activity. Ultrafiltered Tryptone-Yeast Extract Broth (UTYEB) was compared against MH and MH with blood supplementation (MHS). For each medium, six groups (n = 4) were assessed: two negative control groups (baseline 48 and 120 h) and four experimental groups (0.0001, 0.001, 0.012, and 0.12% CHX). S. mutans biofilm grew on glass slides of each media containing 1% sucrose. After 48 h of growth, biofilms of baseline 48 h were collected and the other groups were treated for 1 min, twice a day, for 3 days, with their respective treatments. The media were changed daily and pH was measured. After 120 h, biofilms were collected and dry weight and viable microorganisms were determined. Results showed CHX dose-response effect being observed in all media for all the variables. However, MH and MHS showed higher sensitivity than UTYEB (p < 0.05). We can conclude that the culture medium does influence dose-response effect of CHX on Streptococcus mutans biofilm and that MH can be used for antibacterial activity. PMID:27293967

Assessment of efficacy of two chlorhexidine mouthrinses on oral hygiene and gingival health in adolescents wearing two types of orthodontic brackets.

PubMed

Jurišić, S; Verzak, Ž; Jurišić, G; Jurić, H

2018-05-01

To investigate the efficacy of two formulations of chlorhexidine 0.2% (CHX) mouthrinses in terms of oral hygiene and gingival health status in adolescents with fixed orthodontic appliances wearing two different types of brackets during 18 weeks. Eighty subjects were randomly divided into two equal groups according to brackets type: (i) metal-stainless steel, (ii) ceramic. Four weeks after the placement of the fixed orthodontic appliances the subjects from each group were randomly allocated into two equal subgroups and were provided with two different mouthrinses for 14 days: (i) alcohol-free CHX, (ii) CHX with antidiscoloration system (CHX-ADS). Assessment was carried out according to gingival index (GI) and oral hygiene index-simplified (OHI-S) performed prior to the placement of the appliance (t 1 ), 6 weeks (t 2 ), and 18 weeks (t 3 ) after the placement. To analyse the data, two-way mixed model MANOVA. Pearson correlations, one-way ANOVA and Independent Samples t test were conducted. Statistically significant decrease in GI and OHI-S indices after 6 weeks and then increase after 18 weeks for all groups was found. Both GI and OHI-S values were lower in subjects wearing ceramic brackets, with statistically significant difference for GI after the usage of the mouthrinse for 14 days, at t 2 (P<.05). The results revealed that the ceramic brackets as well as usage of CHX-ADS resulted in improved gingival status. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Comparative effects of chlorhexidine and essential oils containing mouth rinse on stem cells cultured on a titanium surface.

PubMed

Park, Jun-Beom; Lee, Gil; Yun, Byeong Gon; Kim, Chang-Hyen; Ko, Youngkyung

2014-04-01

Chlorhexidine (CHX) and Listerine (LIS), an essential oil compound, are the two commonly used adjunctive agents for mechanical debridement, for reducing the bacterial load in the treatment of peri-implant inflammation. However, antimicrobial agents have been reported to be cytotoxic to the alveolar bone cells and gingival epithelial cells. The present study was performed to examine the effects of antiseptics CHX and LIS, on the morphology and proliferation of stem cells. Stem cells derived from the buccal fat pad were grown on machined titanium discs. Each disc was immersed in CHX or LIS for 30 sec, 1.5 min or 4.5 min. Cell morphology was evaluated with a confocal laser microscope and the viability of the cells was quantitatively analyzed with the cell counting kit-8 (CCK-8). The untreated cells attached to the titanium discs demonstrated well-organized actin cytoskeletons. No marked alterations in the cytoskeletal organization were observed in any of the treated groups. The treatment with CHX and LIS of the titanium discs decreased the viability of the cells grown on the treated discs (P<0.05). The stem cells derived from the buccal fat pad were sensitive to CHX and LIS, and a reduction in cellular viability was observed when these agents were applied to the discs for 30 sec. Further studies are required to determine the optimal application time and concentration of this antimicrobial agent for maximizing the reduction of the bacterial load and minimizing the cytotoxicity to the surrounding cells.

The sustaining effect of three polymers on the release of chlorhexidine from a controlled release drug device for root canal disinfection.

PubMed

Lee, Doug-Youn; Spångberg, Larz S W; Bok, Young-Bin; Lee, Chang-Young; Kum, Kee-Yeon

2005-07-01

The aim of this in vitro study was to evaluate the suitability of using chitosan, poly (lactide-co-glycolide) (PLGA), and polymethyl methacrylate (PMMA) to control the release of chlorhexidine digluconate (CHX) from a prototype of controlled release drug device for root canal disinfection. Four different prototypes with different formulations were prepared. Group A (n = 12): the device (absorbent paper point) was loaded with CHX as control. Group B (n = 12): same as group A, but the device was coated with chitosan (Texan MedTech). In Groups C and D, the device was treated in the same way as group A and then coated 3 times with 5% PMMA (Group C, n = 12, Aldrich), or coated 3 times with 3% PLGA (Group D, n = 12, Sigma). The devices were randomly allocated to experimental groups of 12 each. All the prototypes of controlled release drug device were soaked in 3 mL distilled water. The concentrations of CHX were determined using a UV spectrophotometer. The surface characteristics of each prototype were observed using a scanning electron microscope. The result showed that release rate of CHX was the greatest in the noncoated group, followed by the chitosan-coated group, the PLGA-coated group, and the PMMA-coated group (P < 0.05). Pores were observed on the surface of the prototypes that were coated with PLGA and PMMA. When the pore size was smaller, the release rate was lower. These data indicate that polymer coating can control the release rate of CHX from the prototypes of controlled release drug device.

Effect of 2% Chlorhexidine Digluconate on the Bond Strength to Normal versus Caries-Affected Dentin

PubMed Central

Komori, Paula C. P.; Pashley, David H.; Tjäderhane, Leo; Breschi, Lorenzo; Mazzoni, Annalisa; de Goes, Mario Fernando; Wang, Linda; Carrilho, Marcela R.

2013-01-01

SUMMARY This study evaluated the effect of 2% chlorhexidine digluconate (CHX) used as a therapeutic primer on the long-term bond strengths of two etch-and-rinse adhesives to normal (ND) and caries-affected (CAD) dentin. Forty extracted human molars with coronal carious lesions, surrounded by normal dentin, were selected for this study. Flat surfaces of two types of dentin (i.e. ND and CAD) were prepared with a water-cooled high speed diamond disc, and then acid-etched, rinsed and air-dried. In control groups, dentin was re-hydrated with distilled water, blot-dried and bonded with a three-step (Scotchbond Multi-Purpose-MP) or a two-step (Single Bond 2-SB) etch-and-rinse adhesive. In experimental groups, dentin was re-hydrated with 2% CHX (60 s), blot-dried and bonded with the same adhesives. Resin composite build-ups were made. Specimens were prepared for microtensile bond testing in accordance with the non-trimming technique and then tested either immediately or after 6-month storage in artificial saliva. Data were analyzed by ANOVA/Bonferroni tests (α = 0.05). CHX did not affect the immediate bond strength to ND or CAD (p>0.05). CHX treatment significantly lowered the loss of bond strength after 6 months seen in control bonds for ND (p<0.05), but it did not alter the bond strength of CAD (p>0.05). Application of MP on CHX-treated ND or CAD produced bonds that did not change over 6 months of storage. PMID:19363971

Cytotoxicity of modified nonequilibrium plasma with chlorhexidine digluconate on primary cultured human gingival fibroblasts.

PubMed

Chen, Hui; Shi, Qi; Qing, Ying; Yao, Yi-chen; Cao, Ying-guang

2016-02-01

The aim of this study was to investigate the cytotoxicity of modified nonequilibrium plasma with chlorhexidine digluconate (CHX) on human gingival fibroblasts (HGFs), and to evaluate the biosecurity of modified nonequilibrium plasma with 2% CHX as a new method of root canal treatment. Tissue samples taken from human gingiva were primarily cultured and passaged. Cells from passages 3-7 were used. HGFs were treated by modified nonequilibrium plasma with 2% CHX for 0 min (control group), 30 s, 1 min, 1.5 min, 3 min, 5 min, and 10 min, respectively, and then they were incubated for 0, 24, and 48 h. After that, cell counting kit-8 (CCK-8) assay was applied to analyze the cytotoxicity of modified nonequilibrium plasma with 2% CHX on HGFs. There was no significant difference between the 0 h group treated with the modified nonequilibrium plasma for 1 min and the control group (P>0.05). However, there were significant differences between all the other treated groups and the control group (P<0.05). When treated for 1.5 min or shorter, the cell viability was obviously increased; while treated for 3 min or longer, it was obviously reduced. Moreover, when successively cultured for 0, 24, and 48 h, cell viability was decreased at first and then increased in the 3-min-treated and 5-min-treated groups. The modified nonequilibrium plasma with 2% CHX was of no influence on cell viability in 1.5 min treatment, and it could be safely used on root canal treatment.

Effect of 2% chlorhexidine digluconate on the bond strength to normal versus caries-affected dentin.

PubMed

Komori, Paula C P; Pashley, David H; Tjäderhane, Leo; Breschi, Lorenzo; Mazzoni, Annalisa; de Goes, Mario Fernando; Wang, Linda; Carrilho, Marcela R

2009-01-01

This study evaluated the effect of 2% chlorhexidine digluconate (CHX) used as a therapeutic primer on the long-term bond strengths of two etch-and-rinse adhesives to normal (ND) and caries-affected (CAD) dentin. Forty extracted human molars with coronal carious lesions, surrounded by normal dentin, were selected for this study. The flat surfaces of two types of dentin (ND and CAD) were prepared with a water-cooled high-speed diamond disc, then acid-etched, rinsed and air-dried. In the control groups, the dentin was re-hydrated with distilled water, blot-dried and bonded with a three-step (Scotchbond Multi-Purpose-MP) or two-step (Single Bond 2-SB) etch-and-rinse adhesive. In the experimental groups, the dentin was rehydrated with 2% CHX (60 seconds), blot-dried and bonded with the same adhesives. Resin composite build-ups were made. The specimens were prepared for microtensile bond testing in accordance with the non-trimming technique, then tested either immediately or after six-months storage in artificial saliva. The data were analyzed by ANOVA/Bonferroni tests (alpha = 0.05). CHX did not affect the immediate bond strength to ND or CAD (p > 0.05). CHX treatment significantly lowered the loss of bond strength after six months as seen in the control bonds for ND (p < 0.05), but it did not alter the bond strength of CAD (p > 0.05). The application of MP on CHX-treated ND or CAD produced bonds that did not change over six months of storage.

Genotoxic assessment of chlorhexidine mouthwash on exfoliated buccal epithelial cells in chronic gingivitis patients

PubMed Central

Khan, Saif; Khan, Asad Ullah; Hasan, Sadaf

2016-01-01

Background: Chlorhexidine (CHX) is the gold standard of all chemical plaque control agents and the most commonly prescribed mouthwash. However, several studies have shown cytotoxic and genotoxic effects of CHX on various eukaryotic cells. In this study, we have used micronuclei as a biomarker of DNA damage in buccal epithelial cells of chronic gingivitis patients who were given adjunct 0.2% CHX for plaque control. Materials and Methods: Chronic gingivitis patients who were exclusively on mechanical plaque control methods were taken as control (Group A) (n = 101), and chronic gingivitis patients who along with mechanical plaque control measures were taking 0.2% chlorhexidine mouthwash as adjunct were taken as cases (Group B) (n = 255). The Group B was further divided into 5 subgroups (B1, B2, B3, B4, B5) (n = 51) on increasing duration of usage of CHX from ≤1 week to 24 weeks. Buccal epithelial cells were gently scrapped from the buccal mucosa using soft toothbrush. The epithelial cells were collected in buffer solution and centrifuged at 8000 rpm for 5 min. The buccal epithelial cells were air dried, fixed, and stained with 5% Giemsa stain on preheated glass microscopic slides and observed under microscope to screen 2000 nucleated cells per individual for number of micronucleated cells and micronuclei as genotoxic measure. Results: The mean number of micronucleated cells was found to be 0.41 ± 0.71 for Group A as compared values ranging from 1.65 ± 2.09 (Group B1) to 11.7 ± 1.87 (Group B5) in different subgroups of Group B, and similarly, the mean number of micronuclei was found to be 0.48 ± 0.80 for Group A as compared to values ranging from 2.57 ± 1.64 (Group B1) to 14.5 ± 2.49 (Group B5) in different subgroups of Group B using analysis of variance (P < 0.001). Conclusion: We conclude that CHX mouthwash is genotoxic to buccal epithelial cells and there is incremental trend in genotoxicity as the duration of usage is increased. PMID:29238137

Comparison of antimicrobial effects of titanium tetrafluoride, chlorhexidine, xylitol and sodium fluoride on streptococcus mutans: An in-vitro study.

PubMed

Eskandarian, Tahereh; Motamedifar, Mohammad; Arasteh, Peyman; Eghbali, Seyed Sajad; Adib, Ali; Abdoli, Zahra

2017-03-01

No studies have yet documented the bactericidal effects of TiF4, and its role in the treatment of dental caries, and no definite protocol has been introduced to regulate its use. The aim of this study was to determine the antimicrobial/bactericidal effects of TiF4 on Streptococcus Mutans ( S. Mutans ) and to compare it with chlorhexidine (Chx), sodium fluoride (NaF) and xylitol. This study was conducted at the Shiraz University of Medical Sciences microbiology laboratory during March 2015 to September 2015. In this in-vitro study, first a bacterial suspension was prepared and adjusted to a 0.5 McFarland standard (equivalent to 1×10 8 CFU/ml). The minimal inhibitory concentration (MIC) and minimal bactericidal concentrations (MBC) of TiF4, Chx, NaF and xylitol were assessed using broth microdilution assay and disk diffusion methods. In order to neutralize the acidic nature of TiF4, we used a sodium hydroxide preparation to obtain a pH of 7.2 and repeated all of the previous tests with the neutralized TiF4 solution. We reported the final results as percentages where appropriate. The MIC of TiF4, NaF and Chx for S. Mutans were 12.5%, 12.5% and 6.25%, respectively. At a concentration of 12.5% the inhibition zone diameters were 9 mm, 15mm and 14mm for TiF4, NaF and Chx, respectively. The MBC was 25%, 12.5% and 12.5% for TiF4, NaF and Chx, respectively. Xylitol failed to show any bactericidal or growth inhibitory effect in all of its concentrations. When we repeated the tests with an adjusted pH, identical results were obtained. TiF4 solutions have anti-growth and bactericidal effects on S. Mutans at a concentration of 12.5% which is comparable with chlorhexidine and NaF, indicating the possible use of this solution in dental practice as an anti-cariogenic agent, furthermore the antimicrobial activity is unaffected by pH of the environment.

Comparison of antimicrobial effects of titanium tetrafluoride, chlorhexidine, xylitol and sodium fluoride on streptococcus mutans: An in-vitro study

PubMed Central

Eskandarian, Tahereh; Motamedifar, Mohammad; Arasteh, Peyman; Eghbali, Seyed Sajad; Adib, Ali; Abdoli, Zahra

2017-01-01

Introduction No studies have yet documented the bactericidal effects of TiF4, and its role in the treatment of dental caries, and no definite protocol has been introduced to regulate its use. The aim of this study was to determine the antimicrobial/bactericidal effects of TiF4 on Streptococcus Mutans (S. Mutans) and to compare it with chlorhexidine (Chx), sodium fluoride (NaF) and xylitol. Methods This study was conducted at the Shiraz University of Medical Sciences microbiology laboratory during March 2015 to September 2015. In this in-vitro study, first a bacterial suspension was prepared and adjusted to a 0.5 McFarland standard (equivalent to 1×108 CFU/ml). The minimal inhibitory concentration (MIC) and minimal bactericidal concentrations (MBC) of TiF4, Chx, NaF and xylitol were assessed using broth microdilution assay and disk diffusion methods. In order to neutralize the acidic nature of TiF4, we used a sodium hydroxide preparation to obtain a pH of 7.2 and repeated all of the previous tests with the neutralized TiF4 solution. We reported the final results as percentages where appropriate. Results The MIC of TiF4, NaF and Chx for S. Mutans were 12.5%, 12.5% and 6.25%, respectively. At a concentration of 12.5% the inhibition zone diameters were 9 mm, 15mm and 14mm for TiF4, NaF and Chx, respectively. The MBC was 25%, 12.5% and 12.5% for TiF4, NaF and Chx, respectively. Xylitol failed to show any bactericidal or growth inhibitory effect in all of its concentrations. When we repeated the tests with an adjusted pH, identical results were obtained. Conclusion TiF4 solutions have anti-growth and bactericidal effects on S. Mutans at a concentration of 12.5% which is comparable with chlorhexidine and NaF, indicating the possible use of this solution in dental practice as an anti-cariogenic agent, furthermore the antimicrobial activity is unaffected by pH of the environment. PMID:28461883

Observational: prospective study of indirect pulp treatment in primary molars using resin-modified glass ionomer and 2% chlorhexidine gluconate: a 12-month Follow-up.

PubMed

Rosenberg, Linda; Atar, Michael; Daronch, Marcia; Honig, Amy; Chey, Marshall; Funny, Margaret D; Cruz, Luis

2013-01-01

This study's purpose was to determine the efficacy of indirect pulp treatment (IPT) in primary molars when using 2% chlorhexidine gluconate disinfecting solution and resin-modified glass ionomer (RMGI) liner after 12 months. Three- to 10-year-old subjects with deep carious lesions who met selection criteria participated. Infected dentin was removed using a caries detector, and residual affected dentin was left on the pulpal floor to prevent pulp exposure. A 2% chlorhexidine gluconate solution and a RMGI liner were placed. Teeth were restored with composite or full-coverage (stainless steel crown [SSC]) restorations. Follow-up evaluations at 3, 6, and 12 months included clinical, radiographic, and photographic assessments. A total of 60 teeth were treated. Treatment was successful in 50/50 (100%), 41/42 (∼98%), and 31/32 (∼97%) teeth at the 3-, 6-, and 12-month follow-up visits, respectively. Failures included one at 6 months in a primary second molar with a composite restoration and another at 12 months in a primary first molar with a SSC. Indirect pulp treatment is effective in primary teeth, although appropriate case selection and an adequate marginal seal are essential for a successful outcome. Further prospective studies are needed to expand the body of evidence that clinicians use to justify decisions on clinical care.

Effect of chlorhexidine pretreatment on bond strength durability of caries-affected dentin over 2-year aging in artificial saliva and under simulated intrapulpal pressure.

PubMed

Mobarak, E H

2011-01-01

To evaluate the influence of 2% and 5% chlorhexidine (CHX) pretreatment on bond durability of a self-etching adhesive to normal (ND) and caries-affected (AD) dentin after 2-years of aging in artificial saliva and under simulated intrapulpal pressure (IPP). One hundred twenty freshly extracted carious teeth were ground to expose ND and AD. Specimens were distributed into three equal groups (n=40) according to whether the dentin substrates were pretreated with 2% or 5% CHX or with water (control). Clearfil SE Bond (Kuraray) was applied to both substrates and composite cylinders (0.9 mm diameter and 0.7 mm height) were formed. Pretreatment and bonding were done while the specimens were subjected to 15 mm Hg IPP. After curing, specimens were aged in artificial saliva at 37°C and under IPP at 20 mm Hg until being tested after 24 hours or 2 years (n=20/group). Microshear bond strength was evaluated. Failure modes were determined using a scanning electron microscope (SEM) at 400× magnification. Data were statistically analyzed using three-way analysis of variance (ANOVA); one-way ANOVA tests, and t-test (p<0.05). Additional specimens (n=5/group) were prepared to evaluate interfacial silver precipitation. For the 24-hour groups, there were no significant differences among the ND groups and AD groups. For ND aged specimens, the 5% CHX group had the highest value followed by the 2% CHX and control groups, although the difference was statistically insignificant. For AD aged specimens, the 5% CHX group revealed statistically higher bond values compared to the 2% CHX and control groups. Fracture modes were predominately adhesive and mixed. Different interfacial silver depositions were recorded. Two percent or 5% CHX pretreatment has no adverse effect on the 24-hour bonding to ND and AD. Five percent CHX was able to diminish the loss in bonding to AD after 2years of aging in artificial saliva and under simulated IPP.

Effectiveness of liquid soap vs. chlorhexidine gluconate for the removal of Clostridium difficile from bare hands and gloved hands.

PubMed

Bettin, K; Clabots, C; Mathie, P; Willard, K; Gerding, D N

1994-11-01

To compare liquid soap versus 4% chlorhexidine gluconate in 4% alcohol for the decontamination of bare or gloved hands inoculated with an epidemic strain of Clostridium difficile. C difficile (6.7 log10 colony-forming units [CFU], 47% spores), was seeded onto bare or latex gloved hands of ten volunteers and allowed to dry. Half the volunteers initially washed with soap and half with chlorhexidine, followed by the other agent 1 week later. Cultures were done with Rodac plates at three sites on the hand: finger/thumbtips, the palmar surfaces of the fingers, and the palm. Statistical comparison was by paired Student's t test. On bare hands, soap and chlorhexidine did not differ in residual bacterial counts on the finger/thumbtips (log10 CFU, 2.0 and 2.1, P = NS) and fingers (log10 CFU, 2.4 and 2.5, P = NS). Counts were too high on bare palms to quantitate. On gloved hands, soap was more effective than chlorhexidine on fingers (log10 CFU 1.3 and 1.7, P < .01) and palms (log10 CFU 1.5 and 2.0, P < .01), but not finger/thumbtips (log10 CFU 1.6 with each, P = NS). Residual C difficile counts were lower on gloved hands than bare hands (P < 0.01 to < 0.0001). The two agents did not differ significantly in residual counts of C difficile on bare hands, but on gloved hands residual counts were lower following soap wash than following chlorhexidine wash. These observations support the use of either soap or chlorhexidine as a handwash for removal of C difficile, but efficacy in the prevention of C difficile transmission must be determined by prospective clinical trials.

A Randomized, Clinical Trial of Preadmission Chlorhexidine Skin Preparation for Lower Extremity Total Joint Arthroplasty.

PubMed

Kapadia, Bhaveen H; Elmallah, Randa K; Mont, Michael A

2016-12-01

Periprosthetic infections are devastating postoperative complications of total joint arthroplasty (TJA), with native skin flora commonly identified as causative organisms. We compared 2% chlorhexidine gluconate-impregnated cloths to standard-of-care antiseptic bathing in patients before TJA, to evaluate periprosthetic infection risk at 1-year follow-up. This was a prospective, randomized, controlled trial at a single institution of patients undergoing hip or knee arthroplasty. Chlorhexidine-treated patients (275 arthroplasties) applied 2% chlorhexidine gluconate-impregnated cloths the night before and morning of admission. The standard-of-care cohort (279 arthroplasties) bathed with soap and water preadmission. Patients were excluded according to the following: (1) unable to comply with study requirements, (2) pregnant, (3) <18 years, (4) medical history of immunosuppression or steroid use, (5) chronic hepatitis B/C infection, (6) had infection around joint requiring surgery, or (7) chose not to participate. A total of 539 patients (554 arthroplasties) were included in the final population. There were no significant differences in American Society of Anesthesiologists grade, cut time, risk scores, or diabetes and smoking prevalence between cohorts (P > .05). A lower periprosthetic infection rate was found in the chlorhexidine cohort (0.4%) when compared to standard-of-care cohorts (2.9%). The infection odds ratio was 8.15 (95% confidence interval = 1.01-65.6; P = .049) for the standard-of-care cohort compared to the chlorhexidine cohort. No differences in assessed risk factors were found between groups. No severe adverse events were observed. Preoperative chlorhexidine cloth use decreased the risk of periprosthetic infection. This may be an appropriate antiseptic protocol to implement for patients undergoing lower extremity TJA. Copyright © 2016 Elsevier Inc. All rights reserved.

Antimicrobial nanocapsules: from new solvent-free process to in vitro efficiency

PubMed Central

Steelandt, Julie; Salmon, Damien; Gilbert, Elodie; Almouazen, Eyad; Renaud, François NR; Roussel, Laurène; Haftek, Marek; Pirot, Fabrice

2014-01-01

Skin and mucosal infections constitute recurrent pathologies resulting from either inappropriate antiseptic procedures or a lack of efficacy of antimicrobial products. In this field, nanomaterials offer interesting antimicrobial properties (eg, long-lasting activity; intracellular and tissular penetration) as compared to conventional products. The aim of this work was to produce, by a new solvent-free process, a stable and easily freeze-dryable chlorhexidine-loaded polymeric nanocapsule (CHX-NC) suspension, and then to assess the antimicrobial properties of nanomaterials. The relevance of the process and the physicochemical properties of the CHX-NCs were examined by the assessment of encapsulation efficiency, stability of the nanomaterial suspension after 1 month of storage, and by analysis of granulometry and surface electric charge of nanocapsules. In vitro antimicrobial activities of the CHX-NCs and chlorhexidine digluconate solution were compared by measuring the inhibition diameters of two bacterial strains (Escherichia coli and Staphylococcus aureus) and one fungal strain (Candida albicans) cultured onto appropriate media. Based on the findings of this study, we report a new solvent-free process for the production of nanomaterials exhibiting antimicrobial activity, suitable stability, and easily incorporable as a new ingredient in various pharmaceutical products. PMID:25278751

EFFICACY OF SODIUM HYPOCHLORITE AND CHLORHEXIDINE AGAINST Enterococcus faecalis – A SYSTEMATIC REVIEW

PubMed Central

Estrela, Carlos; Silva, Julio Almeida; de Alencar, Ana Helena Gonçalves; Leles, Claudio Rodrigues; Decurcio, Daniel Almeida

2008-01-01

The efficacy of the sodium hypochlorite (NaOCl) and chlorhexidine (CHX) on Enterococcus faecalis was evaluated by systematic review and meta-analysis. The search strategies included search in electronic biomedical journal databases (MEDLINE, EMBASE, CENTRAL) and handsearching records, using different matches of keywords for NaOCl, CHX and Enterococcus faecalis. From 41 in vivo studies, 5 studies met the inclusion criteria. In a sample containing 159 teeth, E. faecalis was detected initially in 16 (10%) teeth by polymerase chain reaction (PCR) and 42 (26.4%) teeth by microbial culture techniques. After root canal disinfection, this species was observed in 11 (6.9%) teeth by PCR and 12 (7.5%) teeth by culture. Risk differences of included studies were combined as generic inverse variance data type (Review Manager Version 5.0 – Cochrane Collaboration, http://www.cc-ims.net, accessed 15 May 2008), taking into account the separate tracking of positive and negative cultures/PCR. The level of statistical significance was set at p<0.05. In conclusion, NaOCl or CHX showed low ability to eliminate E. faecalis when evaluated by either PCR or culture techniques. PMID:19082392

Comparing the antiplaque efficacy of 0.5% Camellia sinensis extract, 0.05% sodium fluoride, and 0.2% chlorhexidine gluconate mouthwash in children.

PubMed

Hambire, Chaitali U; Jawade, Rashmi; Patil, Amol; Wani, Vaibhav R; Kulkarni, Ankur A; Nehete, Parag B

2015-01-01

Dental caries is a multifactorial disease which requires a susceptible host, a cariogenic microflora, and a suitable substrate that must be present for a sufficient length of time. Tea is prepared by the infusion of dried leaves of the tea plant, Camellia sinensis, which contains bioactive compounds like polyphenols, flavonoids, and catechins that are thought to be responsible for the health benefits that have traditionally been attributed to tea. These compounds have multidimensional effects such as antibacterial action, inhibitory action on the bacterial and salivary amylase, and inhibition of acid production. The aim of this study is to compare the antiplaque efficacy of 0.5% C. sinensis extract, 0.05% sodium fluoride, and 0.2% chlorhexidine gluconate mouthwash in children. A randomized blinded controlled trial with 60 healthy children of age group 9-14 years was carried out. The subjects were randomly assigned to three groups, i.e. group A - 0.2% chlorhexidine gluconate, group B - 0.05% sodium fluoride, and group C - 0.5% C. sinensis extract, with 20 subjects per group. Plaque accumulation and gingival condition were recorded using plaque index and gingival index. Oral hygiene was assessed by simplified oral hygiene index (OHIS). Salivary pH was assessed using indikrom pH strips. Plaque, gingival, and simplified OHI scores as well as salivary pH were recorded at baseline, immediately after first rinse, after 1 week, and in the 2(nd) week. The data were analyzed using a computer software program (SPSS version 17). Analysis of variance (ANOVA) tests were used to identify significant differences between the means of the study groups. Finally, paired t-tests were used to assess the significance of changes within each group between time periods. Critical P values of significance were set at 0.05 and the confidence level set at 95%. Mean plaque and gingival scores were reduced over the 2-week trial period in the experimental groups. Antiplaque effectiveness was observed in all groups, the highest being in group C (P < 0.05). Chlorhexidine gluconate and tea showed comparative effectiveness on gingiva better than sodium fluoride (P < 0.05). The salivary pH increase was sustained and significant in groups B and C compared to group A. Oral hygiene improvement was better appreciated in groups A and C. The effectiveness of 0.5% C. sinensis extract was more compared to 0.05% sodium fluoride and 0.2% chlorhexidine gluconate mouth rinses. It should be explored as a cost-effective and safe long-term adjunct to oral self-care of patients as it has prophylactic benefits with minimum side effects.

Efficacy of chlorhexidine varnish for the prevention of adult caries: a randomized trial.

PubMed

Papas, A S; Vollmer, W M; Gullion, C M; Bader, J; Laws, R; Fellows, J; Hollis, J F; Maupomé, G; Singh, M L; Snyder, J; Blanchard, P

2012-02-01

The Prevention of Adult Caries Study, an NIDCR-funded multicenter, double-blind, randomized clinical trial, enrolled 983 adults (aged 18-80 yrs) at high risk for developing caries (20 or more intact teeth and 2 or more lesions at screening) to test the efficacy of a chlorhexidine diacetate 10% weight per volume (w/v) dental coating (CHX). We excluded participants for whom the study treatment was contraindicated or whose health might affect outcomes or ability to complete the study. Participants were randomly assigned to receive either the CHX coating (n = 490) or a placebo control (n = 493). Coatings were applied weekly for 4 weeks and a fifth time 6 months later. The primary outcome (total net D(1-2)FS increment) was the sum of weighted counts of changes in tooth surface status over 13 months. We observed no significant difference between the two treatment arms in either the intention-to-treat or per-protocol analyses. Analysis of 3 protocol-specified secondary outcomes produced similar findings. This trial failed to find that 10% (w/v) chlorhexidine diacetate coating was superior to placebo coating for the prevention of new caries (Clinicaltrials.gov registration number NCT00357877).

Qualitative analysis of precipitate formation on the surface and in the tubules of dentin irrigated with sodium hypochlorite and a final rinse of chlorhexidine or QMiX.

PubMed

Kolosowski, Kamil P; Sodhi, Rana N S; Kishen, Anil; Basrani, Bettina R

2014-12-01

Interaction of sodium hypochlorite (NaOCl) mixed with chlorhexidine (CHX) produces a brown precipitate containing para-chloroaniline (PCA). When QMiX is mixed with NaOCl, no precipitate forms, but color change occurs. The aim of this study was to qualitatively assess the formation of precipitate and PCA on the surface and in the tubules of dentin irrigated with NaOCl, followed either by EDTA, NaOCl, and CHX or by saline and QMiX by using time-of-flight secondary ion mass spectrometry (TOF-SIMS). Dentin blocks were obtained from human maxillary molars, embedded in resin, and cross-sectioned to expose dentin. Specimens in group 1 were immersed in 2.5% NaOCl, followed by 17% EDTA, 2.5% NaOCl, and 2% CHX. Specimens in group 2 were immersed in 2.5% NaOCl, followed by saline and QMiX. The dentin surfaces were subjected to TOF-SIMS spectra analysis. Longitudinal sections of dentin blocks were then exposed and subjected to TOF-SIMS analysis. All samples and analysis were performed in triplicate for confirmation. TOF-SIMS analysis of group 1 revealed an irregular precipitate, containing PCA and CHX breakdown products, on the dentin surfaces, occluding and extending into the tubules. In TOF-SIMS analysis of group 2, no precipitates, including PCA, were detected on the dentin surface or in the tubules. Within the limitations of this study, precipitate containing PCA was formed in the tubules of dentin irrigated with NaOCl followed by CHX. No precipitates or PCA were detected in the tubules of dentin irrigated with NaOCl followed by saline and QMiX. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Effectiveness of root canal debris removal using passive ultrasound irrigation with chlorhexidine digluconate or sodium hypochlorite individually or in combination as irrigants.

PubMed

Ferreira, Rafael Brandao; Marchesan, Melissa Andreia; Silva-Sousa, Yara Teresinha; Sousa-Neto, Manoel

2008-07-01

The aim of this in vitro study was to evaluate the cleaning capacity of different auxiliary chemical substances energized with ultrasound in radicular dentin using morphologic analysis. Twenty-eight single-canal, mandibular incisors were prepared with the Hero 642 canal preparation system following the sequence: 25/12, 30/06, 35/02, and 40/02, 1 mm from the apex. The specimens were then divided into four groups of seven teeth. During biomechanical preparation the teeth were irrigated with 2 ml of distilled water between files. Each group of specimens (n=7) received a final irrigation with 100 ml of the following irrigants that were activated with ultrasound for 3 minutes: Group 1- distilled water; Group 2- 0.2% chlorhexidine digluconate (CHX); Group 3- 2.5% sodium hypochlorite (NaOCl); and Group 4-the filtrate obtained after combining 0.2% CHX and 2.5% NaOCl. The apical portions of the root canals from each group were then submitted to histological processing and analyzed using optical microscopy. Results showed statistical differences between the groups (p<0.01). Groups 1 and 2 (distilled water and 0.2% CHX respectively) were statistically similar in terms of a greater amount of debris, whereas 2.5% NaOCl and the filtrate were more efficient in removal of debris. There is no additional benefit in terms of debris removal from root canal walls by irrigating with the filtrate obtained from the combination of NaOCl and CHX when compared to using NaOCl alone. The findings of this study suggest the time and expense of preparing and using a combination of NaOCl and CHX is not warranted compared to using NaOCl alone for root canal irrigation.

Evaluation of new chlorhexidine- and cetylpyridinium chloride-based mouthrinse formulations adjunctive to scaling and root planing: pilot study.

PubMed

García-Gargallo, M; Zurlohe, M; Montero, E; Alonso, B; Serrano, J; Sanz, M; Herrera, D

2017-11-01

To compare the effect of two newly formulated chlorhexidine (CHX) and cetylpyridinium chloride (CPC) mouthrinses after scaling and root planing (SRP) in terms of clinical, microbiological, patient-based variables and adverse events, with a positive control with the same active components, already marketed and tested. A pilot, randomized clinical trial, double-blind, parallel design with 1-month follow-up was conducted. Chronic periodontitis patients requiring non-surgical periodontal therapy were enrolled and randomly assigned to: (i) SRP and test-1 (new reformulation: 0.12% CHX and 0.05% CPC); (ii) SRP and test-2 (new formulation: 0.03% CHX and 0.05% CPC); or (iii) SRP and positive control (commercial product: 0.12% CHX and 0.05% CPC). All variables were evaluated at baseline and 1 month after SRP. Quantitative variables were compared by means of anova or Kruskal-Wallis test and qualitative variables by chi-square or McNemar tests. Thirty patients (10 per group) were included. After 1 month, there were significant differences among groups in plaque levels (P = 0.016) as test-1 showed less sites with plaque than test-2 (31.15% [standard error-SE 2.21%] versus 49.39% [SE 4.60%), respectively). No significant differences were found for global patient perception of the product or in adverse effects. Test groups showed better results in levels and proportions (P = 0.022) of Capnocytophaga spp. Within the limitations of this pilot study, it can be concluded that the newly formulated 0.12% CHX and 0.05% CPC mouthrinse showed larger plaque level reductions, without showing more adverse effects, when compared to the other two mouthrinses, after SRP. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

In vitro effect of chlorhexidine gel on torque and detorque values of implant abutment screw.

PubMed

Asli, Hamid Neshandar; Saberi, Bardia Vadiati; Fatemi, Arezoo Sadat

2017-01-01

Use of chlorhexidine (CHX) gel to eliminate the malodor of implant cavity may decrease the friction coefficient and effective preload and result in abutment screw loosening. This study aimed to assess the effect of CHX gel on the preload, torque, and detorque values. This in vitro experimental study was conducted on three groups of five implants. Group A (G1) was the control group and no material was applied to the implant cavity. In Group B (G2), implant cavity was filled with saliva before abutment screw tightening. In Group C (G3), implant cavity was first filled with saliva and then with CHX gel. The abutments were torqued to 24 N/cm2 according to the manufacturer's instructions and were then loosened. These processes were repeated five times. The ratio of the mean percentage of detorque to torque values was measured in all groups. The collected data were analyzed using ANOVA and post hoc Tukey's test. No significant difference was noted between G1 and G2. Group G2 had significantly higher detorque value (p < 0.05). ANOVA detected a significant difference in the mean torque (p < 0.05) and detorque (p < 0.001) values among the three groups. G3 showed maximum difference between torque and detorque values; the minimum difference was noted in G2. Application of CHX gel (to decrease the malodor of the implant cavity) decreases the detorque and preload values and increases the risk of screw loosening.

Comparison of the in vivo antimicrobial effectiveness of sodium hypochlorite and chlorhexidine used as root canal irrigants: a molecular microbiology study.

PubMed

Rôças, Isabela N; Siqueira, José F

2011-02-01

The purpose of this clinical study was to compare the antimicrobial effects of 2.5% sodium hypochlorite (NaOCl) and 0.12% chlorhexidine digluconate (CHX) when used as irrigants during treatment of teeth with apical periodontitis. Forty-seven single-rooted single-canal teeth with necrotic pulps and asymptomatic apical periodontitis were selected for this study according to stringent inclusion/exclusion criteria. Bacterial samples were taken at the baseline (S1) and after (S2) chemomechanical preparation using 2.5% NaOCl (n = 30) or 0.12% CHX (n = 17) as the irrigant. Bacterial, archaeal, and fungal presence was evaluated by broad-range polymerase chain reaction (PCR), whereas bacterial identifications were performed by a closed-ended reverse-capture checkerboard approach targeting 28 candidate endodontic pathogens. All S1 samples were PCR positive for bacterial presence but negative for both archaea and fungi. Both NaOCl- and CHX-based protocols were significantly effective in reducing the bacterial levels and number of taxa. No significant differences were observed between them in all tested parameters including the incidence of negative PCR results in S2 (40% for NaOCl vs 47% for CHX, p = 0.8), reduction in the number of taxa per canal (p = 0.3), and reduction in the bacterial levels (p = 0.07). The most prevalent taxa in S2 samples from the NaOCl group were Propionibacterium acnes, Streptococcus species, Porphyromonas endodontalis, and Selenomonas sputigena. In the CHX group, the most prevalent taxa in S2 were Dialister invisus, Actinomyces israelii, Prevotella baroniae, Propionibacterium acidifaciens, and Streptococcus species. Treatment protocols using irrigation with either NaOCl or CHX succeeded in significantly reducing the the number of bacterial taxa and their levels in infected root canals, with no significant difference between these substances. Copyright © 2011 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Endotoxin levels after chemomechanical preparation of root canals with sodium hypochlorite or chlorhexidine: a systematic review of clinical trials and meta-analysis.

PubMed

Neelakantan, P; Herrera; Pecorari, V; Gomes, B P F A

2018-06-09

The aim of this systematic review was to answer the following question: In patients with primary endodontic infection, is there a statistically significant difference in the endotoxin levels after chemomechanical preparation with sodium hypochlorite (NaOCl) or chlorhexidine (CHX)? A protocol was prepared and registered on PROSPERO (CRD42017069996). Four electronic databases (MEDLINE via PubMeb, Scopus, Web of Science and Cochrane Library) were searched from their start dates to 1st March 2017 using strict inclusion and exclusion criteria and reviewed following PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Only clinical trials (randomized and non-randomized) that compared the effectiveness of NaOCl and CHX to reduce endotoxins during chemomechanical preparation of teeth with primary endodontic infection were included. Two reviewers independently assessed the eligibility for inclusion, extracted data, and assessed the quality using the risk of bias tool. From 712 articles that resulted from the initial search, 37 studies were included for full-text appraisal; four studies met the inclusion criteria for quantitative synthesis. A single meta-analysis was performed to compare the endotoxin levels before and after chemomechanical preparation with NaOCl or CHX. The forest plot of LPS levels indicated that the data was heterogeneous [I2=63.9%; Tau2=574.5 (P=0.04)]. The use of NaOCl and CHX during chemomechanical preparation reduced LPS levels significantly compared to the initial ones. Chemomechanical canal preparation with both NaOCl and CHX reduced the endotoxin levels compared to the initial levels in primary endodontic infections. When NaOCl was used during chemomechanical preparation, endotoxins levels were lower than those obtained after chemomechanical preparation with CHX. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Qualitative Time-of-Flight Secondary Ion Mass Spectrometry Analysis of Root Dentin Irrigated with Sodium Hypochlorite, EDTA, or Chlorhexidine.

PubMed

Kolosowski, Kamil P; Sodhi, Rana N S; Kishen, Anil; Basrani, Bettina R

2015-10-01

Sodium hypochlorite (NaOCl), chelating agents, and chlorhexidine (CHX), which are commonly used irrigants during endodontic treatment, have the potential to alter the physical and chemical properties of the dentin structure. The aim of this study was to use time-of-flight secondary ion mass spectrometry to qualitatively evaluate the chemical characteristics of dentin surface and compare it with dentin exposed to NaOCl, EDTA, or CHX. Four blocks of dentin from a root of a human maxillary molar were embedded in resin and trimmed with a microtome to expose the dentin. Samples were randomly assigned to 4 treatment groups: (1) no irrigation treatment (sample A), (2) 2.5% NaOCl (sample B), (3) 17% EDTA (sample C), and (4) 2% CHX (sample D). Dentin surfaces were analyzed by time-of-flight secondary ion mass spectrometry, which allowed characterization of dentin surface chemistry by both imaging and mass spectroscopic analysis obtained in high mass and spatial resolution modes. Sample A revealed intense peaks characteristics of hydroxyapatite in addition to Na(+), K(+), CH4N(+), CN(-), CNO(-), Mg(+), F(-), and HCO2(-) peaks. Sample B showed severely decreased CH4N(+) and increased intensity of Cl(-). Sample C lacked Ca(+) and Mg(+) and showed decreased PO2(-) and PO3(-). Sample D exhibited a distinct presence of CHX. The spectral image of sample A displayed even distribution of Na(+) and Ca(+) on a smeared surface. The surfaces of samples B and D had patent dentinal tubules, whereas sample D showed an intense CHX signal. Sample C had some patent dentinal tubules and lacked Ca(+). NaOCl removed protein components from the dentin matrix, EDTA removed calcium and magnesium ions from the dentin, and CHX formed an adsorbed layer on the dentin surface. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Antibacterial Efficacy of Octenisept, Alexidine, Chlorhexidine, and Sodium Hypochlorite against Enterococcus faecalis Biofilms.

PubMed

Bukhary, Sundus; Balto, Hanan

2017-04-01

The purpose of this study was to evaluate the antibacterial effectiveness of Octenisept (OCT; Schülke & Mayr GmBH, Norderstedt, Germany), 1% alexidine (ALX) (Santa Cruz Biotechnology, Inc, Santa Cruz, CA), and 2% chlorhexidine (CHX) against Enterococcus faecalis biofilm using confocal laser scanning microscopy. Root dentin discs were prepared from extracted human teeth, sterilized, and inoculated with E. faecalis strain (ATCC 29212) to establish 3-week-old biofilm model. Infected dentin discs were exposed to OCT (n = 20), 1% ALX (n = 20), and 2% CHX (n = 20) for 10 minutes. Dentin discs (n = 15) exposed to 5.25% sodium hypochlorite (NaOCl) were used as a positive control, whereas specimens exposed to saline (n = 15) were used as a negative control. After exposure, the dentin discs were stained with fluorescent LIVE/DEAD BacLight dye (Invitrogen Molecular Probes, Eugene, OR) and analyzed with confocal laser scanning microscopy to determine the proportion of dead cells in the biofilm. Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney U tests (P < .05). The highest proportion of dead cells was found in the 5.25% NaOCl group (94.14%; range, 92.30%-98.20%) compared with the experimental groups (P < .05). A significantly greater proportion of dead cells was found in the OCT group (74.14%; range, 70.03%-78.96%) compared with the 1% ALX and 2% CHX groups (P < .05). The proportion of dead cells was 43.89% (range, 24.86%-55.63%) and 42.78% (range, 25.45%-55.06%) in the 1% ALX and 2% CHX groups, respectively, with no statistical significant difference between the 2 groups (P > .05). NaOCl had significantly greater antimicrobial activity against E. faecalis biofilms compared with OCT, CHX, and ALX. OCT was more effective than CHX and ALX. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Daily Bathing with Chlorhexidine and Its Effects on Nosocomial Infection Rates in Pediatric Oncology Patients.

PubMed

Raulji, Chittalsinh M; Clay, Kristin; Velasco, Cruz; Yu, Lolie C

2015-01-01

Infections remain a serious complication in pediatric oncology patients. To determine if daily bathing with Chlorhexidine gluconate can decrease the rate of nosocomial infection in pediatric oncology patients, we reviewed rates of infections in pediatric oncology patients over a 14-month span. Intervention group received daily bath with Chlorhexidine, while the control group did not receive daily bath. The results showed that daily bath with antiseptic chlorhexidine as daily prophylactic antiseptic topical wash leads to decreased infection density amongst the pediatric oncology patients, especially in patients older than 12 years of age. Furthermore, daily chlorhexidine bathing significantly reduced the rate of hospital acquired infection in patients older than 12 years of age. The findings of this study suggest that daily bathing with chlorhexidine may be an effective measure of reducing nosocomial infection in pediatric oncology patients.

The effect of umbilical cord cleansing with chlorhexidine on omphalitis and neonatal mortality in community settings in developing countries: a meta-analysis

PubMed Central

2013-01-01

Background There is an increased risk of serious neonatal infection arising through exposure of the umbilical cord to invasive pathogen in home and facility births where hygienic practices are difficult to achieve. The World Health Organization currently recommends ‘dry cord care’ because of insufficient data in favor of or against topical application of an antiseptic. The primary objective of this meta-analysis is to evaluate the effects of application of chlorhexidine (CHX) to the umbilical cord to children born in low income countries on cord infection (omphalitis) and neonatal mortality. Standardized guidelines of Child Health Epidemiology Reference Group (CHERG) were followed to generate estimates of effectiveness of topical chlorhexidine application to umbilical cord for prevention of sepsis specific mortality, for inclusion in the Lives Saved Tool (LiST). Methods Systematic review and meta-analysis. Data sources included Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, PubMed, CINHAL and WHO international clinical trials registry. Only randomized trials were included. Studies of children in hospital settings were excluded. The comparison group received no application to the umbilical cord (dry cord care), no intervention, or a non-CHX intervention. Primary outcomes were omphalitis and all-cause neonatal mortality. Results There were three cluster-randomised community trials (total participants 54,624) conducted in Nepal, Bangladesh and Pakistan that assessed impact of CHX application to the newborn umbilical cord for prevention of cord infection and mortality. Application of any CHX to the umbilical cord of the newborn led to a 23% reduction in all-cause neonatal mortality in the intervention group compared to control [RR 0.77, 95 % CI 0.63, 0.94; random effects model, I2=50 %]. The reduction in omphalitis ranged from 27 % to 56 % compared to control group depending on severity of infection. Based on CHERG rules, effect size for all-cause mortality was used for inclusion to LiST model as a proxy for sepsis specific mortality. Conclusions Application of CHX to newborn umbilical cord can significantly reduce incidence of umbilical cord infection and all-cause mortality among home births in community settings. This inexpensive and simple intervention can save a significant number of newborn lives in developing countries. PMID:24564621

Antibacterial and residual antimicrobial activities against Enterococcus faecalis biofilm: A comparison between EDTA, chlorhexidine, cetrimide, MTAD and QMix.

PubMed

Zhang, Rui; Chen, Min; Lu, Yan; Guo, Xiangjun; Qiao, Feng; Wu, Ligeng

2015-08-06

We compared the antibacterial and residual antimicrobial activities of five root canal irrigants (17% EDTA,2% chlorhexidine,0.2% cetrimide, MTAD, and QMix) in a model of Enterococcus faecalis biofilm formation. Sixty dentin blocks with 3-week E. faecalis biofilm were divided into six equal groups and flushed with irrigant for 2 min or left untreated. A blank control group was also established. Antibacterial activities of the irrigants were evaluated by counting colony forming units. To test residual antimicrobial activities, 280 dentin blocks were divided into seven equal groups and flushed with irrigant for 2 min or left untreated and then incubated with E. faecalis suspension for 48 h, or used as a blank. No bacteria were observed in the blank control group. The number of viable E. faecalis was significantly fewer in the irrigant-treated groups compared with the untreated control (P < 0.05). Among the five irrigants, QMix had the strongest antibacterial activity. Residual antimicrobial activities of CHX were significantly higher at 12 h, 24 h and 36 h compared to untreated control (P < 0.05). All five root canal irrigants were effective to some extent against E. faecalis, but QMix and CHX had the strongest, and CHX the longest (up to 36 h), antimicrobial activity.

Antimicrobial activity of Chlorhexidine, Peracetic acid and Sodium hypochlorite/etidronate irrigant solutions against Enterococcus faecalis biofilms.

PubMed

Arias-Moliz, M T; Ordinola-Zapata, R; Baca, P; Ruiz-Linares, M; García García, E; Hungaro Duarte, M A; Monteiro Bramante, C; Ferrer-Luque, C M

2015-12-01

To evaluate the antimicrobial effect of 2.5% sodium hypochlorite alone (NaOCl) and associated with 9% HEBP (NaOCl/HEBP), 2% peracetic acid (PAA) and 2% chlorhexidine (CHX), on the viability of Enterococcus faecalis biofilms attached to dentine. Biofilms of E. faecalis were grown on the surface of dentine blocks for 5 days and then exposed to the irrigating solutions for 3 min. Distilled water was used as the control. The total biovolume and the percentage of dead cells of the infected dentine were measured by means of confocal microscopy and the live/dead technique. Nonparametric tests were used to determine statistical differences (P < 0.05). NaOCl and the NaOCl/HEBP mixture were associated with a significantly greater percentage of dead cells, followed by PAA (P < 0.05). No significant antimicrobial effect of CHX was observed in comparison with the control group. Total biovolume decreased significantly in NaOCl, NaOCl/HEBP and PAA solutions in comparison with the CHX and control groups. NaOCl alone or associated with HEBP were the most effective irrigant solutions in dissolving and killing E. faecalis biofilms. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Inhibitory effects of antiseptic mouthrinses on Streptococcus mutans, Streptococcus sanguinis and Lactobacillus acidophilus.

PubMed

Evans, A; Leishman, S J; Walsh, L J; Seow, W K

2015-06-01

Oral antiseptics are valuable in controlling oral infections caused by cariogenic bacteria. The aim of this study was to investigate the effects of mouthrinses and pure antiseptic compounds on Streptococcus mutans and non-mutans bacteria (Streptococcus sanguinis and Lactobacillus acidophilus). The agar diffusion assay was employed to determine bacterial growth inhibition. Commercial mouthrinses containing chlorhexidine gluconate (0.2%), cetylpyridinium chloride (0.05%) and sodium fluoride (0.05%) produced statistically similar growth inhibition of S. mutans, S. sanguinis and L. acidophilus (with zones of inhibition ranging from 7.56 ± 0.52 mm to 7.39 ± 0.53 mm, 17.44 ± 0.94 mm to 18.31 ± 0.62 mm and 8.61 ± 1.43 to 8.67 ± 1.43 mm respectively, p > 0.05). The chlorhexidine mouthwash produced the greatest mean growth inhibition of S. sanguinis and S. mutans compared to all other mouthrinses tested (p < 0.01). The minimum concentrations at which inhibition against S. mutans could be detected were chlorhexidine gluconate at 0.005% (wt/vol), cetylpyridinium chloride 0.01% (wt/ vol), povidone iodine 10% (wt/vol) and sodium hypochlorite 0.5% (vol/vol). Chlorhexidine (0.01%), cetylpyridinium chloride (0.01%), povidone iodine (10%) and sodium hypochlorite (0.5%) are effective at inhibiting the growth of S. mutans, S. sanguinis and L. acidophilus. © 2015 Australian Dental Association.

Antibacterial action of calcium hydroxide vehicles and calcium hydroxide pastes.

PubMed

Pacios, María Gabriela; Silva, Clara; López, María Elena; Cecilia, Marta

2012-11-01

To evaluate the in vitro action of vehicles alone and with calcium hydroxide against different bacterial species. Agar plates were inoculated with the microbial suspensions, and wells were made and filled with the calcium hydroxide pastes and the vehicles used to prepare the pastes. The zones of inhibited bacterial growth were recorded, and the resulting measurements were statistically analyzed. Enterococcus faecalis was the most resistant microorganism to all medicaments. Calcium hydroxide + p-monochlorophenol; calcium hydroxide + p-monochlorophenol-propylene glycol pastes; and p-monochlorophenol, p-monochlorophenol-propylene glycol, and chlorhexidine gluconate gel alone showed the largest zones of inhibition against all the tested microorganisms. The vehicle used to prepare the calcium hydroxide paste might contribute to its antibacterial action. Chlorhexidine gluconate gel used alone, and camphorated p-monochlorophenol and camphorated p-monochlorophenol-propylene glycol as vehicles of calcium hydroxide, could be recommended, in an antimicrobial sense. © 2012 Wiley Publishing Asia Pty Ltd.

Outer membrane changes in Pseudomonas stutzeri resistant to chlorhexidine diacetate and cetylpyridinium chloride.

PubMed

Tattawasart, U; Maillard, J Y; Furr, J R; Russell, A D

2000-11-01

Changes in outer membrane proteins (OMP) and lipopolysaccharide (LPS) in cells of strains of Pseudomonas stutzeri sensitive and resistant to chlorhexidine diacetate (CHA) or cetylpyridinium chloride (CPC) have been examined. Four of five CHA-resistant strains had alterations in OMP profiles, including the expression of two additional protein bands. All the CPC-resistant strains had altered OMP profiles but the changes varied from strain to strain. Loss of the fastest-migrating bands was observed in the LPS from CHX-resistant strains. In strain JM 302R with high-level CHX resistance (minimal inhibitory concentration 100 mg/l as opposed to 2.5 mg/l in the parent-strain, JM 302), all the fast-migrating bands were lost and the strain showed 'cross-resistance' to polymyxin, gentamicin and ethylenediamine tetraacetic acid. It is however, possible that the altered LPS patterns reflect a response to alterations in other components rather than being directly associated per se with the enhanced resistance.

Comparative effect of fluoride, essential oil and chlorhexidine mouth rinses on dental plaque and gingivitis in patients with and without dental caries: a randomized controlled trial.

PubMed

Charugundla, B R; Anjum, S; Mocherla, M

2015-05-01

The objective of this study was to compare the effectiveness of fluoride, essential oil (EO) and chlorhexidine (CHX)-containing mouth rinses on dental plaque and gingivitis and to compare their relative efficacy in patients with and without dental caries. A randomized, controlled, double- blind, crossover clinical trial was conducted for a period of 8 weeks. Thiry-six qualifying subjects, aged 12-44 years, were included in the study. Subjects were divided into caries and caries-free groups and were randomly assigned to one of the following mouth rinse groups: fluoride; EO; CHX and saline as negative control. Subjects used their respective mouth rinse for a period of 7-days each with 1-week wash-out periods. Primary efficacy variables were Quigley-Hein plaque index (PI) and Loe and Silness gingival index. Fluoride and CHX mouth rinses showed significant reduction in plaque after use of mouth rinses (P < 0.05). However, no significant differences were observed with respect to each other in reducing gingivitis (P > 0.05). Further significant differences were found in reducing plaque and gingivitis in caries-free subjects in comparison to those with caries (P < 0.05). All the three mouth rinses significantly reduced plaque accumulation and gingivitis especially in caries-free subjects in comparison to those with caries, and amongst the three, fluoride and CHX proved to be more effective than EO mouth rinse. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Antibacterial and antiplaque efficacy of a commercially available octenidine-containing mouthrinse.

PubMed

Welk, Alexander; Zahedani, Maral; Beyer, Carolin; Kramer, Axel; Müller, Gerald

2016-09-01

The purpose of this clinical study was to determine the antibacterial and antiplaque efficacy of a recently introduced octenidine-containing mouthrinse (Octenidol®) in comparison with established antiseptic mouthrinses. In a 4-day plaque-regrowth study employing a four-replicate cross-over design, a 0.1 % octenidine mouthrinse (Octenidol®/OCT-MR) was compared with a 0.12 % chlorhexidine mouthrinse (Paroex®/CHX-MR), an essential oil mouthrinse (Listerine®/EO-MR), and a placebo mouthrinse/P-MR. Plaque regrowth was assessed with a modified Quigley-Hein plaque index. The antibacterial effect was assessed by taking bacterial counts from the tooth surface and oral mucosa after professional tooth cleaning and after first rinsing with the allocated mouthrinse on days 1 and 5. Sixteen volunteers suspended tooth cleaning and rinsed twice daily with the allocated mouthrinse for 4 days. All tested antiseptic mouthrinses were significantly more effective than the placebo mouthrinse in inhibiting plaque, but no significant differences were observed between OCT-MR and CHX-MR, OCT-MR and EO-MR, and CHX-MR and EO-MR. After 4 days, comparable bacterial count levels were found on both the tooth surface and mucosa applying OCT-MR and CHX-MR, which were significantly lower than that of EO-MR and P-MR. Octenidol® and Paroex® showed comparable antibacterial and antiplaque efficacy in the human oral cavity. The recently introduced octenidine-containing mouthrinse Octenidol® may become a suitable alternative to 0.12 % chlorhexidine-containing mouthrinses such as Paroex®.

Effect of fluoride and chlorhexidine digluconate mouthrinses on plaque biofilms.

PubMed

Rabe, Per; Twetman, Svante; Kinnby, Bertil; Svensäter, Gunnel; Davies, Julia R

2015-01-01

To develop a model in which to investigate the architecture of plaque biofilms formed on enamel surfaces in vivo and to compare the effects of anti-microbial agents of relevance for caries on biofilm vitality. Materials and Methodology : Enamel discs mounted on healing abutments in the pre-molar region were worn by three subjects for 7 days. Control discs were removed before subjects rinsed with 0.1% chlorhexidine digluconate (CHX) or 0.2% sodium fluoride (NaF) for 1 minute. Biofilms were stained with Baclight Live/Dead and z-stacks of images created using confocal scanning laser micoscopy. The levels of vital and dead/damaged bacteria in the biofilms, assessed as the proportion of green and red pixels respectively, were analysed using ImageTrak(®) software. Results : The subjects showed individual differences in biofilm architecture. The thickness of the biofilms varied from 28-96µm although cell density was always the greatest in the middle layers. In control biofilms, the overall levels of vitality were high (71-98%) especially in the area closest to the enamel interface. Rinsing with either CHX or NaF caused a similar reduction in overall vitality. CHX exerted an effect throughout the biofilm, particularly on the surface of cell clusters whereas NaF caused cell damage/death mainly in the middle to lower biofilm layers. Conclusion : We describe a model that allows the formation of mature, undisturbed oral biofilms on human enamel surfaces in vivo and show that CHX and NaF have a similar effect on overall vitality but differ in their sites of action.

Antimicrobial Activity of Endodontic Medicaments and Vehicles using Agar Well Diffusion Method on Facultative and Obligate Anaerobes

PubMed Central

Bhat, Kishore G; Sogi, Suma

2016-01-01

Aims The aim of this study was to determine the relative antimicrobial effectiveness of these endodontic medicaments and various vehicles using an agar well diffusion assay. Materials and methods Double Antibiotic Paste(DAP), modified DAP, 2% Chlorhexidine gluconate and their combination with four vehicles namely Polyethylene glycol 400 (PEG), Propylene glycol (PG), combinations of PG with PEG and lastly Glycerine were tested using agar well diffusion assay. The minimum bactericidal concentration was noted against four standard strains of organisms ie Streptococcus mutans ATCC( American Type Culture Collection) 25175, Staphylococcus aureus ATCC 12598, Enterococcus faecalis ATCC 35550 and Eschericia coli ATCC 25922. Successful endodontic therapy depends upon thorough disinfection of root canals. In some refractory cases, routine endodontic therapy is not sufficient, so intracanal medicaments are used for proper disinfection of canals. Issues of resistance, limited spectrum of activity and lack of antifungal properties, the hunt for the ideal intracanal medicament continues. In this regard, the vehicles used to form the pastes play a supportive role by forming the appropriate consistency for placement and may dramatically influence their chemical characteristics like their solubility and diffusion. Thus, inorder to use safer and equally effective intracanal medicaments, Chlorhexidine gluconate is being unveiled in this study. Results The difference between the four vehicles when combined with the same endodontic medicament studied above is nonsignificant (NS) except against Porphyromonas gingivalis. Propylene glycol is significantly effective than Glycerine when used with DAP ie C+M medicament combination. (p = 0.029) Conclusion 2% chlorhexidine gluconate and modified DAP can definitely replace DAP and triple antibiotic paste as end-odontic medicaments with chlorhexidine having an added advantage of bactericidal action, substantivity, biocompatibility, low toxicity, and lesser chances of developing resistance. How to cite this article Nalawade TM, Bhat KG, Sogi S. Antimicrobial Activity of Endodontic Medicaments and Vehicles using Agar Well Diffusion Method on Facultative and Obligate Anaerobes. Int J Clin Pediatr Dent 2016;9(4):335-341. PMID:28127166

In vitro antimicrobial activity of Sodium hypochlorite, Chlorhexidine gluconate and Octenidine Dihydrochloride in elimination of microor- ganisms within dentinal tubules of primary and permanent teeth

PubMed Central

Bodur, Haluk; Ece, Gülden

2012-01-01

The aim of this study was to evaluate the effectiveness of different irrigation solutions at different time intervals for the elimination of E.faecalis and C.albicans penetrated into the dentine tubules of primary and permanent teeth in vitro. The 4 mm primary and permanent teeth sections were sterilized and contaminated with a mixture of E.faecalis and C.albicans strains. After the application of different irrigation solutions (Sodium hypochlorite, Chlorhexidine gluconate, Octenidine Dihydrochloride, saline) to the contaminated tooth sections according to study groups, neutralizers were applied for inactivation of the solutions after 30 sec, 1 min and 5 min. Dentine shavings were placed into TSB and 10µL from each tube was inoculated on agar plates, followed by an incubation period of 24h at 37°C. The colonies were counted macroscopically. The results were compared by using Kruskal-Wallis and Mann Whitney U tests, with a significance level at p<0.05. Among the irrigation solutions that were tested against E.faecalis on primary and permanent teeth, the most effective one was found as 5-minute application of 0.1% Octenidine Dihydrochloride. The antibacterial effects of the tested solutions on the same time periods against C.albicans revealed no significant difference. There were no statistically significant differences between primary and permanent teeth with respect to the antimicrobial activity of the tested solutions. Moreover, Octenidine Dihydrochloride may be used as an alternative endodontic irrigant. Key words:Chlorhexidine gluconate, dentine tubules, irrigation solutions, Octenidine Dihydrochloride, Sodium hypochlorite. PMID:22143724

Antimicrobial and physical characteristics of orthodontic primers containing antimicrobial agents.

PubMed

Chung, Shin-Hye; Cho, Soha; Kim, Kyungsun; Lim, Bum-Soon; Ahn, Sug-Joon

2017-03-01

To compare the antimicrobial and physical properties of experimental primers containing chlorhexidine (CHX) or ursolic acid (UA) with a commercial primer. Two antibacterial agents, 3 mg each of CHX and UA were incorporated respectively into 1 ml of Transbond XT primer (TX) to form antibacterial primers, TX-CHX and TX-UA. The antimicrobial activity of the three primers (TX, TX-CHX, and TX-UA) against Streptococcus mutans in both planktonic and biofilm phases was analyzed by determining minimum inhibitory and bactericidal concentrations and by performing growth and biofilm assays. Growth and biofilm assays were performed in both the absence and presence of thermocycling in a water tank to analyze the effects of water aging on the antimicrobial activities of primers. After bonding brackets onto bovine incisors using the primers, shear bond strength and mode of fracture were analyzed to compare physical properties. TX-CHX had stronger antimicrobial activity against S. mutans in the planktonic and biofilm phases than did TX or TX-UA. When applied, TX-CHX completely inhibited the growth and biofilm formation of S. mutans . In addition, the antimicrobial activity of TX-CHX was maintained after thermocycling. However, TX-UA did not show significant antimicrobial activity compared with TX. There was no significant difference in either shear bond strength or bond failure interface among the primers. Incorporation of CHX into an orthodontic primer may help prevent enamel demineralization around surfaces without compromising its physical properties.

Health care providers' perspectives regarding the use of chlorhexidine gel for cord care in neonates in rural Kenya: implications for scale-up.

PubMed

Muriuki, Angela; Obare, Francis; Ayieko, Bill; Matanda, Dennis; Sisimwo, Kenneth; Mdawida, Brian

2017-04-26

This paper explores the perspectives of health care providers regarding the use of 7.1% Chlorhexidine Digluconate (CHX) gel that releases 4% chlorhexidine for newborn umbilical cord care under a managed access program (MAP) implemented in Bungoma County of Kenya. Understanding the perspectives of providers regarding CHX is important since they play a key role in the health system and the fact that their views could be influenced by prior beliefs and inconsistent practices regarding umbilical cord care. Data are from in-depth interviews conducted between April and June 2016 with 39 service providers from 21 facilities that participated in the program. The data were transcribed, typed in Word and analyzed for content. Analysis entailed identifying recurring themes based on the interview guides. Use of CHX gel for cord care in neonates was acceptable to the health care providers, with all of them supporting scaling up its use throughout the country. Their views were largely influenced by positive outcomes of the medication including fast healing of the cord as reported by mothers, minimal side effects, reduced newborn infections based on what their records showed and mothers' reports, ease of use that made it simple for them to counsel mothers on how to apply it, positive feedback from mothers which demonstrated satisfaction with the medication, and general acceptance of the medication by the community. They further noted that successful scale-up of the medication required community sensitization, adequate follow-up mechanisms to ensure mothers use the medication correctly, addressing issues of staffing levels and staff training, developing guidelines and protocols for provision of the medication, adopting appropriate service delivery approaches to ensure all groups of mothers are reached, and ensuring constant supply of the medication. Use of CHX gel for cord care in neonates is likely to be acceptable to health care workers in settings with high prevalence of neonatal morbidity and mortality arising from cord infections. In scaling up the use of the medication in such settings, some of the health systems requirements for successful roll-out can be addressed by programs while others are likely to be a persistent challenge.

Chlorhexidine gluconate, its properties and applications in endodontics

PubMed Central

Mohammadi, Zahed

2008-01-01

The major objective in endodontic therapy is to disinfect the entire root canal system. This requires that the pulpal content be eliminated as sources of infection. This goal may be accomplished by mechanical instrumentation and chemical irrigation, in conjunction with medication of the root canal between treatment sessions. Microorganisms and their by-products are considered to be the major cause of pulpal and periradicular pathosis. In order to reduce or eliminate bacteria from the root canal system, various irrigants have been used during treatment. Chlorhexidine is a cationic solution which can be used during treatment. It has a wide range of antimicrobial activity. Furthermore, because of its cationic structure, chlorhexidine has a unique property named substantivity. The purpose of this paper is to review different aspects of chlorhexidine in endodontics. PMID:24265633

SCI with Brain Injury: Bedside-to-Bench Modeling for Developing Treatment and Rehabilitation Strategies

DTIC Science & Technology

2012-10-01

GLUCONATE 1 SIMVASTATIN 2 SIMVASTATIN 1 METOPROLOL 1 METOPROLOL 1 Discharge  Medications Note that the length of stay in rehabilitation is shorter in SCVMC...ENOXAPARIN 3 ENOXAPARIN 3 GABAPENTIN 3 GABAPENTIN 2 DOXYCYCLINE 3 DOXYCYCLINE 1 LISINOPRIL 3 LISINOPRIL 1 CHLORHEXIDINE 2 CHLORHEXIDINE 2 METOPROLOL 2... METOPROLOL 2 DEXTROSE 2 DEXTROSE 1 MICONAZOLE 2 MICONAZOLE 1 HEPARIN 1 HEPARIN 3 FENTANYL 1 FENTANYL 2 BACLOFEN 1 BACLOFEN 1 FERROUS  SULFATE 1 FERROUS

Antimicrobial efficacy of the combination of chlorhexidine digluconate and dexpanthenol

PubMed Central

Kramer, Axel; Assadian, Ojan; Koburger-Janssen, Torsten

2016-01-01

Objective: The objective of this standardised experimental study was to investigate the antimicrobial efficacy of the combination of chlorhexidine digluconate (CHX) and the anti-inflammatory pro-vitamin dexpanthenol, which stimulates wound-healing, in the form of Bepanthen® Antiseptic Wound Cream, in order to rule out possible antagonistic combination effects of CHX and the alcohol analogue of pantothenic acid (vitamin B5) dexpanthenol. Method: Testing was carried out using the quantitative suspension test at conditions simulating wound bio-burden. Test strains included Enterococcus hirae (ATCC 10541) and Candida albicans (ATCC 10231) in accordance with the standard methods of the German Hygiene and Microbiology Society with the following three organic challenges: i) cell culture medium MEM with Earle’s salts, L-glutamine and 10% foetal calf serum (CCM); ii) 10% sheep’s blood; iii) or a mixture of 4.5% albumin, 4.5% sheep’s blood and 1% mucin. For methodological reasons, the wound cream was tested as a 55% dilution, prepared with 1% Tween 80 (equivalent to a content of 0.275% CHX instead of 0.5% as in the original preparation). CHX 0.275% was tested as control in an aqueous solution and in 1% Tween 80. Additionally, 1% Tween 80 was tested in order to rule out an interfering effect of the dilution medium. A combination of 3% Tween 80, 3% saponin, 0.1% histidine, 0.3% lecithin, 0.5% Na-thiosulphate and 1% ether sulphate was identified as the most appropriate neutraliser during the experiments. Results: Exposed to CCM or 10% sheep’s blood, the tested wound cream fulfilled the requirements for a wound antiseptic against both test species with ≥3 log reduction at 10 minutes. Even at the the worst-case challenge test with 4.5% albumin, 4.5% sheep’s blood and 1% mucin, the requirement for a ≥3 log reduction was met after 24 hours of exposure. Interestingly, the aqueous solution of 0.275% CHX tested as control did not achieve the antimicrobial efficacy of the combination of CHX and 5% dexpanthenol. 1% Tween 80 was ineffective against both test species. Conclusion: Bepanthen® Antiseptic Wound Cream achieves the in vitro bactericidal and fungicidal efficacy required for a wound antiseptic under three different challenges, despite dilution to 55% of the original preparation. So far, the addition of dexpanthenol was intended to support wound healing. However, our results indicate that the antiseptic efficacy of CHX is synergistically increased by adding 5% dexpanthenol. Acknowledging the antimicrobial and residual efficacy of CHX, and bearing in the mind the contraindications to CHX (allergy and anaphylaxis), the tested wound cream should be regarded as better suitable to be used as wound antiseptic than preparations on basis of CHX alone. PMID:27999767

Antimicrobial efficacy of the combination of chlorhexidine digluconate and dexpanthenol.

PubMed

Kramer, Axel; Assadian, Ojan; Koburger-Janssen, Torsten

2016-01-01

Objective: The objective of this standardised experimental study was to investigate the antimicrobial efficacy of the combination of chlorhexidine digluconate (CHX) and the anti-inflammatory pro-vitamin dexpanthenol, which stimulates wound-healing, in the form of Bepanthen ® Antiseptic Wound Cream, in order to rule out possible antagonistic combination effects of CHX and the alcohol analogue of pantothenic acid (vitamin B5) dexpanthenol. Method: Testing was carried out using the quantitative suspension test at conditions simulating wound bio-burden. Test strains included Enterococcus hirae (ATCC 10541) and Candida albicans (ATCC 10231) in accordance with the standard methods of the German Hygiene and Microbiology Society with the following three organic challenges: i) cell culture medium MEM with Earle's salts, L-glutamine and 10% foetal calf serum (CCM); ii) 10% sheep's blood; iii) or a mixture of 4.5% albumin, 4.5% sheep's blood and 1% mucin. For methodological reasons, the wound cream was tested as a 55% dilution, prepared with 1% Tween 80 (equivalent to a content of 0.275% CHX instead of 0.5% as in the original preparation). CHX 0.275% was tested as control in an aqueous solution and in 1% Tween 80. Additionally, 1% Tween 80 was tested in order to rule out an interfering effect of the dilution medium. A combination of 3% Tween 80, 3% saponin, 0.1% histidine, 0.3% lecithin, 0.5% Na-thiosulphate and 1% ether sulphate was identified as the most appropriate neutraliser during the experiments. Results: Exposed to CCM or 10% sheep's blood, the tested wound cream fulfilled the requirements for a wound antiseptic against both test species with ≥3 log reduction at 10 minutes. Even at the the worst-case challenge test with 4.5% albumin, 4.5% sheep's blood and 1% mucin, the requirement for a ≥3 log reduction was met after 24 hours of exposure. Interestingly, the aqueous solution of 0.275% CHX tested as control did not achieve the antimicrobial efficacy of the combination of CHX and 5% dexpanthenol. 1% Tween 80 was ineffective against both test species. Conclusion: Bepanthen ® Antiseptic Wound Cream achieves the in vitro bactericidal and fungicidal efficacy required for a wound antiseptic under three different challenges, despite dilution to 55% of the original preparation. So far, the addition of dexpanthenol was intended to support wound healing. However, our results indicate that the antiseptic efficacy of CHX is synergistically increased by adding 5% dexpanthenol. Acknowledging the antimicrobial and residual efficacy of CHX, and bearing in the mind the contraindications to CHX (allergy and anaphylaxis), the tested wound cream should be regarded as better suitable to be used as wound antiseptic than preparations on basis of CHX alone.

Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study

PubMed Central

John, Priya; Lazarus, Flemingson; Selvam, Arul; Prabhuji, Munivenkatappa Lakshmaiah Venkatesh

2015-01-01

Introduction PerioChip a bovine origin gelatine based CHX chip has shown beneficial effects in the management of Chronic Periodontitis. A new fish collagen based CHX chip similar to PerioChip is currently available; however this product has not been thoroughly researched. Aim The aim of the present study was to evaluate the effectiveness of a new Piscean collagen-based controlled-release chlorhexidine chip (CHX chip) as an adjunctive therapy to scaling and root planing (SRP). Settings and Design The study was conducted as a randomised, split-mouth, controlled clinical trial at Krishnadevaraya College of Dental Sciences, Bangalore, India. Materials and Methods In a split–mouth study involving 20 sites in 10 patients with chronic periodontitis, control sites received scaling and root planing and test sites received scaling and root planing (SRP) and the intrapocket CHX chip placement as an adjunct. Subgingival plaque samples were collected from both control and test sites at baseline, 11 days and 11 weeks and the anaerobic colony count were assessed. Clinical parameters that were recorded at baseline and 11 weeks were gingival index, Plaque index, Probing pocket depth (PPD), and Clinical attachment level (CAL). Plaque index was recorded additionally at 11 days. Results In the test group there was a statistically significant reduction in the total anaerobic colony count, gingival index and plaque scores from baseline as compared to control sites at all time intervals. An additional 0.8mm reduction in mean probing pocket depth was noted in the test group. Gain in Clinical attachment level was comparable in both groups. Conclusion The adjunctive use of the new collagen-based CHX chip yielded significant antimicrobial benefit accompanied by a reduction in probing depth and a clinical attachment level gain as compared to SRP alone. This suggests that it may be a useful treatment option of nonsurgical periodontal treatment of chronic periodontitis. PMID:26155567

Antibacterial and residual antimicrobial activities against Enterococcus faecalis biofilm: A comparison between EDTA, chlorhexidine, cetrimide, MTAD and QMix

NASA Astrophysics Data System (ADS)

Zhang, Rui; Chen, Min; Lu, Yan; Guo, Xiangjun; Qiao, Feng; Wu, Ligeng

2015-08-01

We compared the antibacterial and residual antimicrobial activities of five root canal irrigants (17% EDTA,2% chlorhexidine,0.2% cetrimide, MTAD, and QMix) in a model of Enterococcus faecalis biofilm formation. Sixty dentin blocks with 3-week E. faecalis biofilm were divided into six equal groups and flushed with irrigant for 2 min or left untreated. A blank control group was also established. Antibacterial activities of the irrigants were evaluated by counting colony forming units. To test residual antimicrobial activities, 280 dentin blocks were divided into seven equal groups and flushed with irrigant for 2 min or left untreated and then incubated with E. faecalis suspension for 48 h, or used as a blank. No bacteria were observed in the blank control group. The number of viable E. faecalis was significantly fewer in the irrigant-treated groups compared with the untreated control (P < 0.05). Among the five irrigants, QMix had the strongest antibacterial activity. Residual antimicrobial activities of CHX were significantly higher at 12 h, 24 h and 36 h compared to untreated control (P < 0.05). All five root canal irrigants were effective to some extent against E. faecalis, but QMix and CHX had the strongest, and CHX the longest (up to 36 h), antimicrobial activity.

Effects of chlorhexidine on a tongue-flora microcosm and VSC production using an in vitro biofilm perfusion model.

PubMed

Greenman, J; McKenzie, C; Saad, S; Wiegand, B; Zguris, J C

2008-12-01

An in vitro perfusion biofilm model, derived from tongue-scrape microflora removed from one individual, was employed to study sulfide biogenesis and the effects of repeated exposure to chlorhexidine (CHX). Volatile sulfur compounds (VSC) were measured using a carbon veil electrode within the biofilm and a halimeter for liquid and gas phase levels, respectively. The microflora of the perfusate and the biofilm were assessed by microbiological techniques and polymerase chain reaction (PCR) to estimate diversity. Biofilms treated with a 1 mL pulse of 0.1% CHX twice a day for three days showed (1) a large reduction in viable count (>90% kill), (2) a (slow) reduction in the VSC production rate, consistent with the reduction in microbes rather than direct inhibitory effects on the biotransformation steps, and (3) a preferential reduction of strict anaerobes. Treated biofilms allowed to recover over 3-5 days showed a nominal amount of regrowth in some experiments, although population numbers were still well below those found in untreated controls. The microbiological composition of biofilms treated but allowed to recover was markedly different from the controls, with proportionally fewer strict anaerobes. Thus, CHX treatment caused detectable ecological shifts with consequent long-term effects on the response of the biofilm in terms of VSC generation, consistent with clinical observations. The model appears highly suited for testing the efficacy of putative anti-malodour or antimicrobial agents.

Root caries prevention via sodium fluoride, chlorhexidine and silver diamine fluoride in vitro.

PubMed

Göstemeyer, Gerd; Kohls, Anna; Paris, Sebastian; Schwendicke, Falk

2018-01-31

Uncertainty exists as to how to best prevent root caries development. The aim of the present study was to compare sodium fluoride (NaF), chlorhexidine (CHX) and silver diamine fluoride (SDF) varnishes (V) and rinses (R) regarding their caries preventive effect in an artificial caries biofilm model. 140 bovine root dentin samples were cut, polished and embedded. Samples were allocated to seven treatment groups (n = 20/group): Four varnishes (applied once prior biofilm challenge): 38% SDF (SDFV), 35% CHX-varnish (CHXV), 22,600 ppm NaF-varnish (NaFV), placebo-varnish (PV); two rinses (applied once daily during biofilm challenge): 500 ppm NaF solution (NaFR), 0.1% CHX solution (CHXR); one untreated group. Caries was induced in a multi-station, continuous-culture Lactobacillus rhamnosus GG (LGG) biofilm model. Bacteria were inoculated 1 × daily, while 2% sucrose was supplied 8 ×/day followed by artificial saliva for 10 min. After 12 days, mineral loss (ΔZ) was measured in the effect area and adjacent to the varnished areas. Bacterial counts were assessed on de-Man-Rogosa-Sharpe agar. ΔZ was significantly lower in the NaFR group compared with all other groups. Varnishes did not significantly prevent mineral loss in adjacent areas. None of the agents had a significant antimicrobial effect on LGG. Regular fluoride rinses showed highest root caries-preventive effect.

Microbicidal activity of octenidine hydrochloride, a new alkanediylbis[pyridine] germicidal agent.

PubMed Central

Sedlock, D M; Bailey, D M

1985-01-01

The potential of octenidine hydrochloride (WIN 41464-2) as a topical microbicide was measured both by in vitro death kinetics and reductions in numbers of bacteria on the skin of cynomolgus monkeys. Semilogarithmic survival curves were plotted to measure the microbicidal activity of various concentrations of octenidine against Staphylococcus aureus. The microbicidal activity of octenidine was also determined for Staphylococcus epidermidis, Proteus mirabilis, Streptococcus pyogenes, Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa, Serratia marcescens, and Candida albicans. Death rates for the same microbial strains were compared with those obtained by using chlorhexidine gluconate. Octenidine concentrations of less than 1.5 microM (0.94 microgram/ml) caused a greater than 99% reduction of each microbial population within 15 min. Staphylococcus epidermidis was the most susceptible of the test organisms, and E. coli and C. albicans were the least susceptible. Octenidine was more active than chlorhexidine against each test strain. Skin-degerming activities of aqueous and formulated octenidine and formulated chlorhexidine were compared in single and multiple applications of these agents to the hand and foot surfaces of monkeys by using a glove-juice extraction procedure to measure the skin microflora. Aqueous octenidine, at a concentration of 0.2 to 1.6% reduced resident microflora populations from 90 to 99.98%, depending on the concentration and number of applications. Octenidine formulated at 2% in a surfactant-based vehicle exhibited significantly better skin-degerming activity than did either a nonmedicated vehicle or the Hibiclens brand of 4% chlorhexidine gluconate. PMID:3909955

Photodynamic Inactivation of Actinomyces naeslundii in Comparison With Chlorhexidine and Polyhexanide--A New Approach for Antiseptic Treatment of Medication-Related Osteonecrosis of the Jaw?

PubMed

Hafner, Sigurd; Ehrenfeld, Michael; Storz, Enno; Wieser, Andreas

2016-03-01

Local antimicrobial therapy is a fundamental principle in the treatment of lesions of medication-related osteonecrosis of the jaw. Antimicrobial photodynamic therapy (aPDT) as a local application for the treatment of microbial infections has become more widely used in recent years. In the mouth, the bone surface is in constant contact with saliva and thus cannot be kept sterile, making the development of strategies for disinfection even more important. Different methods currently in use include local rinses with chlorhexidine (CHX), polyhexanide (PHX), or aPDT. This study compared the efficiency of these 3 methods. The in vitro activity of 3 different agents against slowly growing Actinomyces naeslundii isolated from a patient with osteonecrosis was evaluated. PHX 0.04% solution, CHX 0.12% solution, and methylene blue (MB) based dye with a laser light of 660-nm wavelength (aPDT) were compared. The decrease in colony-forming units by each method was measured using an in vitro killing assay based on a water-exposed surface in a well plate. MB dye with laser (10 seconds) decreased the bacterial load by more than 4 orders of magnitude and was superior to PHX and CHX exposure for 60 seconds. Laser exposure alone and MB dye exposure alone decreased bacterial loads slightly, but less efficiently than 60-second exposure to PHX or CHX. The most effective means of decreasing colony-forming units was achieved by a combination of laser light and dye, which also can be used clinically. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

Effect of Green Coffee Bean Extract on Streptococcus mutans Count: A Randomised Control Trial

PubMed Central

Kaushik, Mamta; Roshni, Roshni; Reddy, Pallavi; Mehra, Neha; Jain, Vallari; Rana, Ritu

2017-01-01

Introduction Mouth rinses have been popularly used as a supplementary oral hygiene aid. A lot of commercially available mouth rinses possess few adverse effects, which has necessitated the search for alternative and herbal mouth rinses. Aim The aim of the study was to assess the effect of rinsing with green coffee bean extract in comparison with chlorhexidine mouthwash and sterile water on salivary Streptococcus mutans count. Materials and Methods A randomized parallel controlled clinical trial was planned and 45 subjects aged between 18-22 years were selected. The subjects were divided into three groups (n=15 in each group): Group A: Study group: 2% Green coffee bean extract, Group B: Positive control: 0.2% Chlorhexidine (CHX), Group C: Negative control: Sterile water. Group A subjects rinsed mouth with 5 ml of 2% Green coffee bean extract for one minute. Group B subjects rinsed mouth with 5 ml 0.2% CHX mouthwash for one minute. Group C subjects rinsed mouth with 5 ml of Sterile water for one minute twice daily for two weeks. Baseline samples (Pre rinse) were collected on day 1 and post rinsing saliva samples were collected after 14 days. The samples were cultured using Mitis Salivarius Agar enriched with Bacitracin and colonies were counted using a hand held digital colony counter. The statistical analysis was done using paired t-test, One-way variance ANOVA and Post-Hoc tests. Results The Green coffee bean extract group showed a statistical significant reduction in Streptococcus mutans colony count before and after intervention which was comparable with CHX group. Conclusion Green coffee bean extract as a mouthwash can be explored as a safe and effective alternative to CHX mouthwash. PMID:28658911

Effectiveness of several solutions to prevent the formation of precipitate due to the interaction between sodium hypochlorite and chlorhexidine and its effect on bond strength of an epoxy-based sealer.

PubMed

Magro, M G; Kuga, M C; Aranda-Garcia, A J; Victorino, K R; Chávez-Andrade, G M; Faria, G; Keine, K C; Só, M V R

2015-05-01

To evaluate the effectiveness of isopropyl alcohol, saline or distilled water to prevent the precipitate formed between sodium hypochlorite (NaOCl) and chlorhexidine (CHX) and its effect on the bond strength of an epoxy-based sealer in radicular dentine. The root canals of 50 extracted human canines (n = 10) were instrumented. In G1, root canals were irrigated with 17% EDTA and 2.5% NaOCl; G2, as G1, except that 2% CHX was used as the final irrigant. In the other groups, intermediate flushes with isopropyl alcohol (G3), saline (G4) or distilled water (G5) were used between NaOCl and CHX. The specimens were submitted to SEM analysis to evaluate the presence of debris and smear layer, in the apical and cervical segments. In sequence, fifty extracted human canines were distributed into five groups (n = 10), similar to the SEM study. After root filling, the roots were sectioned transversally to obtain dentine slices, in the cervical, middle and apical thirds. The root filling was submitted to a push-out bond strength test using an electromechanical testing machine. Statistical analysis was performed using Kruskal-Wallis and Dunn's tests (α = 5%). All groups had similar amounts of residue precipitated on the canal walls (P > 0.05). The push-out bond strength values were similar for all groups, independently of the root third evaluated (P > 0.05). Isopropyl alcohol, saline and distilled water failed to prevent the precipitation of residues on canal walls following the use of NaOCl and CHX. The residues did not interfere with the push-out bond strength of the root filling. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

A novel approach to the use of subgingival controlled-release chlorhexidine delivery in chronic periodontitis: a randomized clinical trial.

PubMed

Gonzales, Jose R; Harnack, Lutz; Schmitt-Corsitto, Gabriella; Boedeker, Rolf H; Chakraborty, Trinad; Domann, Eugen; Meyle, Joerg

2011-08-01

We aimed to analyze clinical, microbiologic, and serologic effects of chlorhexidine (CHX) chips used as a subgingival controlled-release delivery device before and immediately after scaling and root planing (SRP). Twenty-four patients presenting with ≥12 teeth with probing depth (PD) ≥5 mm and bleeding on probing were assigned in test or control groups. After prophylaxis, CHX chips (test) or placebo chips (control) were placed in pockets with PD ≥5 mm. Ten days later, SRP was performed in all teeth with PD ≥4 mm in a single appointment. Immediately after SRP, new chips were inserted in all pockets with PD ≥5 mm. Parameters were assessed at baseline; beginning of SRP; and 1, 3, and 6 months after treatment. Subgingival samples were obtained at baseline; beginning of SRP; and at 1 month after treatment. Periodontal pathogens Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia, and Treponema denticola were analyzed. Serum levels of high sensitive C-reactive and lipopolysaccharide-binding proteins were measured. The changes of the parameters between and within the groups were tested by Mann-Whitney U test (P <0.05). All clinical and serologic parameters improved in both groups over time. There was a significant difference in clinical attachment level (CAL) gain from baseline to 6 months between groups (1.17 mm in the test group versus 0.79 mm in the placebo group) (P <0.05). The treatment with CHX chips showed a greater reduction of the microorganisms of the "red complex" after 1 month (P = 0.02). The use of CHX chips before and immediately after SRP improved CAL and reduced the subgingival microorganisms of the red complex in the treatment of chronic periodontitis.

Antibacterial Effects of Different Concentrations of Althaea officinalis Root Extract versus 0.2% Chlorhexidine and Penicillin on Streptococcus mutans and Lactobacillus (In vitro).

PubMed

Haghgoo, Roza; Mehran, Majid; Afshari, Elahe; Zadeh, Hamide Farajian; Ahmadvand, Motahare

2017-01-01

The aims of the present study were to determine and compare the effects of different concentrations of Althaea officinalis extract, 0.2% chlorhexidine (CHX), and penicillin on Streptococcus mutans and Lactobacillus acidophilus in vitro . The laboratory study was done, for a period of 8 weeks. Minimum inhibitory concentration (MIC) in the test tube, minimum bactericidal concentration (MBC) in a plate culture medium, and growth inhibition zone diameter methods were used to compare the antibacterial effects of 0.2% CHX, penicillin, and different concentrations of A. officinalis root extract. The data were analyzed by SPSS version 24 using ANOVA and t -test analysis. The results showed A. officinalis root extract had antibacterial effect, but significant differences were in MIC and MBC against L. acidophilus and S. mutans with penicillin and 0.2% CHX mouthwash. In addition, the mean growth inhibition zones of all the concentrations of the plant extract were less than that of the positive control group ( P = 0.001). However, the difference in the maximum growth inhibition zone from that with the negative control group was significant. In addition, the antibacterial effect of the extract increased with an increase in its concentration. The extract exerted a greater antibacterial effect on S. mutans than on L. acidophilus . The plant polyphenols content is 3.7% which is equivalent to 29.93 g/ml. The root extract of A. officinalis exhibited antibacterial effects on S. mutans and L. acidophilus , but this effect was less than those of CHX mouthwash and penicillin. The antibacterial effect increased with an increase in the concentration of the extract.

Cost-effectiveness of strategies to prevent methicillin-resistant Staphylococcus aureus transmission and infection in an intensive care unit.

PubMed

Gidengil, Courtney A; Gay, Charlene; Huang, Susan S; Platt, Richard; Yokoe, Deborah; Lee, Grace M

2015-01-01

OBJECTIVE To create a national policy model to evaluate the projected cost-effectiveness of multiple hospital-based strategies to prevent methicillin-resistant Staphylococcus aureus (MRSA) transmission and infection. DESIGN Cost-effectiveness analysis using a Markov microsimulation model that simulates the natural history of MRSA acquisition and infection. PATIENTS AND SETTING Hypothetical cohort of 10,000 adult patients admitted to a US intensive care unit. METHODS We compared 7 strategies to standard precautions using a hospital perspective: (1) active surveillance cultures; (2) active surveillance cultures plus selective decolonization; (3) universal contact precautions (UCP); (4) universal chlorhexidine gluconate baths; (5) universal decolonization; (6) UCP + chlorhexidine gluconate baths; and (7) UCP+decolonization. For each strategy, both efficacy and compliance were considered. Outcomes of interest were: (1) MRSA colonization averted; (2) MRSA infection averted; (3) incremental cost per colonization averted; (4) incremental cost per infection averted. RESULTS A total of 1989 cases of colonization and 544 MRSA invasive infections occurred under standard precautions per 10,000 patients. Universal decolonization was the least expensive strategy and was more effective compared with all strategies except UCP+decolonization and UCP+chlorhexidine gluconate. UCP+decolonization was more effective than universal decolonization but would cost $2469 per colonization averted and $9007 per infection averted. If MRSA colonization prevalence decreases from 12% to 5%, active surveillance cultures plus selective decolonization becomes the least expensive strategy. CONCLUSIONS Universal decolonization is cost-saving, preventing 44% of cases of MRSA colonization and 45% of cases of MRSA infection. Our model provides useful guidance for decision makers choosing between multiple available hospital-based strategies to prevent MRSA transmission.

A Multicenter Pragmatic Interrupted Time Series Analysis of Chlorhexidine Gluconate Bathing in Community Hospital Intensive Care Units.

PubMed

Dicks, Kristen V; Lofgren, Eric; Lewis, Sarah S; Moehring, Rebekah W; Sexton, Daniel J; Anderson, Deverick J

2016-07-01

OBJECTIVE To determine whether daily chlorhexidine gluconate (CHG) bathing of intensive care unit (ICU) patients leads to a decrease in hospital-acquired infections (HAIs), particularly infections caused by methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE). DESIGN Interrupted time series analysis. SETTING The study included 33 community hospitals participating in the Duke Infection Control Outreach Network from January 2008 through December 2013. PARTICIPANTS All ICU patients at study hospitals during the study period. METHODS Of the 33 hospitals, 17 hospitals implemented CHG bathing during the study period, and 16 hospitals that did not perform CHG bathing served as controls. Primary pre-specified outcomes included ICU central-line-associated bloodstream infections (CLABSIs), primary bloodstream infections (BSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infections (CAUTIs). MRSA and VRE HAIs were also evaluated. RESULTS Chlorhexidine gluconate (CHG) bathing was associated with a significant downward trend in incidence rates of ICU CLABSI (incidence rate ratio [IRR], 0.96; 95% confidence interval [CI], 0.93-0.99), ICU primary BSI (IRR, 0.96; 95% CI, 0.94-0.99), VRE CLABSIs (IRR, 0.97; 95% CI, 0.97-0.98), and all combined VRE infections (IRR, 0.96; 95% CI, 0.93-1.00). No significant trend in MRSA infection incidence rates was identified prior to or following the implementation of CHG bathing. CONCLUSIONS In this multicenter, real-world analysis of the impact of CHG bathing, hospitals that implemented CHG bathing attained a decrease in ICU CLABSIs, ICU primary BSIs, and VRE CLABSIs. CHG bathing did not affect rates of specific or overall infections due to MRSA. Our findings support daily CHG bathing of ICU patients. Infect Control Hosp Epidemiol 2016;37:791-797.

Influence of matrix metalloproteinase synthetic inhibitors on dentin microtensile bond strength of resin cements.

PubMed

Stape, T H S; Menezes, M S; Barreto, B C F; Aguiar, F H B; Martins, L R; Quagliatto, P S

2012-01-01

This study evaluated the effect of dentin pretreatment with 2% chlorhexidine (CHX) or 24% ethylenediamine tetra-acetic acid gel (EDTA) on the dentin microtensile bond strength (μTBS) of resin cements. Composite blocks were luted to superficial noncarious human dentin (n=10) using two resin cements (RelyX ARC [ARC] and RelyX U100 [U100]) and three dentin pretreatments (without pretreatment-control, CHX, and EDTA). CHX was applied for 60 seconds on the acid-etched dentin in the ARC/CHX group, and for the same time on smear layer-covered dentin in the U100/CHX group. EDTA was applied for 45 seconds on smear-covered dentin in the U100/EDTA group, and it replaced phosphoric acid conditioning in the ARC/EDTA group for 60 seconds. After storage in water for 24 hours, specimens were prepared for microtensile bond strength testing. The results were submitted to two-way analysis of variance (ANOVA) followed by Tukey test. ARC produced significantly higher μTBS (p<0.05) compared to the U100, except when EDTA was used. For ARC, no pretreatment and CHX produced higher μTBS than EDTA. For U100, EDTA produced higher μTBS; no statistical difference occurred between CHX pretreatment and when no pretreatment was performed. While CHX did not affect immediate dentin bond strength of both cements, EDTA improved bond strength of U100, but it reduced dentin bond strength of ARC.

Antibacterial Activity of Freshly Prepared Ozonated Water and Chlorhexidine on Mutans Streptococcus When Used as an Oral Rinse - A Randomised Clinical Study.

PubMed

Anumula, Lavanya; Kumar, Kv Suneel; Krishna, Chnv Murali; Lakshmi, K Sree

2017-07-01

Dental caries is one of the most common causes of morbidity of the tooth. Attempts have been made to reduce the pathogen population size i.e., Mutans Streptococci (MS) to demote the incidence of caries and increase the resistance of the tooth to cariogenic attack. To evaluate the antibacterial efficacy of freshly prepared ozonated water, in proposing it as an alternative mouth rinse on MS in comparison to Chlorhexidine (CHX). Subjects with high caries incidence and MS counts more than 105 Colony Forming Unit (CFU) were selected and divided by block randomization into two groups of 23 subjects each. The subjects were advised to use the respective mouth rinses under the operator surveillance, consecutively for 14 days. Stimulated salivary samples were collected from the subjects on the first day, 7 th and 14 th day to analyse the changes in MS counts during the course of use of oral rinses. The obtained data was tabulated and statistically analysed. Freshly prepared ozonated water showed a statistically significant reduction in MS counts after an interval of 7 days and 14 days when compared to CHX. Ozonated water when consecutively used as a mouth rinse resulted in a significant reduction of MS counts. Hence, it can be used as an alternative to chlorhexidine.

Chlorhexidine Gluconate Cleansing in Preventing Central Line Associated Bloodstream Infection and Acquisition of Multi-drug Resistant Organisms in Younger Patients With Cancer or Undergoing Donor Stem Cell Transplant

ClinicalTrials.gov

2018-02-05

Bacterial Infection; Benign Neoplasm; Malignant Neoplasm; Methicillin-Resistant Staphylococcus Aureus Infection; Recurrent Childhood Acute Lymphoblastic Leukemia; Recurrent Childhood Acute Myeloid Leukemia; Untreated Childhood Myeloid Neoplasm

Anti-sessile bacterial and cytocompatibility properties of CHX-loaded nanohydroxyapatite.

PubMed

Barros, J; Grenho, L; Fernandes, M H; Manuel, C M; Melo, L F; Nunes, O C; Monteiro, F J; Ferraz, M P

2015-06-01

Nanohydroxyapatite possesses exceptional biocompatibility and bioactivity regarding bone cells and tissues, justifying its use as a coating material or as a bone substitute. Unfortunately, this feature may also encourage bacterial adhesion and biofilm formation. Surface functionalization with antimicrobials is a promising strategy to reduce the likelihood of bacterial infestation and colonization on medical devices. Chlorhexidine digluconate is a common and effective antimicrobial agent used for a wide range of medical applications. The purpose of this work was the development of a nanoHA biomaterial loaded with CHX to prevent surface bacterial accumulation and, simultaneously, with good cytocompatibility, for application in the medical field. CHX (5-1500 mg/L) was loaded onto nanoHA discs and the materials were evaluated for CHX adsorption and release profile, physic-chemical features, antibacterial activity against Escherichia coli, Staphylococcus aureus and Staphylococcus epidermidis, and cytocompatibility toward L929 fibroblasts. Results showed that the adsorption of CHX on nanoHA surface occurred by electrostatic interactions between the cationic group of CHX and the phosphate group of nanoHA. The release of CHX from CHX-loaded nanoHA showed a fast initial rate followed by a slower kinetics release, due to constraints caused by dilution and diffusion-limiting processes. NanoHA.50 to nanoHA.1500 showed strong anti-sessile activity, inhibiting bacterial adhesion and the biofilm formation. CHX-nanoHA caused a dose- and time-dependent inhibitory effect on the proliferation of fibroblasts for nanoHA.100 to nanoHA.1500. Cellular behavior on nanoHA.5 and nanoHA.50 was similar to control. Therefore, CHX-loaded nanoHA surfaces appear as a promising alternative to prevention of devices-related infections. Copyright © 2015 Elsevier B.V. All rights reserved.

Effect of Biomineralization Ability on Push-out Strength of Proroot Mineral Trioxide Aggregate, Mineral Trioxide Aggregate Branco, and Calcium Phosphate Cement on Dentin: An In vitro Evaluation.

PubMed

Revankar, Vanita D; Prathap, M S; Shetty, K Harish Kumar; Shahul, Azmin; Sahana, K

2017-11-01

Biomineralization is a process which leads to the formation of an interfacial layer with tag-like structures at the cement-dentin interface. It is due to interaction of mineral trioxide aggregate (MTA) and Portland cement with dentin in phosphate-buffered solution (PBS). This study is aimed to evaluate the effect of influence of biomineralization process on push-out bond strength of ProRoot MTA (Dentsply Tulsa Dental, Tulsa, OK, USA), MTA Branco (Angelus Soluc¸o˜es Odontolo´gicas, Londrina, PR, Brazil) and calcium phosphate cement (BioGraft CPC). The aim of this study was to evaluate the effect of biomineralization process on the push-out strength of ProRoot MTA, MTA Branco, and CPC after mixing with 0.2% chlorhexidine gluconate solution (0.2% CHX) and 2% lidocaine solution (2% LA) on the bond strength of MTA-dentin. Dentin discs with uniform cavities were restored with ProRoot MTA, MTA Branco, and calcium phosphate cement after mixing with 0.2% CHX solution and 2% lidocaine solution. The samples were uniformly distributed into two groups. Experimental group being immersed in PBS solution and control group being immersed in saline for 2 months. Instron testing machine (Model 4444; Instron Corp., Canton, MA, USA) was used to determine the bond strength. A two-way analysis of variance and post hoc analysis by Bonferroni test. All samples immersed in experimental group displayed a significantly greater resistance to displacement than that observed for the samples in control group ( P < 0.05). MTAs displayed a significantly greater resistance to displacement than calcium phosphate cements. The main conclusion of this study was that the push-out bond strength of the cements, mainly the MTA groups, was positively influenced by the biomineralization process.

Effectiveness of pre-treatment with chlorhexidine in restoration retention: A 36-month follow-up randomized clinical trial.

PubMed

Favetti, Morgana; Schroeder, Thaiane; Montagner, Anelise Fernandes; Correa, Marcos Britto; Pereira-Cenci, Tatiana; Cenci, Maximiliano Sergio

2017-05-01

This study evaluated the effect of the pre-treatment with 2% chlorhexidine digluconate (CHX) as coadjutant in restoration retention of noncarious cervical lesions (NCCL), after 36 months of follow-up. A randomized controlled split-mouth and triple-blind (operators, patients and evaluator) trial was carried out. Patients (n=42) with at least two non-carious cervical lesions were included. The teeth with NCCL were randomly assigned to two treatment groups: application of 2% CHX (experimental group) or a placebo solution (control group) for 60s after acid etching and before the adhesive application. A trained and calibrated examiner evaluated the restorations at baseline (1 week) and at each recall (6, 12, 24 and 36 months) using the FDI criteria. A total of 225 restorations were evaluated after 36-month follow-up. Data were subjected to survival analysis using the Kaplan-Meier method, and the log-rank test was used to evaluate the existence of differences between the survival curves (α=0.05). The restorations survival rate after 36 months of follow-up was 76.1%. There was no difference in the retention and failure rates between the experimental and the control group (p=0.968). There was an increased failure trend when restorations were located subgingival compared to those at the gingival level or supragingival. The pre-treatment with 2% chlorhexidine digluconate did not promote further restoration retention of noncarious cervical lesions. The cavity pre-treatment with chlorhexidine for inhibition of hybrid layer degradation does not add any beneficial effect to the clinical performance of restorations. Copyright © 2017 Elsevier Ltd. All rights reserved.

Morphological and chemical changes in dentin after using endodontic agents: Fourier transform Raman spectroscopy, energy-dispersive x-ray fluorescence spectrometry, and scanning electron microscopy study

NASA Astrophysics Data System (ADS)

Pascon, Fernanda Miori; Kantovitz, Kamila Rosamilia; Soares, Luís Eduardo Silva; Santo, Ana Maria do Espírito; Martin, Airton Abraha~o.; Puppin-Rontani, Regina Maria

2012-07-01

We examine the morphological and chemical changes in the pulp chamber dentin after using endodontic agents by scanning electron microscopy (SEM), Fourier transform Raman spectroscopy (FT-Raman), and micro energy-dispersive x-ray fluorescence spectrometry (μEDXRF). Thirty teeth were sectioned exposing the pulp chamber and divided by six groups (n=5): NT-no treatment; CHX-2% chlorhexidine; CHXE-2% chlorhexidine+17% EDTA E-17% EDTA; SH5-5.25% NaOCl; SH5E-5.25% NaOCl+17% EDTA. The inorganic and organic content was analyzed by FT-Raman. μEDXRF examined calcium (Ca) and phosphorus (P) content as well as Ca/P ratio. Impressions of specimens were evaluated by SEM. Data were submitted to Kruskal-Wallis and Dunn tests (p<0.05). Differences were observed among groups for the 960 cm-1 peak. Ca and P content differences were significant (SH5>NT=SH5E>CHX>E>CHXE). CHXE and E presented the highest Ca/P ratio values compared to the other groups (p<0.05). The SEM images in the EDTA-treated groups had the highest number of open tubules. Erosion in the tubules was observed in CHX and SH5E groups. Endodontic agents change the inorganic and organic content of pulp chamber dentin. NaOCl used alone, or in association with EDTA, was the most effective agent considering chemical and morphological approaches.

Development of antimicrobial coating by later-by-layer dip coating of chlorhexidine-loaded micelles.

PubMed

Tambunlertchai, Supreeda; Srisang, Siriwan; Nasongkla, Norased

2017-06-01

Layer-by-layer (LbL) dip coating, accompanying with the use of micelle structure, allows hydrophobic molecules to be coated on medical devices' surface via hydrogen bonding interaction. In addition, micelle structure also allows control release of encapsulated compound. In this research, we investigated methods to coat and maximize the amount of chlorhexidine (CHX) on silicone surface through LbL dip coating method utilizing hydrogen bonding interaction between PEG on micelle corona and PAA. The number of coated cycles was varied in the process and 90 coating cycles provided the maximum amount of CHX loaded onto the surface. In addition, pre-coating the surface with PAA enhanced the amount of coated CHX by 20%. Scanning electron microscope (SEM) and Fourier Transform Infrared Spectroscopy (FTIR) were used to validate and characterize the coating. For control release aspect, the coated film tended to disrupt at physiological condition; hence chemical crosslinking was performed to minimize the disruption and maximize the release time. Chemical crosslinking at pH 2.5 and 4.5 were performed in the process. It was found that chemical crosslinking could help extend the release period up to 18 days. This was significantly longer when compared to the non-crosslinking silicone tube that could only prolong the release for 5 days. In addition, chemical crosslinking at pH 2.5 gave higher and better initial burst release, release period and antimicrobial properties than that of pH 4.5 or the normal used pH for chemical crosslinking process.

Comparison of the antibacterial activity of an ozonated oil with chlorhexidine digluconate and povidone-iodine. A disk diffusion test.

PubMed

Montevecchi, Marco; Dorigo, Antonio; Cricca, Monica; Checchi, Luigi

2013-07-01

Ozonated oils are antiseptics obtained from the chemical reaction between ozone and unsaturated fatty acids of vegetable oils. The aim of this study was to investigate the antimicrobial effectiveness of a commercially available ozonated oil (O3-Oil), in comparison with 0.2% chlorhexidine digluconate (CHX) and 10% povidone-iodine (PVP-I) through a disk diffusion test. For each antiseptic a series of two-fold dilutions was made, obtaining seven dilutions: 1:2, 1:4, 1:8, 1:16, 1:32, 1:64 and 1:128. The undiluted antiseptics and the seven dilutions were tested against two freeze-dried bacterial strains: Staphylococcus aureus (Sa) and Porphyromonas gingivalis (Pg). O3-Oil showed significantly greater diameters of growth inhibition (p<0.01) than CHX and PVP-I in all dilutions for both tested strains. CHX lost any antibacterial efficacy when diluted more than 1:32. At the highest dilution, the diameters of growth inhibition against Sa were 20.67±0.58 mm and 15.33±0.58 mm, for O3-Oil and PVP-I, respectively. At the same dilution, the diameters of growth inhibition against Pg were: 19.00 mm for O3-Oil and 13.67±0.58 mm for PVP-I. The promising results obtained for the O3-Oil, against the opportunistic Sa, and Pg, one of the main periodontal pathogens, suggest its potential applicability for periodontal treatment. Further preclinical and clinical investigations are warranted.

Chlorhexidine Prevents Root Dentine Mineral Loss and Fracture Caused by Calcium Hydroxide over Time

PubMed Central

Thomaz, Érika Bárbara Abreu Fonseca; Lima, Darlon Martins; Bauer, José

2017-01-01

Purpose. To evaluate the mineral ion loss of root dentine after treatment with 2% chlorhexidine solution (CHX) and to compare its yield and flexural strength (fs) after exposure to calcium hydroxide [Ca(OH)2]. Materials and Methods. Dentine bars (DB) were made from 90 roots of bovine incisors and randomized into three groups: GControl: distilled/deionized water (DDW), GNaOCl: 2.5% sodium hypochlorite + 17% EDTA, and GCHX: CHX + DDW. The release of phosphate (PO4) and calcium (Ca) ions was measured by spectrophotometry. The DB were exposed to Ca(OH)2 paste for 0, 30, 90, and 180 days. DB were subjected to the three-point bending test to obtain yield and fs values. The fracture patterns were evaluated (20x). Data were analyzed using Kruskal-Wallis and Dunn's post hoc tests or one- and two-way ANOVA followed by Tukey's post hoc test (α = 0.05). Results. GCHX showed lower PO43− and Ca2+ ionic release than GNaOCl (p < 0.001). For yield and fs, GCHX > GNaOCl in all periods (p < 0.001), except for yield strength values on 90 days (p = 0.791). A larger frequency of vertical fractures was observed in GNaOCl and that of oblique fractures in GCHX (p < 0.05). Conclusions. CHX prevented PO43− and Ca2+ loss and showed a tendency to preserve the yield and fs of root dentine over time following exposure to Ca(OH)2 paste. PMID:28539937

Periodontal Therapy Effects on Nitrite Related to Oral Bacteria: A 6-Month Randomized Clinical Trial.

PubMed

Cortelli, Sheila C; Costa, Fernando O; Rodrigues, Edson; Cota, Luis O M; Cortelli, Jose R

2015-08-01

Nitrite is a biologic factor relevant to oral and systemic homeostasis. Through an oral bacteria reduction process, it was suggested that periodontal therapy and chlorhexidine (CHX) rinse could affect nitrite levels, leading to negative effects, such as an increase in blood pressure. This 6-month randomized clinical trial evaluated the effects of periodontal therapeutic protocols on salivary nitrite and its relation to subgingival bacteria. One hundred patients with periodontitis were allocated randomly to debridement procedures in four weekly sections (quadrant scaling [QS]) or within 24 hours (full-mouth scaling [FMS]) in conjunction with a 60-day CHX (QS + CHX and FMS + CHX), placebo (QS + placebo and FMS + placebo), or no mouthrinse (QS + none and FMS + none) use. Real-time polymerase chain reaction determined total bacterial, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Streptococcus oralis, and Actinomyces naeslundii levels. Salivary nitrite concentration was determined with Griess reagent. Data were analyzed statistically at baseline and 3 and 6 months by analysis of variance, Kruskal-Wallis, Mann-Whitney U, and Spearman correlation tests (P <0.05). Nitrite concentrations did not tend to change over time. Regarding CHX use, there was a negative correlation between nitrite and total bacterial load at 6 months (FMS + CHX) and one positive correlation between P. gingivalis and nitrite at baseline (QS + CHX). Independently of rinse type, in the FMS group, nitrite correlated negatively with several microbial parameters and also with a higher percentage of deep periodontal pockets. The relationship between nitrite and bacterial levels appears weak. Short-term scaling exhibited a greater influence on nitrite concentrations then long-term CHX use.

Influence of irrigation protocols on the bond strength of fiber posts cemented with a self-adhesive luting agent 24 hours after endodontic treatment.

PubMed

Lima, Jessica Ferraz Carvalho; Lima, Adriano Fonseca; Humel, Maria Malerba Colombi; Paulillo, Luis Alexandre Maffei Sartini; Marchi, Giselle Maria; Ferraz, Caio Cezar Randi

2015-01-01

The aim of this in vitro study was to evaluate the influence of different irrigation protocols on the bond strength, at different root depths, of fiber posts cemented with a self-adhesive cement 24 hours after endodontic treatment. Fifty-six bovine incisor roots were endodontically prepared and separated into 7 groups (n = 8) according to irrigation protocols: group 1, sterile saline (control); group 2, chlorhexidine (CHX) gel 2% and saline; group 3, sodium hypochlorite (NaOCl) 5.25% and saline; group 4, CHX and saline (final irrigation with ethylenediaminetetraacetic acid [EDTA] 17%); group 5, NaOCl and saline (final irrigation with EDTA); group 6, CHX and saline (final irrigation with NaOCl and EDTA); and group 7, NaOCl (final irrigation with CHX and EDTA). No statistically significant difference was found among the groups. Within the limitations of this study, it can be concluded that the different irrigation protocols did not influence the bond strength of self-adhesive resin cement, which presented similar behaviors at the 3 root depths studied.

Disinfecting Effects of Rotary Instrumentation with Either 2.5% Sodium Hypochlorite or 2% Chlorhexidine as the Main Irrigant: A Randomized Clinical Study.

PubMed

Rôças, Isabela N; Provenzano, José Claudio; Neves, Mônica A S; Siqueira, José F

2016-06-01

This randomized clinical study compared the antibacterial effects of irrigation with either 2.5% sodium hypochlorite (NaOCl) or 2% chlorhexidine (CHX) during the preparation of infected root canals with rotary nickel-titanium instruments. The root canals of 50 single-rooted teeth with apical periodontitis were prepared by using BioRaCe rotary instruments (FKG Dentaire, La Chaux-de-Fonds, Switzerland) and irrigation with either 2.5% NaOCl (n = 25) or 2% CHX (n = 25). Samples were taken from the canal at baseline (S1) and after (S2) chemomechanical preparation. DNA was extracted from the clinical samples, and the reduction of the levels of total bacteria and streptococci was evaluated by means of a 16S ribosomal RNA gene-based quantitative polymerase chain reaction assay. All S1 samples were positive for the presence of bacteria. After chemomechanical preparation using either 2.5% NaOCl or 2% CHX, 44% and 40% of the root canals still had detectable bacteria, respectively. As for total bacterial counts, a mean number of 3.7 × 10(5) bacterial cell equivalents was present in S1 samples from the NaOCl group, with a substantial reduction in S2 to a mean of 5.49 × 10(2) cell equivalents (P < .001). In the CHX group, a mean bacterial load of 8.77 × 10(4) cell equivalents occurred in S1, with a significant reduction in S2 to a mean of 2.81 × 10(3) cells (P < .001). The differences in both the presence/absence and quantitative data were not statistically significant (P > .05). Both irrigation protocols were highly effective in reducing the levels of Streptococcus species (P < .001). No significant difference was observed for the clinical antibacterial effectiveness of rotary preparation using either 2.5% NaOCl or 2% CHX as the main irrigant. Copyright © 2016. Published by Elsevier Inc.

Clinical and microbiological benefits of strict supragingival plaque control as part of the active phase of periodontal therapy.

PubMed

Feres, Magda; Gursky, Lauren Christine; Faveri, Marcelo; Tsuzuki, Claudia Ota; Figueiredo, Luciene Cristina

2009-10-01

To compare the clinical and microbiological effects of scaling and root planing (SRP) alone or combined with mechanical [professional plaque control (PPC)] or chemical [chlorhexidine rinsing (CHX)] control of supragingival plaque in the treatment of chronic periodontitis. Sixty subjects were randomly assigned to receive SRP alone or combined with PPC (twice a week) or with CHX rinsing (twice a day). The adjunctive treatments began with SRP and were continued for 42 days. Clinical and microbiological examinations were performed at baseline, 2 and 6 months post-therapy. Subgingival plaque samples were analysed for 38 bacterial species by checkerboard DNA-DNA hybridization. The two test treatments were more effective in improving probing depth and clinical attachment level (CAL) than SRP alone, even in intermediate and deep sites. CAL gain was better maintained in the CHX group. The most beneficial microbiological changes were observed in CHX-treated subjects, who showed a significant reduction in the proportions of red and orange complexes, as well as an increase in the proportions of the host-compatible bacterial species. Strict plaque control performed during and after SRP improves periodontal treatment outcomes. The greatest microbiological and clinical benefits were observed with the use of CHX rinsing.

In-vitro evidence for efficacy of antimicrobial mouthrinses

PubMed Central

Pan, Pauline C.; Harper, Scott; Ricci-Nittel, Danette; Lux, Renate; Shi, Wenyuan

2010-01-01

SUMMARY Objectives The objective of this study was to compare the antimicrobial activity of commercially available antiseptic mouthrinses against saliva-derived plaque biofilms in static and flow-through biofilm systems in vitro. Methods Nine mouthrinses were tested in a recirculating flow-through biofilm model (RFTB) with viability assessment by ATP bioluminescence. In addition, five mouthrinses were evaluated in a batch chamber slide biofilm (BCSB) model, using live- dead staining and confocal laser scanning microscopy. Results In the RFTB model, essential oil (EO) and chlorhexidine (CHX)-containing rinses showed equivalent antimicrobial activity and were more effective than a range of cetyl pyridinium chloride (CPC1) formulations. In the BCSB model, twice-daily mouthrinse exposure demonstrated that the EO rinse was significantly more effective than rinses containing amine and stannous fluorides, a combination of CPC/CHX and CPC2. EO showed biofilm kill comparable to the CHX rinse. Conclusions The present studies have shown that mouthrinses vary significantly in their capability to kill plaque biofilm bacteria in BCSB and RFTB models. The EO mouthrinse demonstrated superior antiplaque biofilm activity to AFSF, CPC/CHX, and CPC rinses and comparable activity to CHX. The methods tested may be of value for the in-vitro screening of antiseptic rinses with different modes of antimicrobial action. PMID:20621239

Antibacterial paperboard packaging using microfibrillated cellulose.

PubMed

Lavoine, Nathalie; Desloges, Isabelle; Manship, Brigitte; Bras, Julien

2015-09-01

The industry and consumers are focusing more and more on the development of biodegradable and lightweight food-packaging materials, which could better preserve the quality of the food and improve its shelf-life. In an attempt to meet these requirements, this study presents a novel bio-substrate able to contain active bio-molecules for future food-packaging applications. Based on a paperboard substrate, the development of an antibacterial bio-packaging material is, therein, achieved using a chlorhexidine digluconate (CHX) solution as a model of an antibacterial molecule, mixed with microfibrillated cellulose (MFC) and used as coating onto paperboard samples. AFM and FE-SEM analyses were performed to underline the nanoporous MFC network able to trap and to progressively release the CHX molecules. The release study of CHX was conducted in an aqueous medium and showed a lower proportion (20 %) of CHX released when using MFC. This led to the constant release of low amounts of CHX over 40 h. Antibacterial tests were carried out to assess the preservation of the antibacterial activity of the samples after the release studies. Samples remained active against Bacillus subtilis, with better results being obtained when MFC was used. The preservation of the quality of a model food was finally evaluated paving the way for future promising applications in the food packaging industry.

Short-term effect of a new mouthrinse formulation on oral malodour after single use in vivo: a comparative, randomized, single-blind, parallel-group clinical study.

PubMed

Wilhelm, D; Gysen, K; Himmelmann, A; Krause, C; Wilhelm, K-P

2010-09-01

This study aimed to compare a new chlorhexidine (CHX)-free mouthrinse containing amine fluoride/stannous fluoride (ASF) against a benchmark containing CHX with respect to their effect on oral malodour after single use. A total of 42 male and female subjects with an intraoral cause of bad breath, each with an organoleptic rating (OR) of at least 2 and a total volatile sulfur compound (VSC) concentration higher than 130 ppb, participated in the study. Subjects were allocated to one of three treatment groups (i.e. CHX-free ASF mouthrinse, CHX benchmark mouthrinse or water) according to a randomization list. Participants received written instructions on precautions to be taken for optimal breath analysis. Eight trained and qualified odour judges assessed the subjects' malodour by OR at baseline and 30 min and 4 h after single use of the mouthrinses. Additionally, VSC levels were measured at baseline and 4 h after using the mouthrinse. Treatment with water alone led already to some reduction in OR with mean differences to baseline of -1.13 at 30 min and -0.64, 4 h after treatment. Both CHX-free ASF product (-1.51) and CHX (-1.48) provided a significantly stronger OR reduction than water at 30 min (p < 0.05). Only CHX-free ASF treatment showed a sustained benefit in terms of significantly better OR reduction after 4 h (-1.17, p < 0.05), whereas CHX (-0.81) was not significantly different from water (-0.64, p = 0.517). Both ASF (-90.9%) and CHX (-81.6%) reduced VSC levels significantly stronger than water (-53.5%; p < 0.001). OR and VSC readings in the group using the CHX mouthrinse did not differ significantly from those in the group using the CHX-free ASF formulation. The newly developed CHX-free ASF mouthrinse significantly reduced oral malodour after single use, both in terms of OR and VSC levels. Efficacy was comparable to that of the CHX benchmark product.

Sensitivity of Candida Albicans Biofilm Cells Grown on Denture Acrylic to Antifungal Proteins and Chlorhexidine

PubMed Central

Pusateri, Christopher R.; Monaco, Edward A.; Edgerton, Mira

2009-01-01

Objectives Candida albicans cells form biofilms on polymeric surfaces of dentures and other prostheses introduced into the oral cavity. Many biofilm microorganisms exhibit resistance to antimicrobial agents; C. albicans cells may also develop resistance to naturally-occurring antifungal peptides in human saliva including histatins (Hsts) and defensins (hBDs). Therefore, we evaluated Hst 5 activity on C. albicans biofilm cells compared to planktonic cells and measured whether surface treatment of denture acrylic with Hst 5, hBD-3, or chlorhexidine gluconate could inhibit in vitro biofilm development. Methods Acrylic disks were preconditioned with 500 μl saliva for 30 min, and inoculated with C. albicans cells (106 cells/ml) for 1 h, at 37 °C. Non-adherent cells were removed by washing and disks and were incubated in YPD growth medium for 24, 48, and 72 h at 37 °C. Candidacidal assays were performed on 48-hour-biofilms and on planktonically-grown cells using Hst 5 (15.5 μM, 31.25 μM, 62 μM). Cell adhesion was compared on disks pre-coated with 0.12% chlorhexidine gluconate, 50 μM Hst 5, or 0.6 μM hBD-3 after 24 h, 48 h, and 72 h growth. Results No significant difference was observed in sensitivity to Hst 5 of biofilm cells compared to planktonic cells (p > 0.05). Pre-coating disks with hBD-3 did not inhibit biofilm development; however, Hst 5 significantly inhibited biofilm development at 72 h, while 0.12% chlorhexidine significantly inhibited biofilm development at all time intervals (p < 0.05). Conclusions C. albicans biofilm cells grown on denture acrylic are sensitive to killing by Hst 5. Surface coating acrylic with chlorhexidine or Hst 5 effectively inhibits biofilm growth and has potential therapeutic application. PMID:19249746

Sealing ability of white and gray mineral trioxide aggregate mixed with distilled water and 0.12% chlorhexidine gluconate when used as root-end filling materials.

PubMed

Shahi, Shahriar; Rahimi, Saeed; Yavari, Hamid Reza; Shakouie, Sahar; Nezafati, Saeed; Abdolrahimi, Majid

2007-12-01

This in vitro study used dye penetration to compare the sealing ability of white and gray mineral trioxide aggregate mixed with distilled water and 0.12% chlorhexidine gluconate when used as root-end filling materials. Ninety-six single-rooted human teeth were cleaned, shaped, and obturated with gutta-percha and AH26 root canal sealer. The apical 3 mm of each root was resected, and 3-mm deep root-end cavity preparations were made. The teeth were randomly divided into 4 experimental groups, each containing 20 teeth, and 2 negative and positive control groups, each containing 8 teeth. Root-end cavities in the experimental groups were filled with the experimental materials. After decoronation of the teeth and application of nail polish, the teeth were exposed to India ink for 72 hours and longitudinally sectioned, and the extent of dye penetration was measured with a stereomicroscope. Statistical analysis showed that there were no significant differences among the 4 experimental groups.

Influence of cavity disinfectant and adhesive systems on the bonding procedure in demineralized dentin - a one-year in vitro evaluation.

PubMed

Sacramento, Patrícia A; de Castilho, Aline R; Banzi, Efani C; Puppi-Rontani, Regina Maria

2012-12-01

To evaluate the influence of a 2% chlorhexidine solution (CHX) on the bond strength and nano leakage of two self-etching adhesive systems on demineralized dentin over a 12-month period. The middle dentin from sound third molars was exposed and demineralized in vitro. Twelve groups were formed using different adhesive systems (Clearfil Protect Bond [PB], Clearfil SE Bond [SE]) dentin treatment (with or without CHX application), and water-storage times (24 h, 6 and 12 months). Composite resin cylinders were bonded to the prepared dentin, and these specimens underwent microshear bond strength (µSBS) testing and nano leakage evaluation. µSBS data were submitted to a three-way ANOVA and Tukey's test. The failure mode and nano leakage were analyzed descriptively by score. There was a statistically significant interaction only between the adhesive system and CHX, and adhesive system and water-storage times. SE showed the lowest µSBS just at 24 h water-storage time regardless of CHX. A significant decrease in µSBS values after 6 months of water storage occurred in all of the groups and was maintained until 12 months. Adhesive failure increased with storage time. All groups showed nano leakage at the resin/dentin interfaces and an increased silver deposition was noticed after 6 and 12 months of water storage. The highest percentages of nano leakage were found in CHX groups. CHX did not interfere with µSBS values for either self-etching adhesive system, but water storage did. Bond strength decreased for both adhesive systems after 6 and 12 months, regardless of CHX application. Nano leakage increased with water-storage time and with CHX application.

Effects of polyhexamethylene guanidine phosphate on human gingival fibroblasts.

PubMed

Vitt, Anton; Slizen, Veronica; Boström, Elisabeth A; Yucel-Lindberg, Tülay; Kats, Anna; Sugars, Rachael V; Gustafsson, Anders; Buhlin, Kåre

2017-10-01

Polyhexamethylene guanidine phosphate (PHMG-P) was compared to chlorhexidine (CHX) in order to determine potential cytotoxic and immune-modulatory effects on human gingival fibroblasts. Cytotoxic effects of PHMG-P and CHX on human gingival fibroblasts were assessed using cell viability assay at various time points and concentrations. The effects of PHMG-P and CHX on the secretion of prostaglandin (PG) E 2 , interleukin (IL)-6, IL-8 and matrix metalloproteinase (MMP)-1 by non-stimulated or IL-1β stimulated fibroblasts were evaluated by enzyme-linked immunosorbent assays. PHMG-P concentration 0.00009% led to the total loss of fibroblast viability within 24 h, whereas inhibition of fibroblast viability by CHX occurred at significantly higher concentrations of 0.0009% (p < .001). Short-term exposure to 0.005% PHMG-P led to loss of fibroblast viability after 5 min, whilst cells exposed to 0.005% CHX survived 30 min of treatment (p < .001). IL-1β stimulation induced an inflammatory response with a significant increase in the secretion of PGE 2 , IL-6, IL-8 and MMP-1. Treatment of IL-1β stimulated fibroblasts in combination with PHMG-P or CHX at concentrations of 0.000045 or 0.0.00009% resulted in significantly decreased PGE 2 , IL-6, IL-8 and MMP-1 levels. PHMG-P or CHX alone did not affect the baseline secretion of PGE 2 , IL-6, IL-8 or MMP-1 by gingival fibroblasts. Cytotoxic effects on gingival fibroblasts were triggered by both PHMG-P and CHX at concentrations below those used in clinical practice. The tested antiseptics did not cause inflammation and reduced IL-1β-induced secretion of inflammatory mediators and collagenase by gingival fibroblasts, which suggests anti-inflammatory properties.

Antibacterial effect of calcium hydroxide combined with chlorhexidine on Enterococcus faecalis: a systematic review and meta-analysis

PubMed Central

SAATCHI, Masoud; SHOKRANEH, Ali; NAVAEI, Hooman; MARACY, Mohammad Reza; SHOJAEI, Hasan

2014-01-01

Objective Enterococcus faecalis (E. faecalis) is the most frequently isolated strain in failed endodontic therapy cases since it is resistant to calcium hydroxide (CH). Whether a combination of CH and chlorhexidine (CHX) is more effective than CH alone against E. faecalis is a matter of controversy. Thus, the aim of this study was to conduct a systematic review and meta-analysis of the literature. Material and Methods A comprehensive search in PubMed, EMbase, EBSCOhost, The Cochrane Library, SciELO, and BBO databases, Clinical trials registers, Open Grey, and conference proceedings from the earliest available date to February 1, 2013 was carried out and the relevant articles were identified by two independent reviewers. Backward and forward search was performed and then inclusion and exclusion criteria were applied. The included studies were divided into "comparisons" according to the depth of sampling and dressing period of each medicament. Meta-analysis was performed using Stata software 10.0. The level of significance was set at 0.05. Results Eighty-five studies were retrieved from databases and backward/forward searches. Fortyfive studies were considered as relevant (5 in vivo, 18 in vitro, 18 ex vivo, and 4 review articles). Nine studies were included for meta-analysis. Inter-observer agreement (Cohen kappa) was 0.93. The included studies were divided into 21 comparisons for meta-analysis. Chi-square test showed the comparisons were heterogeneous (p<0.001). Random effect model demonstrated no significant difference between CH/CHX mixture and CH alone in their effect on E. faecalis (p=0.115). Conclusions According to the evidence available now, mixing CH with CHX does not significantly increase the antimicrobial activity of CH against E. faecalis. It appears that mixing CH with CHX does not improve its ex vivo antibacterial property as an intracanal medicament against E. faecalis. Further in vivo studies are necessary to confirm and correlate the findings of this study with the clinical outcomes. PMID:25466470

A randomized clinical study comparing the plaque inhibition effect of a SnF2/SHMP dentifrice (blend-a-med EXPERT GUMS PROTECTION) and a chlorhexidine digluconate dentifrice (Lacalut Aktiv).

PubMed

Bellamy, P G; Khera, N; Day, T N; Mussett, A J; Barker, M L

2009-01-01

To compare the plaque inhibition benefits of a control 0.454% stannous fluoride/sodium hexametaphosphate/sodium fluoride dentifrice (SnF2/SHMP with 1450 ppm F) to a chlorhexidine digluconate (0.05%), aluminum lactate (0.8%), and aluminum fluoride (AlF3/Chx with 1400 ppm F) dentifrice. Twenty-nine subjects were randomized to a two-period, two-treatment, double-blind crossover sequence using blend-a-med EXPERT GUMS PROTECTION toothpaste (SnF2/SHMP) and Lacalut Aktiv toothpaste (AlF3/Chx). Each treatment was used along with a standard manual toothbrush (Oral-B P35 Indicator) for 17 days. Digital plaque image analysis (DPIA) was used at the end of each period for three consecutive days to evaluate plaque levels; a) overnight (A.M. pre-brush); b) following 40 seconds of brushing with the test product (A.M. post-brush); and c) mid-afternoon (P.M.). Images were analyzed using an objective computer algorithm to calculate the total area of visible plaque. A four-day washout period was instituted for the crossover phase. Twenty-seven subjects completed the study. The SnF2/SHMP dentifrice provided a statistically significant lower level of plaque area coverage compared to the AlF3/Chx dentifrice at all time points. For the SnF2/SHMP dentifrice, plaque coverage was 19.4% lower (p = 0.0043) at the A.M. pre-brush, 25.6% lower (p = 0.0014) at the A.M. post-brush, and 19.8% lower (p = 0.0057) at the P.M. measure relative to the AlF3/Chx dentifrice. The blend-a-med EXPERT GUMS PROTECTION toothpaste inhibits plaque regrowth, both overnight and during the day, to a significantly greater degree than Lacalut Aktiv. Additionally, immediately after brushing with blend-a-med EXPERT GUMS PROTECTION, subjects had significantly less plaque than after brushing with Lacalut Aktiv.

Evaluation and prevention of the precipitate formed on interaction between sodium hypochlorite and chlorhexidine.

PubMed

Krishnamurthy, Shashikala; Sudhakaran, Sunu

2010-07-01

The purpose of this study was (1) to evaluate maximum thickness the and chemical composition of the precipitate formed between sodium hypochlorite (NaOCl) and chlorhexidine (CHX) and (2) to evaluate effectiveness of absolute alcohol to remove residual NaOCl and thereby prevent the formation of the precipitate. Forty extracted single-rooted human teeth were decoronated, and the canals were instrumented. In the test group (Ts group), canals were irrigated with 17% EDTA and 2.5% NaOCl followed by 2% CHX. In the absolute alcohol (Aba), saline (Sa), and distilled water (Dw) groups, intermediate flushes of absolute alcohol, saline, and distilled water were used between the last two irrigants. Teeth were sectioned longitudinally and subjected to stereomicroscopic examination. The Ts group samples showed orange-brown precipitate, concentrated more in the coronal and middle thirds, whereas the Aba group showed no evidence of precipitate. The Sal and Dw groups showed minimal precipitate in the coronal and middle thirds. The thickness of the precipitate was measured using the ProgRes computer software (Olympus, Hamburg, Germany). The chemical composition of the precipitate was confirmed by Beilstein and HCl tests, and the nuclear magnetic resonance imaging technique confirmed chlorine in the para position of the benzene ring. The interaction between NaOCl and CHX resulted in an insoluble neutral salt as a precipitate that can be prevented using absolute alcohol and minimized using saline and distilled water as intermediate flushes. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

The effectiveness of a preprocedural mouthrinse containing cetylpyridinium chloride in reducing bacteria in the dental office.

PubMed

Feres, Magda; Figueiredo, Luciene Cristina; Faveri, Marcelo; Stewart, Bernal; de Vizio, William

2010-04-01

During oral procedures, microorganisms from the oral cavity may contaminate nearby surfaces. The authors evaluated the efficacy of a commercial preprocedural mouthrinse containing 0.05 percent cetylpyridinium chloride (CPC) in reducing the levels and composition of viable bacteria in oral spatter. The authors randomly assigned 60 participants receiving oral prophylaxis with an ultrasonic scaler to one of four groups: a preprocedural rinse solution containing 0.05 percent CPC, 0.12 percent chlorhexidine (CHX) or water, or no rinsing. Airborne microorganisms were collected on blood agar plates. The composition of the spatter was analyzed for 39 oral bacterial species by means of checkerboard DNA-DNA hybridization. CPC and CHX were equally effective in lowering the levels of spatter bacteria and performed better than water and no rinsing (P < .05, Kruskal-Wallis test). The composition of the spatter from the control groups showed higher proportions (P < .05, Kruskal-Wallis test) of Fusobacterium species and lower proportions of Capnocytophaga species when compared with the spatter from the CPC and CHX groups. A commercial mouthrinse containing 0.05 percent CPC when used as a preprocedural mouthrinse was equally effective as CHX in reducing the levels of spatter bacteria generated during ultrasonic scaling. Owing to its strong antibacterial effect and the fact that it has fewer side effects than CHX, a solution containing 0.05 percent CPC may be a good alternative to that containing 0.12 CHX as a preprocedural mouthrinse used to help decrease the level of contamination in spatter.

Long-term bonding effectiveness of simplified etch-and-rinse adhesives to dentin after different surface pre-treatments

PubMed Central

Verma, Radhika; Singh, Udai Pratap; Tyagi, Shashi Prabha; Nagpal, Rajni; Manuja, Naveen

2013-01-01

Objective: To evaluate the effect of 2% chlorhexidine (CHX) and 30% proanthocyanidin (PA) application on the immediate and long-term bond strength of simplified etch-and-rinse adhesives to dentin. Materials and Methods: One hundred twenty extracted human molar teeth were ground to expose the flat dentin surface. The teeth were equally divided into six groups according to the adhesives used, either Tetric N Bond or Solobond M and pretreatments given either none, CHX, or PA. Composite cylinder was bonded to each specimen using the respective adhesive technique. Half the samples from each group (n = 10) were then tested immediately. The remaining samples were tested after 6 month storage in distilled water. Results: The mean bond strength of samples was not significantly different upon immediate testing being in the range of 8.4(±0.7) MPa. The bond strength fell dramatically in the control specimens after 6 month storage to around 4.7(±0.33) MPa, while the bond strength was maintained in the samples treated with both CHX and PA. Conclusion: Thirty percent PA was comparable to 2% CHX with respect to preservation of the resin dentin bond over 6 months. PMID:23956543

Cellulose Nanocrystal Membranes as Excipients for Drug Delivery Systems

PubMed Central

Barbosa, Ananda M.; Robles, Eduardo; Ribeiro, Juliana S.; Lund, Rafael G.; Carreño, Neftali L. V.; Labidi, Jalel

2016-01-01

In this work, cellulose nanocrystals (CNCs) were obtained from flax fibers by an acid hydrolysis assisted by sonochemistry in order to reduce reaction times. The cavitation inducted during hydrolysis resulted in CNC with uniform shapes, and thus further pretreatments into the cellulose are not required. The obtained CNC exhibited a homogeneous morphology and high crystallinity, as well as typical values for surface charge. Additionally, CNC membranes were developed from CNC solution to evaluation as a drug delivery system by the incorporation of a model drug. The drug delivery studies were carried out using chlorhexidine (CHX) as a drug and the antimicrobial efficiency of the CNC membrane loaded with CHX was examined against Gram-positive bacteria Staphylococcus aureus (S. Aureus). The release of CHX from the CNC membranes is determined by UV-Vis. The obtaining methodology of the membranes proved to be simple, and these early studies showed a potential use in antibiotic drug delivery systems due to the release kinetics and the satisfactory antimicrobial activity. PMID:28774122

Postoperative pain following the use of two different intracanal medications.

PubMed

Gama, Tulio G V; de Oliveira, Julio C Machado; Abad, Ernani C; Rôças, Isabela N; Siqueira, José F

2008-12-01

This study evaluated the incidence of postoperative pain after intracanal dressings with either 0.12% chlorhexidine digluconate gel (CHX) or a calcium hydroxide/camphorated paramonochlorophenol/glycerin paste (CH/CPMC). Overall, 138 asymptomatic teeth had their canals instrumented under irrigation with 2.5% NaOCl and then dressed with either CH/CPMC or CHX. The incidence of different intensity levels of postoperative pain was registered for the period between appointments. Data revealed that 84% of the total number of cases treated with either medicament showed absence of any level of pain. No case medicated with CH/CPMC and four cases (5.8%) medicated with CHX were categorized as flare-ups. There were no statistically significant differences between all possible comparisons involving the two medicaments in treatment/retreatment cases and teeth with/without apical periodontitis lesions. The low incidence of postoperative pain after the use of both medications, coupled to their antimicrobial effectiveness, gives support to using one or the other in routine treatment/retreatment.

Effect of cavity disinfectants on antibacterial activity and microtensile bond strength in class I cavity.

PubMed

Kim, Bo-Ram; Oh, Man-Hwan; Shin, Dong-Hoon

2017-05-31

This study was performed to compare the antibacterial activities of three cavity disinfectants [chlorhexidine (CHX), NaOCl, urushiol] and to evaluate their effect on the microtensile bond strength of Scotchbond Universal Adhesive (3M-ESPE, St. Paul, MN, USA) in class I cavities. In both experiments, class I cavities were prepared in dentin. After inoculation with Streptococcus mutans, the cavities of control group were rinsed and those of CHX, NaOCl and urushiol groups were treated with each disinfectant. Standardized amounts of dentin chips were collected and number of S. mutans was determined. Following the same cavity treatment, same adhesive was applied in etch-and-rinse mode. Then, microtensile bond strength was evaluated. The number of S. mutans was significantly reduced in the cavities treated with CHX, NaOCl, and urushiol compared with control group (p<0.05). However, there was a significant bond strength reduction in NaOCl group, which showed statistical difference compared to the other groups (p<0.05).

Recolonization of mutans steptococci on teeth with orthodontic appliances after antimicrobial therapy.

PubMed

Attin, R; Thon, C; Schlagenhauf, U; Werner, C; Wiegand, A; Hannig, C; Attin, T

2005-10-01

The aim of the present study was to compare the recolonization pattern of mutans streptococci on densely colonized teeth with and without fixed orthodontic appliances after treatment with a 40 per cent chlorhexidine (CHX) varnish (EC 40, Explore). Healthy subjects free of carious lesions requiring fixed orthodontic appliance treatment but with high bacterial mutans streptococci saliva counts were recruited (n = 10). For baseline registration, plaque from buccal sites was sampled and cultivated on Dentocult strips. Following professional tooth cleaning, CHX varnish was applied to all teeth for 8 minutes. Subsequently, orthodontic brackets and bands were inserted in either the upper or lower arch. Eight weeks after varnish application the degree of recolonization with mutans streptococci was reassessed on the buccal sites. Statistical analysis showed that recolonization with mutans streptococci was significantly higher (P < 0.05) on teeth with orthodontic appliances. The results indicate that the use of fixed orthodontic appliances creates artificial environments suitable for the proliferation of mutans streptococci after CHX varnish suppression.

Boric acid irrigation as an adjunct to mechanical periodontal therapy in patients with chronic periodontitis: a randomized clinical trial.

PubMed

Sağlam, Mehmet; Arslan, Uğur; Buket Bozkurt, Şerife; Hakki, Sema S

2013-09-01

The purpose of this single-masked, randomized, controlled clinical trial was to evaluate the effects of boric acid irrigation as an adjunct to scaling and root planing (SRP) on clinical and microbiologic parameters and compare this method with chlorhexidine irrigation and SRP alone in patients with chronic periodontitis (CP). Forty-five systemically healthy patients with CP are included in this study. They were divided into three groups: 1) SRP + saline irrigation (C); 2) SRP + chlorhexidine irrigation (CHX); and 3) SRP + boric acid irrigation (B). To determine an ideal concentration of boric acid, a preclinical analysis was conducted. At baseline, 1 month, and 3 months after treatment, clinical measurements, including plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP), were performed, and subgingival plaque samples were taken. Quantitative analysis of Porphyromonas gingivalis (Pg), Tannerella forsythia (Tf), and Treponema denticola (Td) was performed using real-time polymerase chain reaction (PCR) procedures. The concentration of boric acid is 0.75% in this study. All clinical parameters showed statistically significant reduction at all time points compared to baseline in all groups (P <0.001). Whole-mouth PD and CAL reduction was similar in all groups at all time points after treatment (P >0.05). The PD and CAL reductions for moderately deep pockets (PD ≥5 and <7) were greater in the B group compared to other groups between baseline and 1 month (P <0.05). For deep pockets (PD ≥7), reductions were similar in the B and CHX groups (P >0.05). BOP (percentage) was significantly lower in the B group compared with the CHX and C groups in the first month after treatment (P <0.001). GI and PI scores were significantly lower in the B and CHX groups compared with the C group at all time points after treatment (P <0.05). The amounts of Pg, Tf, and Td were significantly reduced in all treatment groups after 1 month (P <0.05). No statistically significant differences were detected among the groups for microbiologic parameters at any time points after treatment (P >0.05). The results of this study suggest that boric acid could be an alternative to chlorhexidine, and it might be more favorable because boric acid was superior in whole-mouth BOP as well as PD and CAL reduction for moderate pockets in early time periods.

Comparison of the Antimicrobial Efficacy of Octenidine Dihydrochloride and Chlorhexidine with and Without Passive Ultrasonic Irrigation - An Invitro Study.

PubMed

Cherian, Bastin; Gehlot, Paras Mull; Manjunath, Mysore Krishnaswamy

2016-06-01

Elimination of microorganisms from infected root canals is a complicated task. Numerous measures have been described to reduce the microbial load in the root canal system, including the use of various instrumentation techniques, irrigation regimens and intracanal medicaments. The drawbacks of few commonly used irrigants include toxic and harmful side effects, microbial resistance to antimicrobial agents and staining. Hence there is a need for alternative agents which are nontoxic, effective and safe. To compare and evaluate antimicrobial effects of 2% Chlorhexidine (CHX) versus 0.1% Octenidine Dihydrochloride (OCT) as root canal irrigant with and without passive ultrasonic irrigation against Enterococcus faecalis (E. faecalis) in vitro and to evaluate the depth of penetration of irrigant solution into the dentinal tubules at the junction of middle and apical third. Forty eight freshly extracted, single rooted human mandibular premolars were decoronated and root specimen standardized to 14mm. Biofilm of E. faecalis (strain ATCC 29212) was grown for seven days and the specimens were divided into four groups (n=12) based on irrigation protocol : Group I- Conventional Syringe Irrigation (CSI) with 2% CHX, Group II- CSI + 0.1% OCT, Group III-Passive Ultrasonic Irrigation (PUI) + 2% CHX and Group IV- PUI+ 0.1% OCT. Dentin shavings were collected at two depths (200μm and 400μm) and total number of colony forming units were determined. The data were statistically analyzed using ANOVA, Scheffes multiple comparison of means and paired t-test (p<0.05). Group III and IV (PUI) showed significant difference compared to Group I and II (CSI) both at 200μm and 400μm (p=0.000). For Group III and Group IV no significant differences were found at 200μm and 400μm (p=1.000 and 0.363 respectively), however significant difference was found between data at 200μm and 400μm for all the four groups (p=0.000). Octenidine (0.1%) was more effective than 2% Chlorhexidine against E. faecalis both at 200μm and 400μm. Passive ultrasonic irrigation proved to enhance the antimicrobial action of the irrigants.

Methacrylate-based root canal sealer containing chlorexidine and α-tricalcium phosphate.

PubMed

Collares, Fabrício Mezzomo; Leitune, Vicente Castelo Branco; Portella, Fernando Freitas; Santos, Paula Dapper; Balbinot, Gabriela de Souza; Dos Santos, Luís Alberto; Parolo, Clarissa Cavalcanti Fatturi; Samuel, Susana Maria Werner

2018-05-01

The aim of this study was to develop and to characterize a methacrylate-based root canal sealer containing chlorhexidine (CHX) and α-tricalcium phosphate (α-TCP). Experimental dual cure methacrylate-based sealer was produced containing 0, 2.5, or 5 wt% of CHX and 0, 25, or 50 wt% of α-TCP. Experimental sealers were evaluated based on flow, film thickness, radiopacity, degree of conversion (DC), degradation in water, pH and antibacterial activity. Flow ranged from 15.09 ± 0.11 to 17.47 ± 0.42 mm. All groups presented mean film thickness lower than 50 µm and had radiopacity equivalent to 3 mmAl. DC was higher than 60% for all compositions. The weight loss (WL) ranged 0.12-3.47%. The groups containing 5% of CHX presented the highest WL and the lower pH values after 28 days of water immersion. All chlorexidine-compositions exhibited antibacterial efficacy against Enterococcus faecalis on direct contact and agar diffusion tests. CHX and α-TCP addition at an experimental methacrylate-based root canal sealer influenced the physicochemical properties and provided antibacterial properties. The incorporation of CHX and α-TCP could be an alternative to antibacterial sealers with potential to improve periapical healing in endodontic treatments. © 2017 Wiley Periodicals, Inc. J Biomater Res Part B: 106B: 1439-1443, 2018. © 2017 Wiley Periodicals, Inc.

Long-term evaluation of the antimicrobial susceptibility and microbial profile of subgingival biofilms in individuals with aggressive periodontitis

PubMed Central

Lourenço, Talita Gomes Baêta; Heller, Débora; do Souto, Renata Martins; Silva-Senem, Mayra Xavier e; Varela, Victor Macedo; Torres, Maria Cynesia Barros; Feres-Filho, Eduardo Jorge; Colombo, Ana Paula Vieira

2015-01-01

This study evaluates the antimicrobial susceptibility and composition of subgingival biofilms in generalized aggressive periodontitis (GAP) patients treated using mechanical/antimicrobial therapies, including chlorhexidine (CHX), amoxicillin (AMX) and metronidazole (MET). GAP patients allocated to the placebo (C, n = 15) or test group (T, n = 16) received full-mouth disinfection with CHX, scaling and root planning, and systemic AMX (500 mg)/MET (250 mg) or placebos. Subgingival plaque samples were obtained at baseline, 3, 6, 9 and 12 months post-therapy from 3–4 periodontal pockets, and the samples were pooled and cultivated under anaerobic conditions. The minimum inhibitory concentrations (MICs) of AMX, MET and CHX were assessed using the microdilution method. Bacterial species present in the cultivated biofilm were identified by checkerboard DNA-DNA hybridization. At baseline, no differences in the MICs between groups were observed for the 3 antimicrobials. In the T group, significant increases in the MICs of CHX (p < 0.05) and AMX (p < 0.01) were detected during the first 3 months; however, the MIC of MET decreased at 12 months (p < 0.05). For several species, the MICs significantly changed over time in both groups, i.e., Streptococci MICs tended to increase, while for several periodontal pathogens, the MICs diminished. A transitory increase in the MIC of the subgingival biofilm to AMX and CHX was observed in GAP patients treated using enhanced mechanical therapy with topical CHX and systemic AMX/MET. Both protocols presented limited effects on the cultivable subgingival microbiota. PMID:26273264

Susceptibility of Torulopsis glabrata in the presence of six antifungal agents determined by comparison of growth at several pHs.

PubMed

Darbord, J C; Vincent, F; Boutron, L; Goury, V; Guyomard, S

1987-03-01

We describe a method using an automated system whereby fungistatic activities can be determined in several conditions. The process was adapted to Torulopsis glabrata, and it showed that benzalkonium chloride, chlorhexidine gluconate, and thimerosal preserve fungistatic activities in acidic medium, whereas acidification reduces the activity of povidone iodine and poloxamer.

Evaluation of Turmeric Chip Compared with Chlorhexidine Chip as a Local Drug Delivery Agent in the Treatment of Chronic Periodontitis: A Split Mouth Randomized Controlled Clinical Trial.

PubMed

Singh, Abhilasha; Sridhar, Raja; Shrihatti, Ravi; Mandloy, Akash

2018-01-01

The aim of this study was to evaluate and compare the effect of chlorhexidine (CHX) chip and turmeric chip as a local drug delivery (LDD) agent in the treatment of patients with chronic periodontitis. A total of 120 sites with pocket depths 5-8 mm were chosen as a split mouth design at 3 sites in the same patient. Selected sites were randomly divided into three groups to receive CHX chip in addition to scaling and root planing (SRP) in group A, turmeric chip in addition to SRP in group B, and SRP only in group C. Clinical parameters, that is, plaque index (PI), gingival index (GI), probing pocket depth (PPD), and relative attachment level (RAL) were recorded at baseline, 1 month, and 3 months interval. On applying statistical analysis, results revealed that there was a significant reduction in all the clinical parameters, that is, PI, GI, PPD, and gain in RAL from baseline to 1 month and 3 months in all the three groups. These results were found to be significantly high in the CHX group and turmeric group than in the SRP group. Also, the results in both the test groups were maintained till the end of the study periods, but SRP group showed a significant deterioration after 1 month as was seen by increase in PPD and decrease in RAL scores after 3 months in the SRP group. Both the treatment modalities with the application of LDD as an adjunct to SRP proved to be equally beneficial in the treatment of chronic periodontitis.

Comparative evaluation of the efficacy of a herbal mouthwash and chlorhexidine mouthwash on select periodontal pathogens: An in vitro and ex vivo study

PubMed Central

Pathan, Multazim Muradkhan; Bhat, Kishore Gajanan; Joshi, Vinayak Mahableshwar

2017-01-01

Background: Several herbal mouthwash and herbal extracts have been tested in vitro and in vivo in search of a suitable adjunct to mechanical therapy for long-term use. In this study, we aimed to look at the antimicrobial effect of the herbal mouthwash and chlorhexidine (CHX) mouthwash on select organisms in in vitro test and an ex vivo model. Materials and Methods: The antimicrobial effects were determined against standard strains of bacteria that are involved in different stages of periodontal diseases. The in vitro tests included determination of minimum inhibitory concentration (MIC) using broth dilution and agar diffusion. In the ex vivo part of the study supragingival dental plaque were obtained from 20 periodontally healthy adult volunteers. Descriptive analysis was done for the entire quantitative and qualitative variable recorded. Results: The MIC by broth dilution method found no statistically significant difference between the mouthwashes. The agar dilution method showed CHX was more effective as compared to the herbal mouthwash against standard strains of Streptococcus mutans, Streptococcus sanguinis, and Aggregatibacter actinomycetemcomitans. However, no difference was observed between the mouthwashes for Porphyromonas, Pseudomonas aeruginosa, and Fusobacterium nucleatum. The ex vivo results conclude that none of the selected mouthwashes were statistically significantly different from each other. Conclusion: In the present study, CHX showed higher levels of antimicrobial action than the herbal mouthwash against bacterial species. The results reinforce the earlier findings that the in vitro testing is sensitive to methods and due diligence is needed when extrapolating the data for further use. However, long-term use and in vivo effectiveness against the periopathogens need to be tested in well-planned clinical trials. PMID:29456300

Effect of 4% chlorhexidine gluconate predisinfection skin scrub prior to hepatectomy: a double-blinded, randomized control study.

PubMed

Hsieh, Ching-Shui; Cheng, Hsiu-Chi; Lin, Jen-Shiou; Kuo, Shou-Jen; Chen, Yao-Li

2014-01-01

This trial was designed to compare the efficacy of 4% chlorhexidine gluconate (CHG) with normal saline (NS) as a predisinfection skin-scrub solution prior to standard presurgical skin preparation. Data was collected at a single transplantation center where patients electing resection of hepatic tumors were recruited between October 2011 and September 2012. In total, 100 patients were consecutively enrolled for random assignment to either 4% CHG or NS as a predisinfection skin-scrub solution prior to surgery. Our aim was to assess the comparative antiseptic efficacy of CHG in this setting, focusing on cutaneous microbial colonization (at baseline, preoperatively, and postoperatively) and postsurgical site infections as primary outcome measures. Positivity rates of baseline, preoperative, and postoperative cultures were similar for both groups, showing significant declines (relative to baseline) after skin preparation and no significant postsurgical rebound. Rates of surgical site infection were also similar in both groups (CHG, 6.0%; NS, 4.1%; P = 1.0). For patients with hepatic tumors undergoing hepatectomy, the effect of 4% CHG as a predisinfection scrub solution was similar to that of NS in terms of skin decontamination and surgical site infections.

Comparative evaluation of terminalia chebula extract mouthwash and chlorhexidine mouthwash on plaque and gingival inflammation - 4-week randomised control trial.

PubMed

Gupta, Devanand; Gupta, Rajendra Kumar; Bhaskar, Dara John; Gupta, Vipul

2015-01-01

The present study was conducted to assess the effectiveness of Terminalia chebula on plaque and gingival inflammation and compare it with the gold standard chlorhexidine (CHX 0.2%) and distilled water as control (placebo). A double-blind randomised control trial was conducted among undergraduate students who volunteered. They were randomly allocated into three study groups: 1) Terminalia chebula mouthwash (n = 30); 2) chlorhexidine (active control) (n = 30); 3) distilled water (placebo) (n = 30). Assessment was carried out according to plaque score and gingival score. Statistical analysis was carried out to compare the effect of both mouthwashes. ANOVA and post-hoc LSD tests were performed using SPSS version 17 with p ≤ 0.05 considered statistically significant. Our result showed that Terminalia chebula mouthrinse is as effective as chlorhexidine in reducing dental plaque and gingival inflammation. The results demonstrated a significant reduction of gingival bleeding and plaque indices in both groups over a period of 15 and 30 days as compared to the placebo. The results of the present study indicate that Terminalia chebula may prove to be an effective mouthwash. Terminalia chebula extract mouthrinse can be used as an alternative to chlorhexidine mouthrinse as it has similar properties without the side-effects of the latter.

Effect of dentin etching and chlorhexidine application on metalloproteinase-mediated collagen degradation

PubMed Central

Raquel, Osorio; Mónica, Yamauti; Estrella, Osorio; Estrella, Ruiz-Requena María; David, Pashley; Franklin, Tay; Manuel, Toledano

2013-01-01

Dentin matrix metalloproteinases (MMPs) are involved in collagen degradation of resin-dentin interfaces. This study evaluated if collagen degradation can be prevented by chlorhexidine after different dentin demineralization procedures. Human dentin demineralization was performed with phosphoric acid (PA), EDTA, or acidic monomers (ClearfilSEBond and XENOV). Specimens were stored (24 h, 1 wk or 3 wk) in the presence or absence of chlorhexidine. In half of the groups, active MMP-2 was incorporated into the storing solution. C-terminal telopeptide determination (ICTP) was performed in the supernatants. Collagen degradation was higher in PA and EDTA-demineralized dentin. Chlorhexidine reduced collagen degradation in these groups only for 24 h. When dentin was demineralized with SEBond or Xeno, collagen degradation was reduced up to 30%, but addition of exogenous MMP-2 significantly increased collagen degradation. In self-etchant treated dentin the inhibitory effect of chlorhexidine on MMPs lasted up to 3 wk. Treating dentin with EDTA, PA or self-etching agents produces enough demineralization to permit cleavage of the exposed collagen. Monomers infiltration may exert protection on demineralized collagen, probably through immobilization of MMPs. The partial inhibitory action of CHX on MMP activity produced by self-etching adhesives was prolonged compared to the short-acting in PA or EDTA-treated dentin. PMID:21244516

Clinical efficacy of a 1% Matricaria chamomile L. mouthwash and 0.12% chlorhexidine for gingivitis control in patients undergoing orthodontic treatment with fixed appliances.

PubMed

Goes, Paula; Dutra, Caio S; Lisboa, Mário R P; Gondim, Delane V; Leitão, Renata; Brito, Gerly A C; Rego, Rodrigo O

2016-01-01

This pilot study evaluated the clinical efficacy of a mouthwash containing 1% Matricaria chamomilla L. (MTC) extract in reducing gingival inflammation and plaque formation in patients undergoing orthodontic treatment with fixed appliances. This randomized, double-blind, placebo-controlled study enrolled a total of 30 males and females (age, 10-40 years) with fixed orthodontic appliances and a minimum of 20 natural teeth. The participants were allocated to three groups (n = 10 each) and asked to rinse with 15 mL of a placebo, 0.12% chlorhexidine (CHX), or 1% MTC mouthwash, immediately after brushing for 1 min, in the morning and evening, for 15 days. Data (mean ± SD) on visible plaque index (VPI) and gingival bleeding index (GBI) were recorded on days 1 and 15. The placebo group exhibited increases in VPI and GBI (10.2% and 23.1%, respectively) from day 1 to day 15. As compared with placebo, VPI and GBI significantly decreased in the MTC group (-25.6% and -29.9%, respectively) and the CHX group (-39.9% and -32.0%, respectively). In summary, MTC reduced biofilm accumulation and gingival bleeding in patients with gingivitis, probably because of its antimicrobial and anti-inflammatory activities.(J Oral Sci 58, 569-574, 2016).

New intracanal formulations containing doxycycline or chlorhexidine against Enterococcus faecalis.

PubMed

Silva, Ana Rita Marques da; Pinto, Shelon Cristina Souza; Santos, Elizabete Brasil dos; Santos, Fábio André dos; Farago, Paulo Vitor; Gomes, João Carlos; Pina-Vaz, Irene; Carvalho, Manuel Fontes

2014-01-01

The present study aims to evaluate the antimicrobial effect of two new intracanal preparations against E. faecalis. Thirty single-rooted human canine teeth were used. The crowns were removed and the roots were instrumented using a conventional technique. Three groups of ten teeth each were infected with 108 CFU/ ml of E. faecalis for 21 days. The root canals were flled with new intracanal medications containing 3% doxycycline hydrochloride (DX) or 2% chlorhexidine digluconate (CHX). Ten teeth received no medication (NM)-negative control. Microbial samples were obtained 21 days after contamination: 14 days under the effect of the intracanal medications and 7 days after replacing the medications by BHI broth. The samples were homogenized, diluted, seeded on BHI agar and incubated for 48h/36°C. The number of colony forming units (CFU/ml) was obtained and analyzed statistically. All intracanal dressings significantly reduced the number of bacterial cells in the root canal after 14 days with medication. After the period with 7 days with BHI broth, the CFU counts of E. faecalis remained at low values. However, the NM group showed a significant increase of CFU in this period to similar values of the initial contamination. 3% doxycycline hydrochloride gel and 2% CHX gel were effective to eliminate E. faecalis from the root canal system.

Sterilization of Biofilm on a Titanium Surface Using a Combination of Nonthermal Plasma and Chlorhexidine Digluconate.

PubMed

Gupta, Tripti Thapa; Karki, Surya B; Matson, Jyl S; Gehling, Daniel J; Ayan, Halim

2017-01-01

Nosocomial infections caused by opportunistic bacteria pose major healthcare problem worldwide. Out of the many microorganisms responsible for such infections, Pseudomonas aeruginosa is a ubiquitous bacterium that accounts for 10-20% of hospital-acquired infections. These infections have mortality rates ranging from 18 to 60% and the cost of treatment ranges from $20,000 to $80,000 per infection. The formation of biofilms on medical devices and implants is responsible for the majority of those infections. Only limited progress has been made to prevent this issue in a safe and cost-effective manner. To address this, we propose employing jet plasma to break down and inactivate biofilms in vitro . Moreover, to improve the antimicrobial effect on the biofilm, a treatment method using a combination of jet plasma and a biocide known as chlorhexidine (CHX) digluconate was investigated. We found that complete sterilization of P. aeruginosa biofilms can be achieved after combinatorial treatment using plasma and CHX. A decrease in biofilm viability was also observed using confocal laser scanning electron microscopy (CLSM). This treatment method sterilized biofilm-contaminated surfaces in a short treatment time, indicating it to be a potential tool for the removal of biofilms present on medical devices and implants.

Efficacy of taurolidine against periodontopathic species--an in vitro study.

PubMed

Eick, Sigrun; Radakovic, Sabrina; Pfister, Wolfgang; Nietzsche, Sandor; Sculean, Anton

2012-06-01

The antimicrobial effect of taurolidine was tested against periodontopathic species in comparison to chlorhexidine digluconate in the presence or absence of serum. Minimal inhibitory concentrations (MIC), microbiocidal concentrations (MBC), as well as killing were determined against 32 different microbial strains including 3 Porphyromonas gingivalis, 3 Aggregatibacter actinomycetemcomitans, and 15 potentially superinfecting species with and without 25% v/v human serum. The MIC(50) of taurolidine against the tested microbial strains was 0.025% and the MIC(90) 0.05%. The respective values for the MBCs were 0.05% and 0.1%. Addition of 25% serum (heat-inactivated) did not change the MIC and MBC values of taurolidine. In contrast, MICs and MBCs of chlorhexidine (CHX) increased by two steps after addition of serum. Taurolidine killed microorganisms in a concentration and time-dependent manner, the killing rate of 1.6% taurolidine was 99.08% ± 2.27% in mean after 2 h. Again, killing activity of taurolidine was not affected if serum was added, whereas addition of inactivated serum clearly reduced the killing rate of all selected bacterial strains by CHX. Therefore, taurolidine possesses antimicrobial properties which are not reduced in the presence of serum as a main component in gingival crevicular fluid and wound fluid. Taurolidine may have potential as an antimicrobial agent in non-surgical and surgical periodontal treatment.

Effects of short-term immersion and brushing with different denture cleansers on the roughness, hardness, and color of two types of acrylic resin.

PubMed

Panariello, Beatriz Helena Dias; Izumida, Fernanda Emiko; Moffa, Eduardo Buozi; Pavarina, Ana Claudia; Jorge, Janaina Habib; Giampaolo, Eunice Teresinha

2015-06-01

To investigate the cumulative effects of brushing (B) or immersion (I), using different cleansing agents, on the surface roughness, hardness and color stability of a heat-polymerized denture resin, Lucitone 550 (L), and a hard chairside reline resin, Tokuyama Rebase Fast II (T). A total of 316 specimens (10 x 2 mm) were fabricated. The specimens (n = 9) were divided into brushing or immersion groups according to the following agents: dentifrice/distilled water (D), 1% sodium hypochlorite (NaOCl), Corega Tabs (Pb), 1% chlorhexidine gluconate (Chx), and 0.2% peracetic acid (Ac). Brushing and immersion were tested independently. Assays were performed after 1, 3, 21, 45 and 90 brushing cycles or immersion of 10 seconds each. Data were evaluated statistically by repeated measures ANOVA. Tukey's honestly significant difference (HSD) post-hoc test was used to determine differences between means (α = 0.05). For L there was no statistically significant difference in roughness, except a significant decrease in roughness by brushing with D. T showed a significant effect on the roughness after 90 immersions with Ac. Hardness values decreased for L when specimens were immersed or brushed in NaOCl and Pb. The hardness of T decreased with increases in the repetitions (immersion or brushing), regardless of the cleaning method. Values of color stability for L resin showed significant color change after brushing with and immersion in Ac and Pb. Brushing with D exhibited a higher incidence of color change. For T there were no significant differences between cleaning agents and repetitions in immersion. A color change was noted after three brushings with the Ac, Chx, and D. Brushing with dentifrice decreased roughness of L. Immersion in or brushing with NaOCl and Pb decreased the hardness of L. For T, hardness decreased with increases in immersions or brushing. Color changes after the immersion in or brushing with cleaning agents were clinically acceptable according to National Bureau of Standards parameters for both resins.

Hyaluronic Acid and Polyethylene Glycol Hybrid Hydrogel Encapsulating Nanogel with Hemostasis and Sustainable Antibacterial Property for Wound Healing.

PubMed

Zhu, Jie; Li, Faxue; Wang, Xueli; Yu, Jianyong; Wu, Dequn

2018-04-25

Immediate hemorrhage control and anti-infection play important roles in the wound management. Besides, a moist environment is also beneficial for wound healing. Hydrogels are promising materials in urgent hemostasis and drug release. However, hydrogels have the disadvantage of rapid release profiles, leading to the exposure to high drug concentrations. In this study, we constructed hybrid hydrogels with rapid hemostasis and sustainable antibacterial property combining aminoethyl methacrylate hyaluronic acid (HA-AEMA) and methacrylated methoxy polyethylene glycol (mPEG-MA) hybrid hydrogels and chlorhexidine diacetate (CHX)-loaded nanogels. The CHX-loaded nanogels (CLNs) were prepared by the enzyme degradation of CHX-loaded lysine-based hydrogels. The HA-AEMA and mPEG-MA hybrid hydrogel loaded with CLNs (labeled as Gel@CLN) displayed a three-dimensional microporous structure and exhibited excellent swelling, mechanical property, and low cytotoxicity. The Gel@CLN hydrogel showed a prolonged release period of CHX over 240 h and the antibacterial property over 10 days. The hemostasis and wound-healing properties were evaluated in vivo using a mouse model. The results showed that hydrogel had the rapid hemostasis capacity and accelerated wound healing. In summary, CLN-loaded hydrogels may be excellent candidates as hemostasis and anti-infection materials for the wound dressing application.

Comparative antibacterial efficacies of hydrodynamic and ultrasonic irrigation systems in vitro.

PubMed

Cachovan, Georg; Schiffner, Ulrich; Altenhof, Saskia; Guentsch, Arndt; Pfister, Wolfgang; Eick, Sigrun

2013-09-01

To ensure root canal treatment success, endodontic microbiota should be efficiently reduced. The in vitro bactericidal effects of a hydrodynamic system and a passive ultrasonic irrigation system were compared. Single-rooted extracted teeth (n = 250) were contaminated with suspensions of Enterococcus faecalis ATCC 29212, mixed aerobic cultures, or mixed anaerobic cultures. First, the antibacterial effects of the hydrodynamic system (RinsEndo), a passive ultrasonic irrigation system (Piezo smart), and manual rinsing with 0.9% NaCl (the control) were compared. Colony-forming units were counted. Second, the 2 systems were used with 1.5% sodium hypochlorite (NaOCl) alone or NaOCl + 0.2% chlorhexidine (CHX). The colony-forming units in the treated and untreated roots were determined during a period of 5 days. Both irrigation systems reduced bacterial numbers more effectively than manual rinsing (P < .001). With NaCl, ultrasonic activated irrigation reduced bacterial counts significantly better than hydrodynamic irrigation (P = .042). The NaOCl + CHX combination was more effective than NaOCl alone for both systems (P < .001), but hydrodynamic irrigation was more effective with NaOCl + CHX than the passive ultrasonic irrigation system. Both irrigation systems, when combined with NaOCl + CHX, removed bacteria from root canals. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Morphological effects of MMPs inhibitors on the dentin bonding

PubMed Central

Li, He; Li, Tianbo; Li, Xiuying; Zhang, Zhimin; Li, Penglian; Li, Zhenling

2015-01-01

Matrix metalloproteinases (MMPs) have been studied extensively, and MMP inhibitors have been used as dental pretreatment agents prior to dentin bonding because they reduce collagen fiber degradation and improve bonding strength. However, morphologic characteristics of the collagen network after etching and of the post-adhesive dentin hybrid layers (DHL) after MMP inhibitors pretreatment have not been evaluated. Thus, we investigated demineralized dentin pretreated with chlorhexidine (CHX) and minocycline (MI) in an etch- and -rinse adhesive system with field emission scanning electron microscopy (FESEM) and immuno-gold labeling markers to observe the collagen network and DHL. FESEM revealed after CHX and MI, a demineralized dentin surface and improved collagen network formation, reduced collagen degradation, and distinct gold-labeling signals. Applying adhesive after either MMP inhibitor created a better dentin interface as evidenced by immuno-gold staining, better adhesive penetration, and higher DHL quality. With microtensile bond strength tests (µTBS) we estimated bonding strength using µTBS data. Immediate µTBS was enhanced with MMP inhibitor application to the bonding surface, and the CHX group was significantly different than non-treated etched surfaces, but no significant change was detected in the MI group. Surface micromorphology of the fractured dentin resin restoration showed that the CHX group had a better resin and dentin tube combination. Both MMP inhibitors created uniform resin coverage. Thus, morphologic results and µTBS data suggest that CHX and MI can inhibit MMP activity, improve immediate bonding strength, and enhance dentin bonding stability with an etch- and -rinse adhesive system. PMID:26379873

Antibacterial Action of a Condensed Tannin Extracted from Astringent Persimmon as a Component of Food Addictive Pancil PS-M on Oral Polymicrobial Biofilms

PubMed Central

Tomiyama, Kiyoshi; Mukai, Yoshiharu; Saito, Masahiro; Watanabe, Kiyoko; Kumada, Hidefumi; Nihei, Tomotaro; Hamada, Nobushiro; Teranaka, Toshio

2016-01-01

The purpose of this study was to evaluate the antibacterial activity against polymicrobial (PM) biofilms of a condensed tannin extracted from astringent persimmon (PS-M), which is contained in refreshing beverages commercially available in Japan. Salivary PM biofilms were formed anaerobically on glass coverslips for 24 and 72 h and were treated for 5 min with sterilized deionized water (DW), 0.05 and 0.2 wt% chlorhexidine digluconate (CHX), and 0.5–4.0 wt% PS-M solution. The colony forming units (CFU/mL) were determined and morphological changes of the biofilms were observed by scanning electron microscopy (SEM). The CFUs were lower in all PS-M and CHX groups compared to the DW group. PS-M exerted a dose-dependent effect. PS-M (1.53 × 107) at a dose of 4.0 wt% had the same effect as 0.2 wt% CHX (2.03 × 107), regardless of the culture period. SEM revealed the biofilm structures were considerably destroyed in the 4.0 wt% PS-M and 0.2 wt% CHX. These findings indicate that the antibacterial effects of PS-M, a naturally derived substance, are comparable to those of CHX. PS-M may keep the oral cavity clean and prevent dental caries and periodontal disease related to dental plaque, as well as systemic disease such as aspiration pneumonitis. PMID:26981533

Antimicrobial effect of three disinfecting agents on Resilon cones and their effect on surface topography: An in vitro study.

PubMed

Chandrappa, Mahesh Martur; Meharwade, Prasanna Mahadevasa; Srinivasan, Raghu; Bhandary, Shreetha; Nasreen, Farhat

2016-01-01

The objective of this study was to evaluate the effectiveness of 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and 2% peracetic acid (PAA) in disinfecting Resilon cones and to evaluate topographical changes microscopically under scanning electron microscope (SEM) after rapid chemical disinfection. Resilon cones were disinfected in an ultraviolet (UV) light chamber for 20 min and contaminated by immersing in a microbial suspension of Enterococcus faecalis for 30 min. The contaminated cones were then immersed in the 5.25% NaOCl, 2% CHX, and 2% PAA for 1 min, 5 min, and 10 min, separately. The cones were then incubated at 37°C in thioglycollate broth for 7 days and examined for turbidity. The samples showing turbidity were subcultured on blood agar and incubated at 37°C for 48 h. Gram staining was done to confirm that the cultured bacteria were E. faecalis. Surface changes of disinfected Resilon cones were evaluated under SEM. The data were analyzed statistically using Kruskal-Wallis, analysis of variance (ANOVA), and Mann-Whitney U-test. In eliminating E. faecalis, 5.25% NaOCl was most effective followed by 2% PAA and 2% CHX. Topographic examination of tested Resilon cones revealed some surface deposits after disinfection with 5.25% NaOCl and 2% CHX, whereas 2% PAA caused surface erosion. In disinfecting Resilon cones, 5.25% NaOCl is most effective followed by 2% PAA and 2% CHX.

Use of the probiotic Lactobacillus plantarum 299 to reduce pathogenic bacteria in the oropharynx of intubated patients: a randomised controlled open pilot study

PubMed Central

Klarin, Bengt; Molin, Göran; Jeppsson, Bengt; Larsson, Anders

2008-01-01

Introduction Ventilator-associated pneumonia (VAP) is usually caused by aspiration of pathogenic bacteria from the oropharynx. Oral decontamination with antiseptics, such as chlorhexidine (CHX) or antibiotics, has been used as prophylaxis against this complication. We hypothesised that the probiotic bacteria Lactobacillus plantarum 299 (Lp299) would be as efficient as CHX in reducing the pathogenic bacterial load in the oropharynx of tracheally intubated, mechanically ventilated, critically ill patients. Methods Fifty critically ill patients on mechanical ventilation were randomised to either oral mechanical cleansing followed by washing with 0.1% CHX solution or to the same cleansing procedure followed by oral application of an emulsion of Lp299. Samples for microbiological analyses were taken from the oropharynx and trachea at inclusion and at defined intervals thereafter. Results Potentially pathogenic bacteria that were not present at inclusion were identified in oropharyngeal samples from eight of the patients treated with Lp299 and 13 of those treated with CHX (p = 0.13). Analysis of tracheal samples yielded similar results. Lp299 was recovered from the oropharynx of all patients in the Lp299 group. Conclusions In this pilot study, we found no difference between the effect of Lp299 and CHX used in oral care procedures, when we examined the effects of those agents on colonisation of potentially pathogenic bacteria in the oropharynx of intubated, mechanically ventilated patients. PMID:18990201

Clinical comparison of plaque inhibition effects of a novel stabilized stannous fluoride dentifrice and a chlorhexidine digluconate dentifrice using digital plaque imaging.

PubMed

Bellamy, P G; Boulding, A; Farmer, S; Day, T N; Mussett, A J; Barker, M L

2011-01-01

To compare the plaque inhibition efficacy of a novel 0.454% stannous fluoride (SnF2) test dentifrice with sodium hexametaphosphate and stannous chloride to a chlorhexidine digluconate (0.05%), aluminium lactate (0.8%), and aluminium fluoride marketed control dentifrice (Lacalut Aktiv or AlF3/Chx). This was a randomized, two-treatment, two-period, double-blind crossover study that compared the SnF2 test dentifrice to the AlF3/Chx control dentifrice. Each of the two treatment periods lasted for 17 consecutive days of product use, during which subjects were required to brush twice per day with their assigned dentifrice using a standard manual toothbrush (Oral-B P35 Indicator). The two periods of the crossover were separated by a four-day washout period. Plaque levels on the facial anterior tooth surfaces were evaluated and averaged among three assessment days at the end of each treatment period using digital plaque imaging analysis (DPIA). The evening prior to assessments, subjects only brushed lingual surfaces. Assessment time points were carried out in the morning following no morning brushing (A.M. pre-brush), following 40 seconds of brushing with the assigned dentifrice (A.M. post-brush), and in the afternoon (P.M.). The DPIA captured images were used to calculate and analyze visible plaque coverage. Twenty-eight subjects were randomized and completed the study. At each assessment time point, the SnF2 test dentifrice demonstrated a statistically significant lower plaque level compared to the AlF3/Chx dentifrice: A.M. mean pre-brush 15.9% lower, p < 0.05; A.M. mean post-brush 22.2% lower, p < 0.05; P.M. mean 24.3% lower, p < 0.005. Compared to the AlF3/Chx control dentifrice, the novel SnF2 test dentifrice significantly inhibited plaque regrowth overnight and during the day. Immediately after brushing there was also significantly less plaque coverage with the SnF2 test dentifrice.

Cytotoxicity and the effect of cationic peptide fragments against cariogenic bacteria under planktonic and biofilm conditions.

PubMed

Kreling, Paula Fernanda; Aida, Kelly Limi; Massunari, Loiane; Caiaffa, Karina Sampaio; Percinoto, Célio; Bedran, Telma Blanca Lombardo; Spolidorio, Denise Madalena Palomari; Abuna, Gabriel Flores; Cilli, Eduardo Maffud; Duque, Cristiane

2016-10-01

This study evaluated the cytotoxicity and effect of fragments derived from three oral cationic peptides (CP): LL-37, D6-17 and D1-23 against cariogenic bacteria under planktonic and biofilm conditions. For cytotoxicity analysis, two epithelial cell lines were used. The minimum inhibitory concentration and the minimal bactericidal concentration were determined for the CP fragments and the control (chlorhexidine-CHX) against cariogenic bacteria. The fractional inhibitory concentration was obtained for the combinations of CP fragments on Streptococcus mutans. Biofilm assays were conducted with the best antimicrobial CP fragment against S. mutans. The results indicated that D6-17 was not cytotoxic. D1-23, LL-37 and CHX were not cytotoxic in low concentrations. D1-23 presented the best bactericidal activity against S. mutans, S. mitis and S. salivarius. Combinations of CP fragments did not show a synergic effect. D1-23 presented a higher activity against S. mutans biofilm than CHX. It was concluded that D1-23 showed a substantial effect against cariogenic bacteria and low cytotoxicity.

Development of dental composites with reactive fillers that promote precipitation of antibacterial-hydroxyapatite layers.

PubMed

Aljabo, Anas; Abou Neel, Ensanya A; Knowles, Jonathan C; Young, Anne M

2016-03-01

The study aim was to develop light-curable, high strength dental composites that would release calcium phosphate and chlorhexidine (CHX) but additionally promote surface hydroxyapatite/CHX co-precipitation in simulated body fluid (SBF). 80 wt.% urethane dimethacrylate based liquid was mixed with glass fillers containing 10 wt.% CHX and 0, 10, 20 or 40 wt.% reactive mono- and tricalcium phosphate (CaP). Surface hydroxyapatite layer thickness/coverage from SEM images, Ca/Si ratio from EDX and hydroxyapatite Raman peak intensities were all proportional to both time in SBF and CaP wt.% in the filler. Hydroxyapatite was, however, difficult to detect by XRD until 4 weeks. XRD peak width and SEM images suggested this was due to the very small size (~10 nm) of the hydroxyapatite crystallites. Precipitate mass at 12 weeks was 22 wt.% of the sample CaP total mass irrespective of CaP wt.% and up to 7 wt.% of the specimen. Early diffusion controlled CHX release, assessed by UV spectrometry, was proportional to CaP and twice as fast in water compared with SBF. After 1 week, CHX continued to diffuse into water but in SBF, became entrapped within the precipitating hydroxyapatite layer. At 12 weeks CHX formed 5 to 15% of the HA layer with 10 to 40 wt.% CaP respectively. Despite linear decline of strength and modulus in 4 weeks from 160 to 101 MPa and 4 to 2.4 GPa, respectively, upon raising CaP content, all values were still within the range expected for commercial composites. The high strength, hydroxyapatite precipitation and surface antibacterial accumulation should reduce tooth restoration failure due to fracture, aid demineralised dentine repair and prevent subsurface carious disease respectively. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

Red fluorescence of dental biofilm as an indicator for assessing the efficacy of antimicrobials

NASA Astrophysics Data System (ADS)

Lee, Eun-Song; de Josselin de Jong, Elbert; Jung, Hoi-In; Kim, Baek-Il

2018-01-01

The study aimed to determine whether the red fluorescence (RF) of a dental microcosm biofilm as measured with quantitative light-induced fluorescence (QLF) technology is useful for assessing the efficacy of antimicrobials. Dental microcosm biofilms were formed on bovine enamel discs and grown under 0.3% sucrose challenge and treated with chlorhexidine (CHX) solutions at different concentrations (0.05%, 0.1%, and 0.5%) plus a negative control [sterile distilled water (DW)] twice daily for 7 days. The biofilms were photographed using a QLF-digital system to evaluate the RF by calculating the red/green ratio, and pH values of the medium were measured daily. After 7 days, the bacterial viability of the biofilm was assessed by measuring the counts of viable total bacteria and aciduric bacteria, and the percentage surface microhardness changes (%SHC) was evaluated. The RF and cariogenic properties were compared for the different concentrations of CHX, and their correlations were examined. The RF and its increase rate were much lower for CHX-treated biofilms than for DW-treated biofilms. The RF after 7 days of maturation decreased significantly with increasing CHX concentrations (p<0.001) and was from 31% (for 0.05% CHX) to 46% (for 0.5% CHX) lower than that of the DW group. Strong correlations were reported between the RF of the 7-day-maturation biofilms and cariogenic properties, such as the number of total bacteria (r=0.93), number of aciduric bacteria (r=0.97), supernatant pH (r=0.43), and %SHC (r=0.98). In conclusion, the RF of dental biofilms as measured with QLF technology can be used to nondestructively assess and monitor the effect of antimicrobials against biofilm.

Comparative antimicrobial activity, in vitro and in vivo, of soft N-chloramine systems and chlorhexidine.

PubMed Central

Selk, S H; Pogány, S A; Higuchi, T

1982-01-01

Antimicrobial activity of the following four new N-chloramine compounds was evaluated: two chlorinated simple amino acids, a chlorinated half-ester of succinic acid, and a chlorinated half-ester of glutaric acid. For comparison, the known bactericidal agents 3-chloro-4,4-dimethyl-2-oxazolidinone and chlorhexidine were evaluated by the same procedure. The contact germicidal efficiency screen was used to examine the in vitro bactericidal activity of all six compounds in the absence and presence of 5% horse serum or 5% Triton X-100. The four new compounds were found to have greater germicidal activity than the other compounds tested and to exhibit low toxicity and skin irritation values. The in vivo bactericidal activity was evaluated in two studies. In the occlusion test, three of the four new compounds plus chlorhexidine diacetate were tested. The N-chloramines were significantly superior to chlorhexidine in preventing the expansion of the normal flora under occlusion. In the scrub test, a gloved-hand wash method was used to compare the antimicrobial effect of a 1% solution of the chlorinated half-ester of succinic acid in triacetin with that of a commercial germicidal hand wash containing 4% chlorhexidine gluconate. The two preparations exhibited essentially the same hand-degerming activity. PMID:6805433

Comparison of the Antimicrobial Efficacy of Octenidine Dihydrochloride and Chlorhexidine with and Without Passive Ultrasonic Irrigation - An Invitro Study

PubMed Central

Cherian, Bastin; Manjunath, Mysore Krishnaswamy

2016-01-01

Introduction Elimination of microorganisms from infected root canals is a complicated task. Numerous measures have been described to reduce the microbial load in the root canal system, including the use of various instrumentation techniques, irrigation regimens and intracanal medicaments. The drawbacks of few commonly used irrigants include toxic and harmful side effects, microbial resistance to antimicrobial agents and staining. Hence there is a need for alternative agents which are nontoxic, effective and safe. Aim To compare and evaluate antimicrobial effects of 2% Chlorhexidine (CHX) versus 0.1% Octenidine Dihydrochloride (OCT) as root canal irrigant with and without passive ultrasonic irrigation against Enterococcus faecalis (E. faecalis) in vitro and to evaluate the depth of penetration of irrigant solution into the dentinal tubules at the junction of middle and apical third. Materials and Methods Forty eight freshly extracted, single rooted human mandibular premolars were decoronated and root specimen standardized to 14mm. Biofilm of E. faecalis (strain ATCC 29212) was grown for seven days and the specimens were divided into four groups (n=12) based on irrigation protocol : Group I- Conventional Syringe Irrigation (CSI) with 2% CHX, Group II- CSI + 0.1% OCT, Group III-Passive Ultrasonic Irrigation (PUI) + 2% CHX and Group IV- PUI+ 0.1% OCT. Dentin shavings were collected at two depths (200μm and 400μm) and total number of colony forming units were determined. The data were statistically analyzed using ANOVA, Scheffes multiple comparison of means and paired t-test (p<0.05). Results Group III and IV (PUI) showed significant difference compared to Group I and II (CSI) both at 200μm and 400μm (p=0.000). For Group III and Group IV no significant differences were found at 200μm and 400μm (p=1.000 and 0.363 respectively), however significant difference was found between data at 200μm and 400μm for all the four groups (p=0.000). Conclusion Octenidine (0.1%) was more effective than 2% Chlorhexidine against E. faecalis both at 200μm and 400μm. Passive ultrasonic irrigation proved to enhance the antimicrobial action of the irrigants. PMID:27504415

Gold Nanoparticle Conjugation Enhances the Antiacanthamoebic Effects of Chlorhexidine

PubMed Central

Aqeel, Yousuf; Siddiqui, Ruqaiyyah; Anwar, Ayaz; Shah, Muhammad Raza

2015-01-01

Acanthamoeba keratitis is a serious infection with blinding consequences and often associated with contact lens wear. Early diagnosis, followed by aggressive topical application of drugs, is a prerequisite in successful treatment, but even then prognosis remains poor. Several drugs have shown promise, including chlorhexidine gluconate; however, host cell toxicity at physiologically relevant concentrations remains a challenge. Nanoparticles, subcolloidal structures ranging in size from 10 to 100 nm, are effective drug carriers for enhancing drug potency. The overall aim of the present study was to determine whether conjugation with gold nanoparticles enhances the antiacanthamoebic potential of chlorhexidine. Gold-conjugated chlorhexidine nanoparticles were synthesized. Briefly, gold solution was mixed with chlorhexidine and reduced by adding sodium borohydride, resulting in an intense deep red color, indicative of colloidal gold-conjugated chlorhexidine nanoparticles. The synthesis was confirmed using UV-visible spectrophotometry that shows a plasmon resonance peak of 500 to 550 nm, indicative of gold nanoparticles. Further characterization using matrix-assisted laser desorption ionization-mass spectrometry showed a gold-conjugated chlorhexidine complex at m/z 699 ranging in size from 20 to 100 nm, as determined using atomic force microscopy. To determine the amoebicidal and amoebistatic effects, amoebae were incubated with gold-conjugated chlorhexidine nanoparticles. For controls, amoebae also were incubated with gold and silver nanoparticles alone, chlorhexidine alone, neomycin-conjugated nanoparticles, and neomycin alone. The findings showed that gold-conjugated chlorhexidine nanoparticles exhibited significant amoebicidal and amoebistatic effects at 5 μM. Amoebicidal effects were observed by parasite viability testing using a Trypan blue exclusion assay and flow-cytometric analysis using propidium iodide, while amoebistatic effects were observed using growth assays. In contrast, chlorhexidine alone, at a similar concentration, showed limited effects. Notably, neomycin alone or conjugated with nanoparticles did not show amoebicidal or amoebistatic effects. Pretreatment of A. castellanii with gold-conjugated chlorhexidine nanoparticles reduced amoeba-mediated host cell cytotoxicity from 90% to 40% at 5 μM. In contrast, chlorhexidine alone, at similar concentrations, had no protective effects for the host cells. Similarly, amoebae treated with neomycin alone or neomycin-conjugated nanoparticles showed no protective effects. Overall, these findings suggest that gold-conjugated chlorhexidine nanoparticles hold promise in the improved treatment of A. castellanii keratitis. PMID:26666949

Comparison of two intracanal irrigants' effect on flare-up in necrotic teeth.

PubMed

Zarei, Mina; Bidar, Maryam

2006-01-01

The aim of this study was to compare the efficacy of two irrigants on decreasing the pain and swelling at different times after treatment of necrotic pulp. Fifty patients with single canal tooth and necrotic pulp were selected and divided into two groups, twenty-five in each. Rotary files were used for preparing the canals and 0.2% chlorhexidine gluconate and 2.5% sodium hypochlorite were used for irrigation of canals. Then canals were filled by lateral condensation technique. A questionnaire was given to patients asking for the level of their pain and swelling. The patients were followed for 48h. Visual Analogue Scale (VAS) was used for determination of pain degree. The scale with 4 levels was used for measurement of the intensity of swelling. The data were statistically analyzed using Mann-Witney and Kruskal-Wallis tests. The research showed no significant difference between irrigant solutions in decreasing the amount of pain and swelling after endodontic treatments. No significant relationship was detected between the incidence of pain with swelling, age, and sex. Flare-up in maxilla was more than mandible. According to results of this in vivo study it was concluded that efficacies of 0.2% chlorhexidine gluconate and 2.5% NaOCl are the same.

Comparison of Two Intracanal Irrigants’ Effect on Flare-Up in Necrotic Teeth

PubMed Central

Zarei, Mina; Bidar, Maryam

2006-01-01

INTRODUCTION: The aim of this study was to compare the efficacy of two irrigants on decreasing the pain and swelling at different times after treatment of necrotic pulp. MATERIALS AND METHODS: Fifty patients with single canal tooth and necrotic pulp were selected and divided into two groups, twenty-five in each. Rotary files were used for preparing the canals and 0.2% chlorhexidine gluconate and 2.5% sodium hypochlorite were used for irrigation of canals. Then canals were filled by lateral condensation technique. A questionnaire was given to patients asking for the level of their pain and swelling. The patients were followed for 48h. Visual Analogue Scale (VAS) was used for determination of pain degree. The scale with 4 levels was used for measurement of the intensity of swelling. The data were statistically analyzed using Mann-Witney and Kruskal-Wallis tests. RESULTS: The research showed no significant difference between irrigant solutions in decreasing the amount of pain and swelling after endodontic treatments. No significant relationship was detected between the incidence of pain with swelling, age, and sex. Flare-up in maxilla was more than mandible. CONCLUSION: According to results of this in vivo study it was concluded that efficacies of 0.2% chlorhexidine gluconate and 2.5% NaOCl are the same. PMID:24379878

Effects of the medicinal plants Curcuma zedoaria and Camellia sinensis on halitosis control.

PubMed

Farina, Vitor Hugo; Lima, Ana Paula de; Balducci, Ivan; Brandão, Adriana Aigotti Haberbeck

2012-01-01

Volatile sulphur compounds (VSC) are the gases mainly responsible for halitosis (bad breath). The aim of this research was to evaluate the effects of medicinal plants on halitosis control. Two commonly used plants were tested: Curcuma zedoaria and Camellia sinensis (green tea). These plants were prepared as an aqueous solution and used as mouthwashes, compared with a standard mouthwash of 0.12% chlorhexidine gluconate and a placebo (water). The experiment was conducted with 30 volunteers from the School of Dentistry of São Jose dos Campos, Univ. Estadual Paulista - UNESP, SP, Brazil. Each volunteer tested the four mouthwashes. The Cysteine Challenge Method, modified for this study, was used for initial breath standardization. Four breath assessments were conducted after volunteers rinsed orally with acetylcysteine: one before the test mouthwash was used; the second, one minute after its use; a third 90 minutes later; and the last 180 minutes later. The results showed that chlorhexidine gluconate lowered VSC production immediately, and that this effect lasted up to 3 hours, while the tested plants had immediate inhibitory effects but no residual inhibitory effects on VSC. We concluded that Curcuma zedoaria and Camellia sinensis, prepared as infusions and used as mouthwashes, did not have a residual neutralizing effect on VSC.

Current Practices of Antiseptic Use in Canadian Neonatal Intensive Care Units.

PubMed

McCord, Helen; Fieldhouse, Elise; El-Naggar, Walid

2018-06-26

 This article assesses the degree of variability in the current practice of skin antiseptics used in Canadian neonatal intensive care units (NICUs) and different experiences related to each antiseptic used.  An anonymous survey was distributed to a clinical representative of each of the 124 Canadian level II and level III NICUs.  One hundred and two respondents (82.2%), representing all Canadian provinces, completed the survey. Chlorhexidine gluconate with/without alcohol was the antiseptic most used (96%) and the antiseptic with the highest reported adverse effects (68% reported skin burns/breakdown). Other antiseptics used include povidone-iodine (35%) and isopropyl alcohol (22%). Specific guidelines for antiseptic use were available in only 50% of the units with many NICUs lacking gestational and/or chronological age restrictions. Only 23% of responders believed that there was awareness among health care providers of the adverse effects of antiseptics used. Less than half (43%) were completely satisfied with the antiseptics used in their units.  Chlorhexidine gluconate is the most commonly used antiseptic in Canadian NICUs. The high number of associated adverse effects and the lack of guidelines regulating antiseptic use are of concern. Large clinical trials are urgently needed to guide practice and improve the safety of antiseptics. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Detergents compared with each other and with antiseptics as skin 'degerming' agents.

PubMed Central

Lilly, H. A.; Lowbury, E. J.; Wilkins, M. D.

1979-01-01

Three detergent preparations (bar soap, 'Hibiscrub' base and 'LIC 76'), TWO ANTISEPTic preparations (0.5% chlorhexidine in 95% ethyl alcohol and an alcohol jelly, 'Alcogel'), and one antiseptic-detergent solution (4% chlorhexidine gluconate in a detergent base, 'Hibiscrub') were compared for their effectiveness, on a single use, in reducing the yield of bacteria from the hands of volunteers. The antiseptic and antiseptic--detergent preparations were more effective than the detergents, with a mean reduction in yield of skin bacteria of 96.0% after use of alcoholic chlorhexidine and of 81.2% after use of Hibiscrub. One of the detergents, LIC 76, appeared more effective than the others, causing a mean reduction in the yield of skin bacteria of 41.5%, compared with reductions of 4.6% by the Hibiscrub detergent base and an increase of 3.2% with bar soap; unlike the other detergents, LIC 76 was found to have appreciable bacteristatic and bactericidal properties. PMID:762408

Bactericidal Effects and Mechanism of Action of Olanexidine Gluconate, a New Antiseptic

PubMed Central

Iwata, Koushi; Nii, Takuya; Nakata, Hikaru; Tsubotani, Yoshie; Inoue, Yasuhide

2015-01-01

Olanexidine gluconate [1-(3,4-dichlorobenzyl)-5-octylbiguanide gluconate] (development code OPB-2045G) is a new monobiguanide compound with bactericidal activity. In this study, we assessed its spectrum of bactericidal activity and mechanism of action. The minimal bactericidal concentrations of the compound for 30-, 60-, and 180-s exposures were determined with the microdilution method using a neutralizer against 320 bacterial strains from culture collections and clinical isolates. Based on the results, the estimated bactericidal olanexidine concentrations with 180-s exposures were 869 μg/ml for Gram-positive cocci (155 strains), 109 μg/ml for Gram-positive bacilli (29 strains), and 434 μg/ml for Gram-negative bacteria (136 strains). Olanexidine was active against a wide range of bacteria, especially Gram-positive cocci, including methicillin-resistant Staphylococcus aureus and vancomycin-resistant enterococci, and had a spectrum of bactericidal activity comparable to that of commercial antiseptics, such as chlorhexidine and povidone-iodine. In vitro experiments exploring its mechanism of action indicated that olanexidine (i) interacts with the bacterial surface molecules, such as lipopolysaccharide and lipoteichoic acid, (ii) disrupts the cell membranes of liposomes, which are artificial bacterial membrane models, (iii) enhances the membrane permeability of Escherichia coli, (iv) disrupts the membrane integrity of S. aureus, and (v) denatures proteins at relatively high concentrations (≥160 μg/ml). These results indicate that olanexidine probably binds to the cell membrane, disrupts membrane integrity, and its bacteriostatic and bactericidal effects are caused by irreversible leakage of intracellular components. At relatively high concentrations, olanexidine aggregates cells by denaturing proteins. This mechanism differs slightly from that of a similar biguanide compound, chlorhexidine. PMID:25987609

Inhibition of Tongue Coat and Dental Plaque Formation by Stabilized Chlorine Dioxide Vs Chlorhexidine Mouthrinse: A Randomized, Triple Blinded Study.

PubMed

Yadav, Seema Roodmal; Kini, Vineet Vaman; Padhye, Ashvini

2015-09-01

Chlorine dioxide (ClO2) is an oxidizing agent with known bactericidal, viricidal and fungicidal properties. Its efficacy in reducing the halitosis has been established by previous literature. However, data evaluating its antiplaque property is scarce. Chlorhexidine (CHX) is considered as the gold standard and an effective adjunctive to mechanical plaque removal. However, it is associated with few reversible side effects. Therefore a study was conducted to assess the antiplaque property of ClO2 containing mouthrinse against CHX mouthrinse. To evaluate the efficacy of stabilized chlorine dioxide containing mouthrinse and CHX containing mouthrinse in inhibition of tongue coat accumulation and dental plaque formation using a four day plaque regrowth model clinically and microbiologically in a healthy dental cohort. A Single Center, Randomized, Triple blinded, Microbiological clinical trial was conducted involving 25 healthy dental students volunteers (11 males, 14 females). Two commercially available mouthrinse: Mouthrinse A - Aqueous based ClO2 mouthrinse Freshchlor(®) and Mouthrinse B - Aqueous based 0.2% CHX mouthrinse Hexidine(®) were selected as the test products. Subjects were asked to rinse and gargle for 1 minute with the allocated mouthrinse under supervision after supragingival scaling, polishing and tongue coat removal. After four hours, smears were taken from the buccal mucosa and tooth surface. On the fifth day from baseline of four day non brushing plaque regrowth model the samples were again taken from buccal mucosa and tooth surface followed by recording of plaque scores by Rastogi Modification of Navy Plaque index, extent of tongue coat by Winkel's tongue coating index and measuring tongue coat wet weight in grams. The samples collected were subjected to microbial analysis and the results were expressed as colony forming units (CFUs) per sample. The Data was analysed using SPSS 16.00 and presented using descriptive statistics. Independent t-test was used for the comparison between mouthrinse A groups & mouthrinse B group. The plaque scores and Winkels tongue coat scores, wet tongue coat weight recorded on the fifth day after the use of the two mouthrinse didn't show a statistically significant difference. The CFU per sample from tooth and mucosa after four hours revealed low bacteria count with respect to mouthrinse B however the CFU obtained on the fifth day did not show a statistically significant difference between the two mouthrinse. The clinical antiplaque efficacy of CHX and ClO2 mouthwash is comparable and so is the efficacy in reducing the oral bacterial load.

Effects of chlorhexidine gluconate oral care on hospital mortality: a hospital-wide, observational cohort study.

PubMed

Deschepper, Mieke; Waegeman, Willem; Eeckloo, Kristof; Vogelaers, Dirk; Blot, Stijn

2018-05-09

Chlorhexidine oral care is widely used in critically and non-critically ill hospitalized patients to maintain oral health. We investigated the effect of chlorhexidine oral care on mortality in a general hospitalized population. In this single-center, retrospective, hospital-wide, observational cohort study we included adult hospitalized patients (2012-2014). Mortality associated with chlorhexidine oral care was assessed by logistic regression analysis. A threshold cumulative dose of 300 mg served as a dichotomic proxy for chlorhexidine exposure. We adjusted for demographics, diagnostic category, and risk of mortality expressed in four categories (minor, moderate, major, and extreme). The study cohort included 82,274 patients of which 11,133 (14%) received chlorhexidine oral care. Low-level exposure to chlorhexidine oral care (≤ 300 mg) was associated with increased risk of death [odds ratio (OR) 2.61; 95% confidence interval (CI) 2.32-2.92]. This association was stronger among patients with a lower risk of death: OR 5.50 (95% CI 4.51-6.71) with minor/moderate risk, OR 2.33 (95% CI 1.96-2.78) with a major risk, and a not significant OR 1.13 (95% CI 0.90-1.41) with an extreme risk of mortality. Similar observations were made for high-level exposure (> 300 mg). No harmful effect was observed in ventilated and non-ventilated ICU patients. Increased risk of death was observed in patients who did not receive mechanical ventilation and were not admitted to ICUs. The adjusted number of patients needed to be exposed to result in one additional fatality case was 47.1 (95% CI 45.2-49.1). These data argue against the indiscriminate widespread use of chlorhexidine oral care in hospitalized patients, in the absence of proven benefit in specific populations.

Comparison of a chlorhexidine and a benzoyl peroxide shampoo as sole treatment in canine superficial pyoderma.

PubMed

Loeffler, A; Cobb, M A; Bond, R

2011-09-03

The clinical and antibacterial efficacy of two shampoos used as a sole antibacterial treatment in dogs with superficial pyoderma were investigated and compared. In a randomised, partially blinded study, a 3 per cent chlorhexidine gluconate shampoo (Chlorhex 3; Leo Animal Health) was compared against a 2.5 per cent benzoyl peroxide shampoo (Paxcutol; Virbac) in 22 dogs with superficial pyoderma. Dogs were washed two to three times weekly with a 10-minute contact time over 21 days. Clinical scores and bacterial counts were assessed on days 1, 8 and 22 and compared within and between treatment groups; overall response was assessed at the end of the study. Twenty dogs completed the study; 15 (68.2 per cent) showed an overall clinical improvement and the clinical signs resolved in three chlorhexidine-treated dogs. In the chlorhexidine-treated group, scores for papules/pustules (P<0.001), investigator-assessed pruritus (P=0.003), total bacterial counts (P=0.003) and counts for coagulase-positive staphylococci (P=0.003) were reduced after three weeks. Scores and bacterial counts did not vary significantly in the benzoyl peroxide-treated group.

Antibacterial activity of Baccharis dracunculifolia in planktonic cultures and biofilms of Streptococcus mutans.

PubMed

Pereira, Cristiane A; Costa, Anna Carolina B Pereira; Liporoni, Priscila Christiane S; Rego, Marcos A; Jorge, Antonio Olavo C

2016-01-01

Streptococcus mutans is an important cariogenic microorganism, and alternative methods for its elimination are required. Different concentrations of Baccharis dracunculifolia essential oil (EO) were tested to determine its minimal inhibitory concentration (MIC) in planktonic cultures, and this concentration was used in S. mutans biofilms. Additionally, we assessed the effect of a 0.12% chlorhexidine (CHX) and saline solution in S. mutans biofilms. The biofilms were grown in discs of composite resin for 48h and exposed to B. dracunculifolia, CHX or saline solution for 5min. The viability of the biofilms was determined by counting the colony-forming units per milliliter (CFU/ml) in agar, which was statistically significant (P<0.05). The MIC of the B. dracunculifolia EO to planktonic growth of S. mutans was 6%. In biofilms of S. mutans clinical isolates, B. dracunculifolia EO (6%) and CHX resulted in reductions of 53.3-91.1% and 79.1-96.6%, respectively. For the biofilm formed by the S. mutans reference strain, the reductions achieved with B. dracunculifolia EO and CHX were, respectively, 39.3% and 88.1%. It was concluded that B. dracunculifolia EO showed antibacterial activity and was able to control this oral microorganism, which otherwise causes dental caries. Copyright © 2015 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Combined effect of zinc ions and cationic antibacterial agents on intraoral volatile sulphur compounds (VSC).

PubMed

Young, A; Jonski, G; Rölla, G

2003-08-01

Volatile sulphur compounds (VSC) are major components of oral malodour. As both zinc ions and cationic antibacterial agents inhibit the formation of oral VSC, this study aimed to determine whether these agents combined have synergistic anti-VSC actions. Baseline oral VSC measurements of mouth air from 10 volunteers following cysteine rinsing (6mM, pH 7.2) were obtained using gas chromatography (GC). Subjects rinsed for 1 min with 10ml of the test solutions, 0.3% zinc acetate (Zn), 0.025% chlorhexidine (CHX), 0.025% cetyl pyridinium (CPC), and the combinations Zn+CHX and Zn+CPC. Cysteine rinses were repeated at 1h, 2h and 3h and VSC measurements recorded. Three subjects rinsed with the Zn+CHX combination and fasted for 9h, undergoing cysteine rinses and VSC measurements at 3h intervals. 10 microl of the test solutions were also added to 1ml aliquots of human whole saliva (n=8). Following incubation at 37 degrees C for 24h VSC levels in the saliva headspace were measured by GC. Inhibition of VSC formation and the fractional inhibitory index indicating synergy were calculated. Zn+CHX mouthrinse had a synergistic anti-VSC effect, and was effective for at least 9h. Zn+CPC mouthrinse was less effective. Both combinations showed a synergistic inhibiting effect in-vitro. Synergy between Zn and the antibacterial agents confirms different mechanisms of operation.

A Randomized Clinical Trial of Schinus terebinthifolius Mouthwash to Treat Biofilm-Induced Gingivitis

PubMed Central

Freires, Irlan de Almeida; Alves, Livia Araújo; Ferreira, Gabriela Lacet Silva; Jovito, Vanessa de Carvalho; de Castro, Ricardo Dias; Cavalcanti, Alessandro Leite

2013-01-01

Objectives. This study aimed to investigate the efficacy of a Schinus terebinthifolius (ST) mouthwash in reducing gingival inflammation levels (GI) and biofilm accumulation (BA) in children with gingivitis. Methods. This was a randomized, controlled, triple blind, and phase II clinical trial, with children aged 9–13 years (n = 27) presenting with biofilm-induced gingivitis. The sample was randomized into experimental (0.3125% ST, n = 14) and control (0.12% chlorhexidine/CHX, n = 13) groups. Products were masked as regards color, flavor and aroma. Intervention protocol consisted in supervised rinsing of 10 mL/day for 01 minute for 10 days. Gingival bleeding and simplified oral hygiene indexes were used to assess the efficacy variables, measured at baseline and after intervention by calibrated examiners. Data were statistically treated with paired t-test, unpaired t-test, and Wilcoxon and Mann-Whitney tests (α = .05). Results. It was found that both ST and CHX were able to significantly reduce GI levels after 10 days (P < 0.001) and there was no significant difference between them (P > 0.05). CHX was the only product able to significantly reduce BA after 10 days when compared to baseline (P < 0.05). Conclusion. ST mouthwash showed significant anti-inflammatory activity (equivalent to CHX), but it was not able to reduce biofilm accumulation. PMID:23843886

In-vitro activity of sodium-hypochlorite gel on bacteria associated with periodontitis.

PubMed

Jurczyk, Karolina; Nietzsche, Sandor; Ender, Claudia; Sculean, Anton; Eick, Sigrun

2016-11-01

The aim of the present study was to assess the antimicrobial activity of a sodium hypochlorite formulation including its components against bacteria associated with periodontal disease. Sodium hypochlorite formulation (NaOCl gel), its components sodium hypochlorite (NaOCl), and the activating vehicle were compared with 0.1 % chlorhexidine digluconate (CHX) solution. The antimicrobial activity was proven by determination of minimal inhibitory concentrations (MIC), minimal bactericidal concentrations, and killing assays. Furthermore, the influence on formation as well as on a 4-day-old 6-species biofilm was tested. Except for one strain (Parvimonas micra ATCC 33270 in case of NaOCl gel), the MICs both of the CHX solution and NaOCl gel did not exceed 10 % of the formulations' concentration. In general, MICs of the NaOCl gel were equal as of the CHX solution against Gram-negatives but higher against Gram-positive bacteria. CHX but not NaOCl gel clearly inhibited biofilm formation; however, the activity of NaOCl gel was more remarkable on a 4-day-old biofilm. NaOCl killed bacteria in the biofilm and interfered with the matrix. The NaOCl gel acts antimicrobial in particular against Gram-negative species associated with periodontitis. Moreover, its component NaOCl hypochlorite is able to alter biofilm matrices. The NaOCl gel may represent a potential alternative for adjunctive topical antimicrobial treatment in periodontitis.

Antimicrobial effect of three disinfecting agents on Resilon cones and their effect on surface topography: An in vitro study

PubMed Central

Chandrappa, Mahesh Martur; Meharwade, Prasanna Mahadevasa; Srinivasan, Raghu; Bhandary, Shreetha; Nasreen, Farhat

2016-01-01

Aim: The objective of this study was to evaluate the effectiveness of 5.25% sodium hypochlorite (NaOCl), 2% chlorhexidine (CHX), and 2% peracetic acid (PAA) in disinfecting Resilon cones and to evaluate topographical changes microscopically under scanning electron microscope (SEM) after rapid chemical disinfection. Materials and Methods: Resilon cones were disinfected in an ultraviolet (UV) light chamber for 20 min and contaminated by immersing in a microbial suspension of Enterococcus faecalis for 30 min. The contaminated cones were then immersed in the 5.25% NaOCl, 2% CHX, and 2% PAA for 1 min, 5 min, and 10 min, separately. The cones were then incubated at 37°C in thioglycollate broth for 7 days and examined for turbidity. The samples showing turbidity were subcultured on blood agar and incubated at 37°C for 48 h. Gram staining was done to confirm that the cultured bacteria were E. faecalis. Surface changes of disinfected Resilon cones were evaluated under SEM. Statistical Analysis Used: The data were analyzed statistically using Kruskal-Wallis, analysis of variance (ANOVA), and Mann–Whitney U-test. Result: In eliminating E. faecalis, 5.25% NaOCl was most effective followed by 2% PAA and 2% CHX. Topographic examination of tested Resilon cones revealed some surface deposits after disinfection with 5.25% NaOCl and 2% CHX, whereas 2% PAA caused surface erosion. Conclusion: In disinfecting Resilon cones, 5.25% NaOCl is most effective followed by 2% PAA and 2% CHX. PMID:27099418

Antiseptic mouth rinses: an update on comparative effectiveness, risks and recommendations.

PubMed

Osso, Diane; Kanani, Nehal

2013-02-01

Antiseptic mouth rinses are widely recommended and marketed to improve oral health. This article summarizes current studies on the comparative effectiveness of selected antiseptic mouth rinses in controlling plaque and gingivitis, as well as risks associated with daily exposure, including salivary flow rate, oral cancer and wear of composite restorations. Electronic database searches were conducted using Google Scholar and PubMed to identify articles comparing the effectiveness of 4 commercially marketed antiseptic mouth rinses differing in active ingredients (0.12% chlorhexidine gluconate, essential oils (menthol, thymol and eucalyptol) and methyl salicylate, 0.7% cetylpyridinium chloride and 20% aloe vera gel) for controlling plaque and gingivitis. Criteria for inclusion included controlled clinical trials and systematic reviews appearing in English language publications evaluating the comparative effectiveness of the mouth rinses in controlling plaque and gingivitis, as well as risks associated with daily usage. The majority of studies have shown mouth rinses containing chlorhexidine gluconate or essential oils and methyl salicylate provide clinically significant anti-gingivitis and anti-plaque benefits. Cetylpyridinium chloride has been found to provide only limited clinical benefits compared to inactive control mouth rinse. Inadequate evidence is available to evaluate the clinical effectiveness of aloe vera gel. Chlorhexidine, essential oils and cetylpyridinium have been found to be safe. However, limited data are available on the effects of the mouth rinse on wear patterns of dental restorations. Studies reviewed reported no significant difference in salivary flow rate related to alcohol based mouth rinse. Research supports the effectiveness of antiseptic mouth rinses in reducing plaque and gingivitis as an adjunct to home care. Insufficient evidence is available to support the claim that oral antiseptics can reduce the risk of developing periodontitis or the rate of progression of periodontitis.

Effects of chlorhexidine-containing adhesives on the durability of resin-dentine interfaces.

PubMed

Stanislawczuk, Rodrigo; Pereira, Fabiane; Muñoz, Miguel Angel; Luque, Issis; Farago, Paulo Vitor; Reis, Alessandra; Loguercio, Alessandro D

2014-01-01

This study evaluated the effect of addition of diacetate CHX in different concentrations into two simplified etch-and-rinse (ER) adhesive systems (XP Bond [XP] and Ambar {AM}) on the ultimate tensile strength (UTS), degree of conversion (DC), 60-day cumulative water sorption (WS), solubility (SO) and CHX release (CR) as well as the immediate (IM) and 1-year (1Y) resin-dentine bond strength (μTBS) and nanoleakage (NL). Ten experimental adhesive systems were formulated according to the addition of CHX diacetate (0 [control], 0.01, 0.05, 0.1 and 0.2%) in the two ER. For UTS and DC, specimens were constructed and tested after 24h. For WS, SO and CR, after specimens build-up, they were stored in water and the properties measured after 60 days. The occlusal enamel of fifty molars was removed and the adhesives were applied in dentine surface after 37% phosphoric acid etching. After composite resin build-ups, specimens were longitudinally sectioned to obtain resin-dentine bonded sticks (0.8mm(2)). Specimens were tested in tension at 0.5mm/min in the IM or 1Y. For NL, 2 bonded sticks from each tooth were prepared and analyzed under SEM. The data were submitted to appropriate statistical analysis (α=0.05). The addition of CHX did not influence UTS, DC, WS and SO (p<0.05). Higher CR was observed in adhesives with higher concentration of CHX (p<0.05). After 1Y, significant reductions of μTBS and increases of NL were observed in the control groups (p<0.05). Reductions of μTBS and increase of NL over time were not observed (AM) for CHX-containing adhesives or it was less pronounced than the control (XP) regardless of the CHX concentration. The addition of CHX diacetate in concentrations until 0.2% in the simplified ER adhesive systems may be an alternative to increase the long-term stability of resin-dentine interfaces, without jeopardizing the adhesives' mechanical properties evaluated. Copyright © 2013. Published by Elsevier Ltd.

Antibacterial effect of hydrogen peroxide-titanium dioxide suspensions in the decontamination of rough titanium surfaces.

PubMed

Wiedmer, David; Petersen, Fernanda Cristina; Lönn-Stensrud, Jessica; Tiainen, Hanna

2017-07-01

The chemical decontamination of infected dental implants is essential for the successful treatment of peri-implantitis. The aim of this study was to assess the antibacterial effect of a hydrogen peroxide-titanium dioxide (H 2 O 2 -TiO 2 ) suspension against Staphylococcus epidermidis biofilms. Titanium (Ti) coins were inoculated with a bioluminescent S. epidermidis strain for 8 h and subsequently exposed to H 2 O 2 with and without TiO 2 nanoparticles or chlorhexidine (CHX). Bacterial regrowth, bacterial load and viability after decontamination were analyzed by continuous luminescence monitoring, live/dead staining and scanning electron microscopy. Bacterial regrowth was delayed on surfaces treated with H 2 O 2 -TiO 2 compared to H 2 O 2 . H 2 O 2 -based treatments resulted in a lower bacterial load compared to CHX. Few viable bacteria were found on surfaces treated with H 2 O 2 and H 2 O 2 -TiO 2 , which contrasted with a uniform layer of dead bacteria for surfaces treated with CHX. H 2 O 2 -TiO 2 suspensions could therefore be considered an alternative approach in the decontamination of dental implants.

KR-12-a5 is a non-cytotoxic agent with potent antimicrobial effects against oral pathogens.

PubMed

Caiaffa, Karina Sampaio; Massunari, Loiane; Danelon, Marcelle; Abuna, Gabriel Flores; Bedran, Telma Blanca Lombardo; Santos-Filho, Norival Alves; Spolidorio, Denise Madalena Palomari; Vizoto, Natalia Leal; Cilli, Eduardo Maffud; Duque, Cristiane

2017-11-01

This study evaluated the cytotoxicity and antimicrobial activity of analogs of cationic peptides against microorganisms associated with endodontic infections. L-929 fibroblasts were exposed to LL-37, KR-12-a5 and hBD-3-1C V and chlorhexidine (CHX, control), and cell metabolism was evaluated with MTT. The minimal inhibitory concentration (MIC) and the minimal bactericidal/fungicidal concentration (MBC/MFC) of the peptides and CHX were determined against oral pathogens associated with endodontic infections. Enterococcus faecalis and Streptococcus mutans biofilms were cultivated in bovine dentin blocks, exposed to different concentrations of the most efficient antimicrobial peptide and analyzed by confocal laser scanning microscopy. CHX and peptides affected the metabolism of L-929 at concentrations > 31.25 and 500 μg ml -1 , respectively. Among the peptides, KR-12-a5 inhibited growth of both the microorganisms tested with the lowest MIC/MBC/MFC values. In addition, KR-12-a5 significantly reduced E. faecalis and S. mutans biofilms inside dentin tubules. In conclusion, KR-12-a5 is a non-cytotoxic agent with potent antimicrobial and anti-biofilm activity against oral pathogens associated with endodontic infections.

Baccharis dracunculifolia-based mouthrinse alters the exopolysaccharide structure in cariogenic biofilms.

PubMed

Aires, Carolina P; Sassaki, Guilherme L; Santana-Filho, Arquimedes P; Spadaro, Augusto C C; Cury, Jaime A

2016-03-01

Baccharis dracunculifolia is a native plant from Brazil with antimicrobial activity. The purpose of this study was to investigate whether a B. dracunculifolia-based mouthrinse (Bd) changes the structure of insoluble exopolysaccharides (IEPS) in Streptococcus mutans UA159 cariogenic biofilm. Biofilms were grown on glass slides and treated with Bd, its vehicle (VC), chlorhexidine digluconate (CHX), or saline solution (NaCl). Among the treatments, only CHX significantly reduced the biofilm biomass and bacterial viability (p<0.05). Gas chromatography-mass spectrometry and nuclear magnetic resonance analyses revealed that IEPS from the four biofilm samples were α- glucans containing different proportions of (1→6) and (1→3) glycosidic linkages. The structural differences among the four IEPS were compared by principal component analysis (PCA). PCA analysis indicated that IEPS from VC- and NaCl-treated biofilms were structurally similar to each other. Compared with the control, IEPS from Bd- and CHX-treated biofilms were structurally different and had distinct chemical profiles. In summary, the fact that Bd changed the IEPS chemical composition indicates that this mouthrinse may affect the cariogenic properties of the S. mutans biofilm formed. Copyright © 2015. Published by Elsevier B.V.

The Effect of Pistacia atlantica Var. mutica Mouthwash on Dental Plaque Bacteria and Subgingival Microorganisms: a Randomized and Controlled Triple-blind Study.

PubMed

Arami, S; Mojaddadi, M A; Pourabbas, R; Chitsaz, M T; Delazar, A; Mobayen, H

2015-09-01

Dental plaque is a well-documented etiologic factor for periodontal diseases. While chlorhexidine (CHX) is the gold-standard agent for treating dental plaques, undesirable side effects are often found after continuous use of the mouthwash. Therefore, this single-center, randomized, triple-blinded and clinical trial was undertaken to evaluate the efficacy of Pistacia atlantica Var. mutica extract mouthwash on de novo dental plaque bacteria and subgingival microorganisms compared to CHX on a total of 28 patients. The mean aerobic plaque bacterial count of patients at baseline was 2.17 × 10(6). After 4 days of treatment, there were statistically significant decreases in the mean aerobic bacteria in the patients who received P. atlantica and/or CHX (7.25 × 10(4), p = 0.006) and (9.91 × 10(3), p = 0.002), respectively, compared to the patients who received the placebo (6.26 × 10(5)). This study showed that P. atlantica mouthwash is effective against gingival microorganisms. Because of its reduced side effects, P. atlantica mouthwash may be a good alternative choice for patients. © Georg Thieme Verlag KG Stuttgart · New York.

Effect of chlorhexidine varnish on gingival growth in orthodontic patients: a randomized prospective split-mouth study.

PubMed

Pretti, Henrique; Barbosa, Gabriella Lopes de Rezende; Lages, Elizabeth Maria Bastos; Gala-García, Alfonso; Magalhães, Claudia Silami de; Moreira, Allyson Nogueira

2015-10-01

Fixed orthodontic appliances patients suffer limitations on the effective control of biofilm by mechanical methods, bringing the need of a coadjutant in the control of inflammation and oral health improvement. The aim of this prospective split-mouth blind study was to analyze the effect of a 40% chlorhexidine (CHX) varnish on gingival growth of patients with orthodontic fixed appliances. Healthy teenage patients with fixed orthodontic appliances and increased gingival volume were recruited (n = 30). Each individual was his own control, having in the maxilla one control side and one treatment side. An application of varnishes occurred on the vestibular area of the upper premolars and first molar crowns, on the control side (placebo varnish) and on the experimental side (EC40(r) Biodentic CHX varnish). The varnishes and sides were randomly chosen and its identification and group was kept by a third party observer and it was not revealed to the researchers and participants until the end of study. In order to establish a baseline registration, digital photographs were taken by a trained photographer before varnish application at baseline (T0), as well as 14 days (T14) and 56 days (T56) after the application. The gingival volume was calculated indirectly using the vestibular areas (mm2) of the upper second premolars' clinical crowns by RapidSketch(r) software, at all study times. The data were analyzed using ANOVA and the Turkey-Krammer test. It was observed, in the final sample of 30 individuals, that at T0, the control and treatment groups were similar. At T14 and T56, a progressive reduction of the clinical crown area was seen in the control group, and an increase in the average area was detected in the experimental group (p < 0,05). The use of 40% CHX varnish decreases the gingival overgrowth in patients undergoing orthodontic treatment. Further studies are necessary to set the action time and frequency of application.

Effect of chlorhexidine varnish on gingival growth in orthodontic patients: a randomized prospective split-mouth study

PubMed Central

Pretti, Henrique; Barbosa, Gabriella Lopes de Rezende; Lages, Elizabeth Maria Bastos; Gala-García, Alfonso; de Magalhães, Claudia Silami; Moreira, Allyson Nogueira

2015-01-01

Introduction: Fixed orthodontic appliances patients suffer limitations on the effective control of biofilm by mechanical methods, bringing the need of a coadjutant in the control of inflammation and oral health improvement. Objective: The aim of this prospective split-mouth blind study was to analyze the effect of a 40% chlorhexidine (CHX) varnish on gingival growth of patients with orthodontic fixed appliances. Methods: Healthy teenage patients with fixed orthodontic appliances and increased gingival volume were recruited (n = 30). Each individual was his own control, having in the maxilla one control side and one treatment side. An application of varnishes occurred on the vestibular area of the upper premolars and first molar crowns, on the control side (placebo varnish) and on the experimental side (EC40(r) Biodentic CHX varnish). The varnishes and sides were randomly chosen and its identification and group was kept by a third party observer and it was not revealed to the researchers and participants until the end of study. In order to establish a baseline registration, digital photographs were taken by a trained photographer before varnish application at baseline (T0), as well as 14 days (T14) and 56 days (T56) after the application. The gingival volume was calculated indirectly using the vestibular areas (mm2) of the upper second premolars' clinical crowns by RapidSketch(r) software, at all study times. The data were analyzed using ANOVA and the Turkey-Krammer test. Results: It was observed, in the final sample of 30 individuals, that at T0, the control and treatment groups were similar. At T14 and T56, a progressive reduction of the clinical crown area was seen in the control group, and an increase in the average area was detected in the experimental group (p < 0,05). Conclusions: The use of 40% CHX varnish decreases the gingival overgrowth in patients undergoing orthodontic treatment. Further studies are necessary to set the action time and frequency of application. PMID:26560823

Cationic compounds with activity against multidrug-resistant bacteria: interest of a new compound compared with two older antiseptics, hexamidine and chlorhexidine.

PubMed

Grare, M; Dibama, H Massimba; Lafosse, S; Ribon, A; Mourer, M; Regnouf-de-Vains, J-B; Finance, C; Duval, R E

2010-05-01

Use of antiseptics and disinfectants is essential in infection control practices in hospital and other healthcare settings. In this study, the in vitro activity of a new promising compound, para-guanidinoethylcalix[4]arene (Cx1), has been evaluated in comparison with hexamidine (HX) and chlorhexidine (CHX), two older cationic antiseptics. The MICs for 69 clinical isolates comprising methicillin-resistant Staphylococcus aureus, methicillin-sensitive S. aureus, coagulase-negative staphylococci (CoNS) (with or without mecA), vancomycin-resistant enterococci, Enterobacteriaceae producing various beta-lactamases and non-fermenting bacilli (Pseudomonas aeruginosa, Acinetobacter baumanii, Stenotrophomonas maltophilia) were determined. Cx1 showed similar activity against S. aureus, CoNS and Enterococcus spp., irrespective of the presence of mecA or van genes, or associated resistance genes, with very good activity against CoNS (MIC <1 mg/L). Variable activities were observed against Enterobacteriaceae; the MICs determined seemed to be dependent both on the genus (MICs of 2, 8 and 64 mg/L for Escherichia coli, Klebsiella pneumoniae and Yersinia enterocolitica, respectively) and on the resistance phenotype production of [Extended Spectrum beta-Lactase (ESBLs) or other beta-lactamases; overproduction of AmpC]. Poor activity was found against non-fermenting bacilli, irrespective of the resistance phenotype. CHX appeared to be the most active compound against all strains, with broad-spectrum and conserved activity against multidrug-resistant strains. HX showed a lower activity, essentially against Gram-positive strains. Consequently, the differences observed with respect to Cx1 suggest that they are certainly not the consequence of antibiotic resistance phenotypes, but rather the result of membrane composition modifications (e.g. of lipopolysaccharide), or of the presence of (activated) efflux-pumps. These results raise the possibility that Cx1 may be a potent new antibacterial agent of somewhat lower activity but significantly lower toxicity than CHX.

A randomised clinical trial to evaluate the effect of a 67 % sodium bicarbonate-containing dentifrice on 0.2 % chlorhexidine digluconate mouthwash tooth staining.

PubMed

Akwagyiram, Ivy; Butler, Andrew; Maclure, Robert; Colgan, Patrick; Yan, Nicole; Bosma, Mary Lynn

2016-08-25

Gingivitis can develop as a reaction to dental plaque. It can be limited by curtailing plaque build-up through actions including tooth brushing and the use of medicinal mouthwashes, such as those containing chlorhexidine digluconate (CHX), that can reach parts of the mouth that may be missed when brushing. This study aimed to compare dental stain control of twice-daily brushing with a sodium fluoride (NaF) dentifrice containing 67 % sodium bicarbonate (NaHCO3) or a commercially available NaF silica dentifrice without NaHCO3, while using a mouthwash containing 0.2 % CHX. This was a 6-week, randomised, two-site, examiner-blind, parallel-group study in healthy subjects with at least 'mild' stain levels on the facial surfaces of ≥4 teeth and ≥15 bleeding sites. Assessment was via modified Lobene Stain Index (MLSI), the score being the mean of stain intensity multiplied by area (MLSI [IxA]). One hundred and fifty of 160 randomised subjects completed the study. There were no significant differences in Overall (facial and lingual) MLSI (IxA) scores between dentifrices. The Facial MLSI (IxA) was statistically significant at 6 weeks, favouring the 67 % NaHCO3 dentifrice (p = 0.0404). Post-hoc analysis, conducted due to a significant site interaction, found significant differences for all MLSI scores in favour of the 67 % NaHCO3 dentifrice at Site 1 (both weeks) but not Site 2. No overall significant differences were found between a 67 and 0 % NaHCO3 dentifrice in controlling CHX stain; a significant difference on facial surfaces suggests advantage of the former on more accessible surfaces. This study was registered at ClinicalTrials.gov ( NCT01962493 ) on 10 October 2013 and was funded by GSK Consumer Healthcare.

Action of Chlorhexidine, Zingiber officinale, and Calcium Hydroxide on Candida albicans, Enterococcus faecalis, Escherichia coli, and Endotoxin in the Root Canals.

PubMed

Valera, Marcia C; Oliveira, Sarah Ac; Maekawa, Lilian E; Cardoso, Flávia Gr; Chung, Adriana; Silva, Stephanie Fp; Carvalho, Cláudio At

2016-02-01

The purpose of this in vitro study was to evaluate the antimicrobial activity of 2% chlorhexidine gel (CHX) as auxiliary chemical substance and intracanal medications on Candida albicans, Enterococcus faecalis, Escherichia coli, and their endotoxins in the root canals. The study was conducted on 48 single-rooted human teeth divided into four groups (n = 12), according to intracanal medications used: (1) Calcium hydroxide + apyrogenic saline solution (Ca(OH)2 + SS), (2) 20% ginger glycolic extract (GEN), (3) calcium hydroxide + 20% ginger glycolic extract (Ca(OH)2 + GEN), (4) apyrogenic SS (control). Collections were made from the root canal content before preparation (baseline-S1), immediately after instrumentation (S2), 7 days after instrumentation (S3), after 14 days the action of intracanal medication (S4), and 7 days after removal of the intracanal medication (S5). The antimicrobial activity and endotoxin content were analyzed for all collections. The results were statistically analyzed by the Kruskal-Wallis and Dunn tests at a significance level of 5%. After instrumentation with CHX, there was complete elimination of E. coli and C. albicans, except for E. faecalis, which was significantly reduced and then completely eliminated after intracanal medication. There was significant reduction of endotoxin after instrumentation. Comparison of collection after instrumentation and intracanal medication revealed reduction of endotoxins in all groups; this reduction was greater in group Ca(OH)2 followed by the group GEN. It was concluded that the instrumentation using CHX and intracanal medication used were able to eliminate the microorganisms from the root canal; the endotoxins were reduced, yet not completely eliminated. This study is important and relevant for searching alternatives during endodontic therapy, since it aims to study the effect of Zingiber officinale on microorganisms and endotoxins present in root canals.

Glass fibre-reinforced composite laced with chlorhexidine digluconate and yeast adhesion.

PubMed

Waltimo, T; Luo, G; Samaranayake, L P; Vallittu, P K

2004-02-01

The aim of this study was to lace dental glass fibre reinforced composite (FRC) prepreg with chlorhexidine digluconate and to examine the adherence of common oral fungal pathogen Candida albicans to FRC made of the prepreg. Four different test and control material groups each comprising 16 test specimens ((5.0 x 5.0 x 0.8) mm3) each were used as substrates for C. albicans adherence. A porous polymer pre-impregnated woven glass fibre prepreg was laced with solution of chlorhexidine gluconate and it was used with autopolymerized denture base polymer to fabricate FRC test specimens. Control group (Group 1) consisted of FRC test specimens stored in water. In Group 2, the test specimens were stored in 10% chlorhexidine digluconate solution for 24 h. Group 3 consisted of specimens fabricated using such fibre reinforcements which were pre-soaked in 20% chlorhexidine digluconate and dried before preparation with denture base resin, and followed by storage of the specimens in water. Group 4 was similar to Group 3 but instead of water storage the specimens were immersed in 10% chlorhexidine digluconate for 24 h. For the candidal adhesion assay the test and control specimens were incubated in standardized suspensions of four different strains of C. albicans, rinsed and prepared for light-microscopy. The mean number of adherent cells in each group was counted microscopically and analysed statistically. There were significantly (P < 0.05) more adherent C. albicans cells found in Group 1 than in the other three groups which did not differ significantly from each other. The lowest numbers of adherent cells were found in Group 3. Pretreating the porous polymer pre-impregnated glass fibre reinforcement with chlorhexidine digluconate result in reduction in the number of adherent yeast cells on the surface FRC material.

Initial effect of controlled release chlorhexidine on subgingival microorganisms.

PubMed

Daneshmand, Nazanin; Jorgensen, Michael G; Nowzari, Hessam; Morrison, John L; Slots, Jørgen

2002-10-01

Little or no data exist on the ability of subgingival application of PerioChip (2.5 mg chlorhexidine gluconate in a biodegradable chip; Astra Pharmaceuticals, Westborough, MA, USA) to suppress periodontopathic microorganisms. The present study compared the subgingival microbiota of periodontitis sites receiving the chlorhexidine chip plus scaling and root planing (Sc/Rp) or Sc/Rp alone. Seven males and six females, mean age 49 years, with moderate to advanced periodontitis participated in the study. In each patient, two bilateral pockets probing 6-7 mm were randomly assigned to treatment by chlorhexidine chip + Sc/Rp, or by Sc/Rp alone. Subgingival placement of chlorhexidine chips was carried out according to the manufacturer's instructions. Sc/Rp was performed with hand instruments for at least 10 min in each study tooth. Subgingival samples were collected by paper-points at baseline, at 2 weeks and at 4 weeks post-treatment. Anaerobic culture methods were used for microbial isolation and identification. The microbiologic examination was carried out blindly. Microbiological data were evaluated by a repeated measures analysis of variance. No statistical difference was found in total colony counts between subgingival sites treated with chlorhexidine chip + Sc/Rp and those treated with Sc/Rp alone. Also, the percentage of major periodontal pathogens (Actinobacillus actinomycetemcomitans, Porphyromonas gingivalis and Bacteroides forsythus) and the percentage of total periodontal pathogens (A. actinomycetemcomitans, P. gingivalis, B. forsythus, Prevotella intermedia-group, Fusobacterium, Eubacterium, Campylobacter rectus, Peptostreptococcus micros, Eikenella corrodens, enteric rods) were not significantly different between the chlorhexidine chip + Sc/Rp group and the Sc/Rp group. At baseline, A. actinomycetemcomitans was recovered from 4 chlorhexidine chip + Sc/Rp sites and 2 Sc/Rp sites, P. gingivalis from 5 chlorhexidine chip + Sc/Rp sites and 4 Sc/Rp sites, and B. forsythus from 9 chlorhexidine chip + Sc/Rp and 7 Sc/Rp sites. At 4 weeks, A. actinomycetemcomitans was detected in 2 chlorhexidine chip + Sc/Rp sites but not in any site receiving Sc/Rp, P. gingivalis in 2 chlorhexidine chip + Sc/Rp sites but not in any Sc/Rp site, and B. forsythus in 1 chlorhexidine chip + Sc/Rp and in 2 Sc/Rp sites. The present data obtained from bilateral periodontitis lesions of 13 adults suggest that chlorhexidine chip treatment of adult periodontitis lesions provides little or no additional antimicrobial benefits compared to thorough Sc/Rp alone.

Impact of daily chlorhexidine baths and hand hygiene compliance on nosocomial infection rates in critically ill patients.

PubMed

Martínez-Reséndez, Michel Fernando; Garza-González, Elvira; Mendoza-Olazaran, Soraya; Herrera-Guerra, Alexis; Rodríguez-López, Juan Manuel; Pérez-Rodriguez, Edelmiro; Mercado-Longoria, Roberto; Camacho-Ortiz, Adrián

2014-07-01

Up to 25% of all nosocomial infections (NIs) develop in critically ill patients. Our objective was to evaluate chlorhexidine (CHX) bathing and hand hygiene (HH) compliance in the reduction of NIs in the intensive care unit. The study comprised three 6-month periods: preintervention (PIP; soap/water bathing), intervention (IP; bathing with CHX-impregnated wipes), and postintervention (PoIP; soap/water bathing). An HH program was implemented during the IP and PoIP. Primary outcomes were global and specific NI rates. A total of 1007 patients were included. Infection rates per 100 discharges were higher in the PIP compared with the IP and also higher in the PoIP compared with the IP (P = .0004 and .0109, respectively). Global infection rates per 1000 hospital-days were higher in the PIP than in the IP (P = .0268). The rates of ventilator-associated pneumonia (VAP) and catheter-associated urinary tract infection (CAUTI) were higher in the PIP than in the IP (P = .036 and .0001, respectively). Isolation of Acinetobacter baumannii from VAP specimens (P = .0204) and isolation of Candida spp from CAUTI specimens (P = .0005) decreased as well. The combined intervention reduced global and specific infection rates, including rates of VAP associated with A baumannii and CAUTI associated with Candida spp. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Exploratory Development of an Ultrafast-Curing Wound Dressing

DTIC Science & Technology

1991-05-31

mils thick: Formulation 2 and 5 .. 36 17. Elution Rates for the 30% Chlorhexidine Gluconate ADD’s at t=0 and Stored at the Temperature Extremes (400C...determined from the in vivo trials conducted earlier (9). The 6 mil thick dressing (Formulation 2) demonstrated effectiveness when tested on guinea pigs...This dressing released approximately 3000 micrograms/sq. cm. in 72 hours or about 64% of the 12 mil dressing tested for shelf stability (Figure 16

Economic impact of Tegaderm chlorhexidine gluconate (CHG) dressing in critically ill patients.

PubMed

Thokala, Praveen; Arrowsmith, Martin; Poku, Edith; Martyn-St James, Marissa; Anderson, Jeff; Foster, Steve; Elliott, Tom; Whitehouse, Tony

2016-09-01

To estimate the economic impact of a Tegaderm TM chlorhexidine gluconate (CHG) gel dressing compared with a standard intravenous (i.v.) dressing (defined as non-antimicrobial transparent film dressing), used for insertion site care of short-term central venous and arterial catheters (intravascular catheters) in adult critical care patients using a cost-consequence model populated with data from published sources. A decision analytical cost-consequence model was developed which assigned each patient with an indwelling intravascular catheter and a standard dressing, a baseline risk of associated dermatitis, local infection at the catheter insertion site and catheter-related bloodstream infections (CRBSI), estimated from published secondary sources. The risks of these events for patients with a Tegaderm CHG were estimated by applying the effectiveness parameters from the clinical review to the baseline risks. Costs were accrued through costs of intervention (i.e. Tegaderm CHG or standard intravenous dressing) and hospital treatment costs depended on whether the patients had local dermatitis, local infection or CRBSI. Total costs were estimated as mean values of 10,000 probabilistic sensitivity analysis (PSA) runs. Tegaderm CHG resulted in an average cost-saving of £77 per patient in an intensive care unit. Tegaderm CHG also has a 98.5% probability of being cost-saving compared to standard i.v. dressings. The analyses suggest that Tegaderm CHG is a cost-saving strategy to reduce CRBSI and the results were robust to sensitivity analyses.

Candida auris: Disinfectants and Implications for Infection Control.

PubMed

Ku, Tsun S N; Walraven, Carla J; Lee, Samuel A

2018-01-01

Candida auris is a rapidly emerging pathogen and is able to cause severe infections with high mortality rates. It is frequently misidentified in most clinical laboratories, thus requiring more specialized identification techniques. Furthermore, several clinical isolates have been found to be multidrug resistant and there is evidence of nosocomial transmission in outbreak fashion. Appropriate infection control measures will play a major role in controlling the management and spread of this pathogen. Unfortunately, there are very few data available on the effectiveness of disinfectants against C. auris . Chlorine-based products appear to be the most effective for environmental surface disinfection. Other disinfectants, although less effective than chlorine-based products, may have a role as adjunctive disinfectants. A cleaning protocol will also need to be established as the use of disinfectants alone may not be sufficient for maximal decontamination of patient care areas. Furthermore, there are fewer data on the effectiveness of antiseptics against C. auris for patient decolonization and hand hygiene for healthcare personnel. Chlorhexidine gluconate has shown some efficacy in in vitro studies but there are reports of patients with persistent colonization despite twice daily body washes with this disinfectant. Hand hygiene using soap and water, with or without chlorhexidine gluconate, may require the subsequent use of alcohol-based hand sanitizer for maximal disinfection. Further studies will be needed to validate the currently studied disinfectants for use in real-world settings.

Candida auris: Disinfectants and Implications for Infection Control

PubMed Central

Ku, Tsun S. N.; Walraven, Carla J.; Lee, Samuel A.

2018-01-01

Candida auris is a rapidly emerging pathogen and is able to cause severe infections with high mortality rates. It is frequently misidentified in most clinical laboratories, thus requiring more specialized identification techniques. Furthermore, several clinical isolates have been found to be multidrug resistant and there is evidence of nosocomial transmission in outbreak fashion. Appropriate infection control measures will play a major role in controlling the management and spread of this pathogen. Unfortunately, there are very few data available on the effectiveness of disinfectants against C. auris. Chlorine-based products appear to be the most effective for environmental surface disinfection. Other disinfectants, although less effective than chlorine-based products, may have a role as adjunctive disinfectants. A cleaning protocol will also need to be established as the use of disinfectants alone may not be sufficient for maximal decontamination of patient care areas. Furthermore, there are fewer data on the effectiveness of antiseptics against C. auris for patient decolonization and hand hygiene for healthcare personnel. Chlorhexidine gluconate has shown some efficacy in in vitro studies but there are reports of patients with persistent colonization despite twice daily body washes with this disinfectant. Hand hygiene using soap and water, with or without chlorhexidine gluconate, may require the subsequent use of alcohol-based hand sanitizer for maximal disinfection. Further studies will be needed to validate the currently studied disinfectants for use in real-world settings. PMID:29706945

Basal and induced NO formation in the pharyngo-oral tract influences estimates of alveolar NO levels.

PubMed

Malinovschi, Andrei; Janson, Christer; Holm, Lena; Nordvall, Lennart; Alving, Kjell

2009-02-01

The present study analyzed how models currently used to distinguish alveolar from bronchial contribution to exhaled nitric oxide (NO) are affected by manipulation of NO formation in the pharyngo-oral tract. Exhaled NO was measured at multiple flow rates in 15 healthy subjects in two experiments: 1) measurements at baseline and 5 min after chlorhexidine (CHX) mouthwash and 2) measurements at baseline, 60 min after ingestion of 10 mg NaNO(3)/kg body wt, and 5 min after CHX mouthwash. Alveolar NO concentration (Calv(NO)) and bronchial flux (J'aw(NO)) were calculated by using the slope-intercept model with or without adjustment for trumpet shape of airways and axial diffusion (TMAD). Salivary nitrate and nitrite were measured in the second experiment. Calv(NO) [median (range)] was reduced from 1.16 ppb (0.77, 1.96) at baseline to 0.84 ppb (0.57, 1.48) 5 min after CHX mouthwash (P < 0.001). The TMAD-adjusted Calv(NO) value after CHX mouthwash was 0.50 ppb (0, 0.85). The nitrate load increased J'aw(NO) from 32.2 nl/min (12.2, 60.3) to 57.1 nl/min (22.0, 119) in all subjects and Calv(NO) from 1.47 ppb (0.73, 1.95) to 1.87 ppb (10.85, 7.20) in subjects with high nitrate turnover (>10-fold increase of salivary nitrite after nitrate load). CHX mouthwash reduced Calv(NO) levels to 1.15 ppb (0.72, 2.07) in these subjects with high nitrate turnover. All these results remained consistent after TMAD adjustment. We conclude that estimated alveolar NO concentration is affected by pharyngo-oral tract production of NO in healthy subjects, with a decrease after CHX mouthwash. Moreover, unknown ingestion of dietary nitrate could significantly increase estimated alveolar NO in subjects with high nitrate turnover, and this might be falsely interpreted as a sign of peripheral inflammation. These findings were robust for TMAD.

Killing activity of LFchimera on periodontopathic bacteria and multispecies oral biofilm formation in vitro.

PubMed

Ruangcharoen, Sopita; Suwannarong, Waraporn; Lachica, Marie Rossini Carmela T; Bolscher, Jan G M; Nazmi, Kamran; Khunkitti, Watcharee; Taweechaisupapong, Suwimol

2017-08-19

Lactoferrin chimera (LFchimera), a heterodimeric peptide containing lactoferrampin (LFampin265-284) and a part of lactoferricin (LFcin17-30), possesses a broad spectrum of antimicrobial activity. However, there is no report on the inhibitory effects of LFchimera against multispecies oral biofilms. This study aimed to determine the effects of LFchimera in comparison to chlorhexidine digluconate (CHX) and minocycline hydrochloride (MH), on in vitro multispecies biofilms derived from subgingival plaque of periodontitis patients harboring Aggregatibacter actinomycetemcomitans. First the effects of LFchimera against planktonic and an 1-day old biofilm of the periodontopathic bacteria, A. actinomycetemcomitans ATCC 43718 were established. Then, the effects on biofilm formation and bacterial viability in the multispecies biofilm were determined by crystal violet staining and LIVE/DEAD BacLight Bacterial Viability kit, respectively. The results revealed that a significant reduction (P < 0.05) in biofilm formation occurred after 15 min exposure to 20 µM of LFchimera or CHX compared to control. In contrast, MH at concentration up to 100 µM did not inhibit biofilm formation. The ratio of live/dead bacteria in biofilm was also significantly lower after 15 min exposure to 20 µM of LFchimera compared to control and 20-50 µM of CHX and MH. Altogether, the results obtained indicate that LFchimera is able to inhibit in vitro subgingival biofilm formation and reduce viability of multispecies bacteria in biofilm better than CHX and MH.

Comparison of two shampoos as sole treatment for canine bacterial overgrowth syndrome.

PubMed

Viaud, S; Maynard, L; Sanquer, A

2012-06-30

Two antibacterial shampoos for the treatment of canine bacterial overgrowth syndrome (BOGS) were compared in a prospective controlled clinical trial. Forty dogs with clinical signs (pruritus, erythema and excoriations without pustules and/or collarettes) and cytological findings compatible with bacterial overgrowth were treated twice weekly with 3 per cent chlorhexidine shampoo (3 per cent CHX) or 2.5 per cent benzoyl peroxide shampoo (2.5 per cent BPO) and evaluated every two weeks for up to six weeks until cytological cure. Pruritus, erythema, greasy seborrhoea, malodour, excoriations, secondary hair loss, lichenification, hyperpigmentation and lesion extent were each scored on a 0 to 3 severity scale and combined to calculate an aggregate score. Among the 34 dogs with good compliance to treatment, reduction of cocci counts of at least 90 per cent was recorded in 11 of 18 dogs after 3 per cent CHX and nine of 16 dogs after 2.5 per cent BPO, with no significant difference between the two products (P=0.98). Lesion score was significantly reduced in both groups (63.48 (34.45)) per cent with 3 per cent CHX v 54.45 (33.61) per cent with 2.5 per cent BPO, P=0.36) and time to cytological cure was not significantly different between groups (P=0.13), at the end of the treatment. In the present study, 3 per cent CHX and 2.5 per cent BPO were similarly effective in the treatment of canine BOGS.

Comparative Evaluation of Two Final Irrigation Techniques for the Removal of Precipitate Formed by the Interaction between Sodium Hypochlorite and Chlorhexidine.

PubMed

Metri, Malasiddappa; Hegde, Swaroop; Dinesh, K; Indiresha, H N; Nagaraj, Shruthi; Bhandi, Shilpa H

2015-11-01

To evaluate the effectiveness of two final irrigation techniques for the removal of precipitate formed by the interaction between sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Sixty freshly extracted human maxillary incisor teeth were taken and randomly divided into three groups, containing 20 teeth each. Group 1 (control group), were irrigated with 5 ml of 2.5% NaOCl and a final flush with 5 ml of 2% chlorhexidine. Group 2 were irrigated with 5 ml of 2.5% NaOCl and 5 ml of 2% chlorhexidine followed by 5 ml of saline and agitated with F-files. Group 3 were irrigated with 5 ml of 2.5% NaOCl and 5 ml of 2% chlorhexidine followed by 5 ml of 15% citric acid and passively agitated with ultrasonics. A thin longitudinal groove was made along the buccal and lingual aspect of the root using diamond disks and split with chisel and mallet. Both halves of the split tooth will be examined under stereomicroscope. Results were tabulated and analyzed statistically using analysis of variance (ANOVA) and Mann-Whitney U test. There was a significant difference between the mean values (p < 0.05) in groups 2 and 3 compared to group 1 at each level. Passive ultrasonic irrigation is more effective than the F-file agitation technique to remove the precipitate at all three levels measured. Combination of sodium hypochlorite and chlorhexidine irrigation protocol has been practiced since from many years to achieve good results. However, it has adverse effect in the form of precipitate and which is considered to be a carcinogenic in nature, hence this precipitate should be removed.

[Efficacy of sodium hydroxide at 2.5 %, chlorhexidine gluconate at 0.5 % and calcium hydroxide against Candida albicans].

PubMed

Ndiaye, D; Diongue, K; Bane, K; Seck, A; Niang, S O; Lèye Benoist, F; Ndiaye, D; Touré, B

2016-12-01

Endodontic flora is dominated in the apical part of the channels by strict anaerobic and some facultative anaerobic bacteria but also by Candida yeasts, especially Candida albicans species that are involved in the maintenance and persistence of endodontic infections. Their elimination of the canal system in practice by chemo-mechanical methods of disinfection is not always guaranteed. Thus, this in vitro study was performed to determine the sensitivity of C. albicans with sodium hypochlorite (NaOCl) dosed at 2.5 %, the chlorhexidine digluconate 0.5 % and calcium hydroxide used in inter-session medication. The diffusion method was used initially to test the sensitivity of C. albicans strains with the above products. Then a dilution technique has allowed us to determine the minimum inhibitory concentration of these active products on C. albicans. Strains from infected pulp teeth of patients showed a sensitivity of C. albicans to sodium hypochlorite to a minimum inhibitory concentration less than 70μg/mL and 30μg/mL for chlorhexidine. This study demonstrated a sensitivity of C. albicans to sodium hypochlorite and chlorhexidine. Copyright © 2016. Published by Elsevier Masson SAS.

Inhibition of Tongue Coat and Dental Plaque Formation by Stabilized Chlorine Dioxide Vs Chlorhexidine Mouthrinse: A Randomized, Triple Blinded Study

PubMed Central

Kini, Vineet Vaman; Padhye, Ashvini

2015-01-01

Background Chlorine dioxide (ClO2) is an oxidizing agent with known bactericidal, viricidal and fungicidal properties. Its efficacy in reducing the halitosis has been established by previous literature. However, data evaluating its antiplaque property is scarce. Chlorhexidine (CHX) is considered as the gold standard and an effective adjunctive to mechanical plaque removal. However, it is associated with few reversible side effects. Therefore a study was conducted to assess the antiplaque property of ClO2 containing mouthrinse against CHX mouthrinse. Aims and Objectives To evaluate the efficacy of stabilized chlorine dioxide containing mouthrinse and CHX containing mouthrinse in inhibition of tongue coat accumulation and dental plaque formation using a four day plaque regrowth model clinically and microbiologically in a healthy dental cohort. Materials and Methods A Single Center, Randomized, Triple blinded, Microbiological clinical trial was conducted involving 25 healthy dental students volunteers (11 males, 14 females). Two commercially available mouthrinse: Mouthrinse A – Aqueous based ClO2 mouthrinse Freshchlor® and Mouthrinse B - Aqueous based 0.2% CHX mouthrinse Hexidine® were selected as the test products. Subjects were asked to rinse and gargle for 1 minute with the allocated mouthrinse under supervision after supragingival scaling, polishing and tongue coat removal. After four hours, smears were taken from the buccal mucosa and tooth surface. On the fifth day from baseline of four day non brushing plaque regrowth model the samples were again taken from buccal mucosa and tooth surface followed by recording of plaque scores by Rastogi Modification of Navy Plaque index, extent of tongue coat by Winkel’s tongue coating index and measuring tongue coat wet weight in grams. The samples collected were subjected to microbial analysis and the results were expressed as colony forming units (CFUs) per sample. Statistical Analysis The Data was analysed using SPSS 16.00 and presented using descriptive statistics. Independent t-test was used for the comparison between mouthrinse A groups & mouthrinse B group. Results The plaque scores and Winkels tongue coat scores, wet tongue coat weight recorded on the fifth day after the use of the two mouthrinse didn’t show a statistically significant difference. The CFU per sample from tooth and mucosa after four hours revealed low bacteria count with respect to mouthrinse B however the CFU obtained on the fifth day did not show a statistically significant difference between the two mouthrinse. Conclusion The clinical antiplaque efficacy of CHX and ClO2 mouthwash is comparable and so is the efficacy in reducing the oral bacterial load. PMID:26501017

PLGA nanoparticles as chlorhexidine-delivery carrier to resin-dentin adhesive interface.

PubMed

Priyadarshini, Balasankar Meera; Mitali, Kakran; Lu, Thong Beng; Handral, Harish K; Dubey, Nileshkumar; Fawzy, Amr S

2017-07-01

To characterize and deliver fabricated CHX-loaded PLGA-nanoparticles inside micron-sized dentinal-tubules of demineralized dentin-substrates and resin-dentin interface. Nanoparticles fabricated by emulsion evaporation were assessed in-vitro by different techniques. Delivery of drug-loaded nanoparticles to demineralized dentin substrates, interaction with collagen matrix, and ex-vivo CHX-release profiles using extracted teeth connected to experimental setup simulating pulpal hydrostatic pressure were investigated. Furthermore, nanoparticles association/interaction with a commercial dentin-adhesive applied to demineralized dentin substrates were examined. The results showed that the formulated nanoparticles demonstrated attractive physicochemical properties, low cytotoxicity, potent antibacterial efficacy, and slow degradation and gradual CHX release profiles. Nanoparticles delivered efficiently inside dentinal-tubules structure to sufficient depth (>10μm) against the simulated upward pulpal hydrostatic-pressure, even after bonding-resins infiltration and were attached/retained on collagen-fibrils. These results verified the potential significance of this newly introduced drug-delivery therapeutic strategy for future clinical applications and promote for a new era of future dental research. This innovative drug-delivery strategy has proven to be a reliable method for delivering treatments that could be elaborated for other clinical applications in adhesive and restorative dentistry. Copyright © 2017 The Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

An in vitro study of anticariogenic compounds incorporated into Bis-GMA/TEGDMA copolymer

NASA Astrophysics Data System (ADS)

Pilly Yadaiah, Vinay Kumar

Composite resins continue to evolve and are increasingly favoured by the people. However, drawbacks such as decreased longevity, secondary caries and costs make choosing composites a dilemma. This study evaluated drug release, inhibitory growth against Streptococcus mutans and drug stability of epigallocatechin-gallate (EGCg) incorporated into dental copolymer compared to resins containing chlorhexidine (CHX). Resin discs (5mm x 3mm) were prepared from 70 mol% Bis-GMA and 30 mol% TEGDMA comonomers containing: placebo, CHX and EGCg. Two corresponding concentrations in weight% of each drug for 0.5 and 1.0 x MIC were incorporated into paste resins and tested at time points: 24 hours, 7 days, 30 days, 60 days and 90 days. There is a significant difference in the 90 days drug delivery and bacterial inhibition among different drugs and drug ratios, which showed stability after 90 days. The results indicate that drug-based composites may reduce bacterial growth, which may improve its longevity.

Antibacterial effect of taurolidine (2%) on established dental plaque biofilm.

PubMed

Arweiler, Nicole Birgit; Auschill, Thorsten Mathias; Sculean, Anton

2012-04-01

Preliminary data have suggested that taurolidine may bear promising disinfectant properties for the therapy of bacterial infections. However, at present, the potential antibacterial effect of taurolidine on the supragingival plaque biofilm is unknown. To evaluate the antibacterial effect of taurolidine on the supragingival plaque biofilm using the vital fluorescence technique and to compare it with the effect of NaCl and chlorhexidine (CHX), 18 subjects had to refrain from all mechanical and chemical hygiene measures for 24 h. A voluminous supragingival plaque sample was taken from the buccal surfaces of the lower molars and wiped on an objective slide. The sample was then divided into three equal parts and mounted with one of the three test or control preparations (a) NaCl, (b) taurolidine 2% and (c) CHX 0.2%. After a reaction time of 2 min, the test solutions were sucked of. Subsequently, the plaque biofilm was stained with fluorescence dye and vitality of the plaque flora was evaluated under the fluorescence microscope (VF%). Plaque samples treated with NaCl showed a mean VF of 82.42 ± 6.04%. Taurolidine affected mean VF with 47.57 ± 16.60% significantly (p < 0.001, paired t test). The positive control CHX showed the lowest mean VF values (34.41 ± 14.79%; p < 0.001 compared to NaCl, p = 0.017 compared to taurolidine). Taurolidine possesses a significant antibacterial effect on the supragingival plaque biofilm which was, however, not as pronounced as that of CHX.

Systematic Review and Cost Analysis Comparing Use of Chlorhexidine with Use of Iodine for Preoperative Skin Antisepsis to Prevent Surgical Site Infection

PubMed Central

Lee, Ingi; Agarwal, Rajender K.; Lee, Bruce Y.; Fishman, Neil O.; Umscheid, Craig A.

2013-01-01

Objective To compare use of chlorhexidine with use of iodine for preoperative skin antisepsis with respect to effectiveness in preventing surgical site infections (SSIs) and cost. Methods We searched the Agency for Healthcare Research and Quality website, the Cochrane Library, Medline, and EMBASE up to January 2010 for eligible studies. Included studies were systematic reviews, meta-analyses, or randomized controlled trials (RCTs) comparing preoperative skin antisepsis with chlorhexidine and with iodine and assessing for the outcomes of SSI or positive skin culture result after application. One reviewer extracted data and assessed individual study quality, quality of evidence for each outcome, and publication bias. Meta-analyses were performed using a fixed-effects model. Using results from the meta-analysis and cost data from the Hospital of the University of Pennsylvania, we developed a decision analytic cost-benefit model to compare the economic value, from the hospital perspective, of antisepsis with iodine versus antisepsis with 2 preparations of chlorhexidine (ie, 4% chlorhexidine bottle and single-use applicators of a 2% chlorhexidine gluconate [CHG] and 70% isopropyl alcohol [IPA] solution), and also performed sensitivity analyses. Results Nine RCTs with a total of 3,614 patients were included in the meta-analysis. Meta-analysis revealed that chlorhexidine antisepsis was associated with significantly fewer SSIs (adjusted risk ratio, 0.64 [95% confidence interval, [0.51–0.80]) and positive skin culture results (adjusted risk ratio, 0.44 [95% confidence interval, 0.35–0.56]) than was iodine antisepsis. In the cost-benefit model baseline scenario, switching from iodine to chlorhexidine resulted in a net cost savings of $16–$26 per surgical case and $349,904–$568,594 per year for the Hospital of the University of Pennsylvania. Sensitivity analyses showed that net cost savings persisted under most circumstances. Conclusions Preoperative skin antisepsis with chlorhexidine is more effective than preoperative skin antisepsis with iodine for preventing SSI and results in cost savings. PMID:20969449

In vitro antimicrobial activity of auxiliary chemical substances and natural extracts on Candida albicans and Enterococcus faecalis in root canals

PubMed Central

VALERA, Marcia Carneiro; MAEKAWA, Lilian Eiko; de OLIVEIRA, Luciane Dias; JORGE, Antonio Olavo Cardoso; SHYGEI, Érika; CARVALHO, Cláudio Antonio Talge

2013-01-01

Objective: The aim of this study was to evaluate the antimicrobial activity of auxiliary chemical substances and natural extracts on Candida albicans and Enterococcus faecalis inoculated in root canals. Material and Methods: Seventy-two human tooth roots were contaminated with C. albicans and E. faecalis for 21 days. The groups were divided according to the auxiliary chemical substance into: G1) 2.5% sodium hypochlorite (NaOCl), G2) 2% chlorhexidine gel (CHX), G3) castor oil, G4) glycolic Aloe vera extract, G5) glycolic ginger extract, and G6) sterile saline (control). The samples of the root canal were collected at different intervals: confirmation collection, at 21 days after contamination; 1st collection, after instrumentation; and 2nd collection, seven days after instrumentation. Microbiological samples were grown in culture medium and incubated at 37º C for 48 hours. Results: The results were submitted to the Kruskal-Wallis and Dunn (5%) statistical tests. NaOCl and CHX completely eliminated the microorganisms of the root canals. Castor oil and ginger significantly reduced the number of CFU of the tested bacteria. Reduction of CFU/mL at the 1st and 2nd collections for groups G1, G2, G3 and G4 was greater in comparison to groups G5 and G6. Conclusion: It was concluded that 2.5% sodium hypochlorite and 2% chlorhexidine gel were more effective in eliminating C. albicans and E. faecalis, followed by the castor oil and glycolic ginger extract. The Aloe vera extract showed no antimicrobial activity. PMID:23739849

In vitro antimicrobial activity of auxiliary chemical substances and natural extracts on Candida albicans and Enterococcus faecalis in root canals.

PubMed

Valera, Marcia Carneiro; Maekawa, Lilian Eiko; de Oliveira, Luciane Dias; Jorge, Antonio Olavo Cardoso; Shygei, Érika; Carvalho, Cláudio Antonio Talge

2013-01-01

The aim of this study was to evaluate the antimicrobial activity of auxiliary chemical substances and natural extracts on Candida albicans and Enterococcus faecalis inoculated in root canals. Seventy-two human tooth roots were contaminated with C. albicans and E. faecalis for 21 days. The groups were divided according to the auxiliary chemical substance into: G1) 2.5% sodium hypochlorite (NaOCl), G2) 2% chlorhexidine gel (CHX), G3) castor oil, G4) glycolic Aloe vera extract, G5) glycolic ginger extract, and G6) sterile saline (control). The samples of the root canal were collected at different intervals: confirmation collection, at 21 days after contamination; 1st collection, after instrumentation; and 2nd collection, seven days after instrumentation. Microbiological samples were grown in culture medium and incubated at 37°C for 48 hours. The results were submitted to the Kruskal-Wallis and Dunn (5%) statistical tests. NaOCl and CHX completely eliminated the microorganisms of the root canals. Castor oil and ginger significantly reduced the number of CFU of the tested bacteria. Reduction of CFU/mL at the 1st and 2nd collections for groups G1, G2, G3 and G4 was greater in comparison to groups G5 and G6. It was concluded that 2.5% sodium hypochlorite and 2% chlorhexidine gel were more effective in eliminating C. albicans and E. faecalis, followed by the castor oil and glycolic ginger extract. The Aloe vera extract showed no antimicrobial activity.

[Evaluation of a waterless, scrubless chlorhexidine gluconate/ethanol surgical scrub and povidone-iodine for antimicrobial efficacy].

PubMed

Choi, Jeong Sil

2008-02-01

The purpose of this study was to compare 1% chlorhexidine-gluconate/61% ethanol (CHG/Ethanol) emollient and 7.5% povidone-iodine (PVI) scrub for antimicrobial,residual effect, and skin condition. CHG/Ethanol emollient hand hygiene was performed waterless, and brushless by operating doctors and nurses (N=20). PVI hand washing was performed with water and a brush (N=20) for 5 min. The subjects were asked to press their left hand in hand-shaped agar before a surgical scrub, immediately after a surgical scrub and after the operation. The amount of isolated microorganisms were calculated by counting the number of divided areas(1 x 1 cm, 160 cell) which were culture positive in the hand culture plate. The skin condition was evaluated. The antimicrobial count of CHG/Ethanol emollient and PVI immediately post surgical scrub was 0.0 vs. 4.1 (p>.05), and after the operation was 0.1 vs. 37.8 (p>.05)respectively. The Residual effect of CHG/Ethanol emollient immediately post surgical scrub and after the operation were 0.0 vs. 0.1 (p>.05), and PVI were 4.1 vs. 37.8 (p>.05)respectively. The skin condition and satisfaction of CHG/Ethanol emollient was higher than PVI (p<.05). The antimicrobial effect between CHG/Ethanol emollient and PVI were the same. Considering skin condition, satisfaction and allergic reaction CHG/Ethanol emollient for surgical scrub is recommended in Korea.

In vitro antimicrobial activity of sodium hypochlorite, chlorhexidine gluconate and octenidine dihydrochloride in elimination of microorganisms within dentinal tubules of primary and permanent teeth.

PubMed

Tirali, Resmiye-Ebru; Bodur, Haluk; Ece, Gülden

2012-05-01

The aim of this study was to evaluate the effectiveness of different irrigation solutions at different time intervals for the elimination of E. faecalis and C. albicans penetrated into the dentine tubules of primary and permanent teeth in vitro. The 4 mm primary and permanent teeth sections were sterilized and contaminated with a mixture of E. faecalis and C. albicans strains. After the application of different irrigation solutions (Sodium hypochlorite, Chlorhexidine gluconate, Octenidine Dihydrochloride, saline) to the contaminated tooth sections according to study groups, neutralizers were applied for inactivation of the solutions after 30 sec, 1 min and 5 min. Dentine shavings were placed into TSB and 10 µL from each tube was inoculated on agar plates, followed by an incubation period of 24 h at 37°C. The colonies were counted macroscopically. The results were compared by using Kruskal-Wallis and Mann Whitney U tests, with a significance level at p<0.05. Among the irrigation solutions that were tested against E. faecalis on primary and permanent teeth, the most effective one was found as 5-minute application of 0.1% Octenidine Dihydrochloride. The antibacterial effects of the tested solutions on the same time periods against C. albicans revealed no significant difference. There were no statistically significant differences between primary and permanent teeth with respect to the antimicrobial activity of the tested solutions. Moreover, Octenidine Dihydrochloride may be used as an alternative endodontic irrigant.

When the tendon autograft is dropped accidently on the floor: A study about bacterial contamination and antiseptic efficacy.

PubMed

Barbier, O; Danis, J; Versier, G; Ollat, D

2015-10-01

Inadvertent contamination of the autograft can occur during anterior cruciate ligament (ACL) reconstruction if the autograft is dropped on the floor during surgery. A study was undertaken to determine the incidence of contamination when a graft is dropped on the operating room floor and the efficacy of antimicrobial solutions to decontaminate it. Samples from 25 patients undergoing ACL reconstruction with a hamstring tendon were sectioned and dropped onto the floor. Cultures were taken after immersion in antiseptic solutions (a chlorhexidine gluconate solution (group 1), a povidone-iodine solution (group 2), and a sodium hypochlorite solution (group 3)). A fourth piece (group 0) was cultured without being exposed to any solution. Cultures of a floor swab were taken at the same time. The floor swab cultures were positive in 96% of cases. The rate of contamination was 40% in group 0, 8% in group 1, 4% in group 2, and 16% in group 3. There was a significant difference between groups 1 and 2 and group 0 (p<0.05) but not between groups 3 and 0. Immersing a graft dropped on the floor during surgery in a chlorhexidine gluconate solution or povidone-iodine solution significantly reduces contamination of the graft. Soaking of the hamstring autograft in one of these solutions is recommended in the case of inadvertent contamination. Laboratory investigation (level 2). Copyright © 2014 Elsevier B.V. All rights reserved.

Effect of multipurpose solutions against Acinetobacter carrying QAC genes.

PubMed

Boost, Maureen V; Chan, Jessica; Shi, Guang-sen; Cho, Pauline

2014-03-01

Acinetobacter has low virulence but causes infections in subjects with reduced immunity. It has been reported in ocular infections including those of patients using contact lenses. Treatment is difficult because Acinetobacter is frequently multidrug resistant. Antibiotic-resistant strains frequently also harbor genes for antiseptic resistance (quaternary ammonium compound [QAC]) genes. Because Acinetobacter is part of the normal flora, it may contaminate contact lens and accessories. This study aims to investigate carriage rates of QAC genes in household and clinical isolates of Acinetobacter and to determine the effectiveness of two multipurpose solutions (MPSs) for soft lenses against organisms carrying QAC genes. DNA was extracted from 11 bathroom isolates and 15 clinical isolates and amplified by polymerase chain reaction to determine the presence of qacEΔ1. Gene-positive and gene-negative control strains were used to challenge the two MPSs, and minimum inhibitory concentrations (MICs) of these organisms to benzalkonium chloride and chlorhexidine gluconate were determined. More than 90% of isolates carried qacEΔ1. The MICs of clinical isolates were higher than those of isolates of bathrooms. Both MPSs were able to produce a 3-log reduction in the numbers of all isolates. Although most isolates carried qacEΔ1 and elevated MICs to benzalkonium chloride and chlorhexidine gluconate were observed, all were susceptible to both MPSs tested. However, if there were to be poor compliance with care procedures, it is probable that such organisms could survive in the presence of diluted or expired solutions.

Synthesis and characterization of arginine-NIPAAm hybrid hydrogel as wound dressing: In vitro and in vivo study.

PubMed

Wu, De-Qun; Zhu, Jie; Han, Hua; Zhang, Jun-Zhi; Wu, Fei-Fei; Qin, Xiao-Hong; Yu, Jian-Yong

2018-01-01

A multi-functional hybrid hydrogel P(M-Arg/NIPAAm) with temperature response, anti-protein adsorption and antibacterial properties was prepared and applied as wound dressing. The hydrogel was carried out by free radical copolymerization of methacrylate arginine (M-Arg) and N-isopropyl acrylamide (NIPAAm) monomers using N,N'-methylene bisacrylamide as a crosslinker, and ammonium persulfate/N,N,N', N'-tetramethylethylenediamine as the redox initiator. To endow the antimicrobial property, chlorhexidine diacetate (CHX) was preloaded into the hydrogel and polyhexamethylene guanidine phosphate (PHMG) was grafted on the hydrogel surface, respectively. The antimicrobial property of two series of hydrogels was evaluated and compared. The successful synthesis of M-Arg, PHMG and hydrogels was proved by 13 C NMR, 1 H NMR and FTIR spectroscopy. The hydrogel morphology characterized by scanning electron microscopy confirmed that the homogeneous porous and interconnected structures of the hydrogels. The swelling, protein adsorption property, in vitro release of CHX, antimicrobial assessment, cell viability as well as in vivo wound healing in a mouse model were studied. The results showed the nontoxicity and antimicrobial P(M-Arg/NIPAAm) hydrogel accelerated the full-thickness wound healing process and had the potential application in wound dressing. Despite the zwitterionic characteristic and biocompatible property of arginine based hydrogels, the brittle behavior and non-transparency still remain as a significant problem for wound dressing. Furthermore promoting the antibacterial property of the zwitterionic hydrogel is also necessary to prevent the bacterial colonization and subsequent wound infection. Therefore, we created a hybrid hydrogel combined methacrylate arginine (M-Arg) and N-isopropyl acrylamide (NIPAAm). NIPAAm improves transparency and mechanical property as well as acts as a temperature-response drug release system. Additionally, chlorhexidine (CHX) was preloaded into the hydrogels and polyhexamethylene guanidine phosphate (PHMG) was grafted on the hydrogel surface, respectively, which make the hydrogel useful as a favorable antibacterial dressing. The hybrid hydrogel has a combination effect of biocompatibility, environmentally responsive transformation behavior, biodegradability, anti-protein adsorption and antimicrobial properties. This report proposes the preparation of P(M-Arg/NIPAAm) hydrogel that has a great potential for wound healing. Copyright © 2017 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Antibacterial activity, surface roughness, flexural strength, and solubility of conventional luting cements containing chlorhexidine diacetate/cetrimide mixtures.

PubMed

Korkmaz, Fatih Mehmet; Tüzüner, Tamer; Baygin, Ozgul; Buruk, Celal Kurtulus; Durkan, Rukiye; Bagis, Bora

2013-08-01

The failure of fixed dental restorations is commonly associated with caries. The use of conventional luting cements containing antibacterial agents may overcome this problem. The purpose of this study was to evaluate the antibacterial activity (ABA), surface roughness (Ra), flexural strength (FS), and solubility (SL) patterns of the conventional dental luting cements zinc phosphate (ZP), zinc polycarboxylate (PC), and glass ionomer (GIC) after the addition of 5% chlorhexidine diacetate/cetrimide (CHX+CT). Antibacterial agents with a total concentration of 5% (2.5% CHX+2.5% CT) were added to antibacterial agent-free conventional luting cement powders (ZPC, PCC, and GICC) and designated as experimental groups (ZPE, PCE, and GICE). ABA against Streptococcus mutans (SM) and Lactobacillus casei (LB) was examined by using the agar diffusion test method. Ra, FS, and SL values were obtained after storage in distilled water at 37°C for 24 hours. The Kruskal-Wallis and Mann Whitney U with Bonferroni correction tests were used to test for agar diffusion (α=.05) and 2-way ANOVA and Fisher Least Significant Difference (LSD) test were used to measure Ra, FS, and SL (α=.05). The control groups exhibited limited ABA. With the exception of PCE>PCC on day 1 for SM, all experimental groups showed significantly greater and longer-lasting protection against SM and LB bacteria for up to 180 days than their controls (P<.05). Ra values decreased (ZPC>ZPE; P>.05, PCC>PCE; P<.05) except that GICE>GICC (P>.05) when compared with their individual controls. Control groups exhibited higher FS values than did the experimental groups (ZPC>ZPE; P<.05, PCC>PCE; P<.05, GICC>GICE; P>.05). The experimental groups exhibited higher solubilities than did their controls in the ZPC (P>.05) and GICC groups (P<.05) but were lower in PCC group (P<.05). Incorporating a 5% CHX+CT mixture into conventional dental luting cements and altering their Ra, FS, and SL values may provide greater antibacterial protection against SM and LB. Copyright © 2013 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

Comparison of the effectiveness of 0.5% tea, 2% neem and 0.2% chlorhexidine mouthwashes on oral health: a randomized control trial.

PubMed

Balappanavar, Aswini Y; Sardana, Varun; Singh, Malkeet

2013-01-01

The aim of this study was to evaluate and compare the effectiveness of 0.5% tea, 2% neem, and 0.2% chlorhexidine mouthwashes on oral health. A randomized blinded controlled trial with 30 healthy human volunteers of age group 18-25 years was carried out. The subjects were randomly assigned to 3 groups i.e., group A - 0.2% chlorhexidine gluconate (bench mark control), Group B - 2% neem, and group C - 0.5% tea of 10 subjects per group. Plaque accumulation and gingival condition were recorded using plaque index and gingival index. Oral hygiene was assessed by simplified oral hygiene index (OHIS). Salivary pH was assessed by indikrom pH strips. Plaque, gingival, and simplified OHI scores as well as salivary pH were recorded at baseline, immediately after 1 st rinse, after 1 week, 2 nd week, and 3 rd week. The 3 rd week was skipped for group A. Mean plaque and gingival scores were reduced over the 3 week trial period for experimental and control groups. Anti-plaque effectiveness was observed in all groups and the highest being in group C (P < 0.05). Neem and tea showed comparative effectiveness on gingiva better than chlorhexidine (P < 0.05). The salivary pH rise was sustained and significant in Group B and C compared to Group A. Oral hygiene improvement was better appreciated in Group B and Group C. The effectiveness of 0.5% tea was more compared to 2% neem and 0.2% chlorhexidine mouth rinse.

Antimicrobial efficacy of octenidine hydrochloride, MTAD and chlorhexidine gluconate mixed with calcium hydroxide.

PubMed

Tirali, Resmiye Ebru; Gulsahi, Kamran; Cehreli, Sevi Burcak; Karahan, Zeynep Ceren; Uzunoğlu, Emel; Elhan, Atilla

2013-05-01

The aim of this in vitro study was to investigate whether mixing with calcium hydroxide [Ca(OH)2] affects the antimicrobial action of Octenidine hydrochloride (Octenisept), MTAD and chlorhexidine against Enterococcus faecalis and Candida albicans. Freshly grown cultures of Enterococcus faecalis, Candida albicans and a mixture of both strains were incubated in agar plates containing brain-heart infusion broth (BHIB). Zones of inhibition were measured at 24 and 48 hours. Statistical analysis was performed using Mann-Whitney U test and Kruskal-Wallis one-way analysis of variance (ANOVA, both p=0.05). Mixing with Ca(OH)2 significantly increased the antibacterial effect of Octenisept (p<0.05), but did not alter its antifungal activity. Only chlorhexidine showed more antibacterial and antifungal efficiency compared to its Ca(OH)2-mixed version (both p<0.05). Mixing with Ca(OH)2 decreased the antibacterial efficacy of MTAD, but increased its antifungal effect (both p<0.05). These results demonstrate the differential effects of Ca(OH)2 addition on the antimicrobial action of the tested endodontic medicaments in vitro. Ca(OH)2 was as effective as its combination with all of the tested medicaments.

Epidemiologic Background of Hand Hygiene and Evaluation of the Most Important Agents for Scrubs and Rubs

PubMed Central

Kampf, Günter; Kramer, Axel

2004-01-01

The etiology of nosocomial infections, the frequency of contaminated hands with the different nosocomial pathogens, and the role of health care workers' hands during outbreaks suggest that a hand hygiene preparation should at least have activity against bacteria, yeasts, and coated viruses. The importance of efficacy in choosing the right hand hygiene product is reflected in the new Centers for Disease Control and Prevention guideline on hand hygiene (J. M. Boyce and D. Pittet, Morb. Mortal. Wkly. Rep. 51:1-45, 2002). The best antimicrobial efficacy can be achieved with ethanol (60 to 85%), isopropanol (60 to 80%), and n-propanol (60 to 80%). The activity is broad and immediate. Ethanol at high concentrations (e.g., 95%) is the most effective treatment against naked viruses, whereas n-propanol seems to be more effective against the resident bacterial flora. The combination of alcohols may have a synergistic effect. The antimicrobial efficacy of chlorhexidine (2 to 4%) and triclosan (1 to 2%) is both lower and slower. Additionally, both agents have a risk of bacterial resistance, which is higher for chlorhexidine than triclosan. Their activity is often supported by the mechanical removal of pathogens during hand washing. Taking the antimicrobial efficacy and the mechanical removal together, they are still less effective than the alcohols. Plain soap and water has the lowest efficacy of all. In the new Centers for Disease Control and Prevention guideline, promotion of alcohol-based hand rubs containing various emollients instead of irritating soaps and detergents is one strategy to reduce skin damage, dryness, and irritation. Irritant contact dermatitis is highest with preparations containing 4% chlorhexidine gluconate, less frequent with nonantimicrobial soaps and preparations containing lower concentrations of chlorhexidine gluconate, and lowest with well-formulated alcohol-based hand rubs containing emollients and other skin conditioners. Too few published data from comparative trials are available to reliably rank triclosan. Personnel should be reminded that it is neither necessary nor recommended to routinely wash hands after each application of an alcohol-based hand rub. Long-lasting improvement of compliance with hand hygiene protocols can be successful if an effective and accessible alcohol-based hand rub with a proven dermal tolerance and an excellent user acceptability is supplied, accompanied by education of health care workers and promotion of the use of the product. PMID:15489352

Development of an in vitro periodontal biofilm model for assessing antimicrobial and host modulatory effects of bioactive molecules.

PubMed

Millhouse, Emma; Jose, Anto; Sherry, Leighann; Lappin, David F; Patel, Nisha; Middleton, Andrew M; Pratten, Jonathan; Culshaw, Shauna; Ramage, Gordon

2014-06-28

Inflammation within the oral cavity occurs due to dysregulation between microbial biofilms and the host response. Understanding how different oral hygiene products influence inflammatory properties is important for the development of new products. Therefore, creation of a robust host-pathogen biofilm platform capable of evaluating novel oral healthcare compounds is an attractive option. We therefore devised a multi-species biofilm co-culture model to evaluate the naturally derived polyphenol resveratrol (RSV) and gold standard chlorhexidine (CHX) with respect to anti-biofilm and anti-inflammatory properties. An in vitro multi-species biofilm containing S. mitis, F. nucleatum, P. gingivalis and A. actinomycetemcomitans was created to represent a disease-associated biofilm and the oral epithelial cell in OKF6-TERT2. Cytotoxicity studies were performed using RSV and CHX. Multi-species biofilms were either treated with either molecule, or alternatively epithelial cells were treated with these prior to biofilm co-culture. Biofilm composition was evaluated and inflammatory responses quantified at a transcriptional and protein level. CHX was toxic to epithelial cells and multi-species biofilms at concentrations ranging from 0.01-0.2%. RSV did not effect multi-species biofilm composition, but was toxic to epithelial cells at concentrations greater than 0.01%. In co-culture, CHX-treated biofilms resulted in down regulation of the inflammatory chemokine IL-8 at both mRNA and protein level. RSV-treated epithelial cells in co-culture were down-regulated in the release of IL-8 protein, but not mRNA. CHX possesses potent bactericidal properties, which may impact downstream inflammatory mediators. RSV does not appear to have bactericidal properties against multi-species biofilms, however it did appear to supress epithelial cells from releasing inflammatory mediators. This study demonstrates the potential to understand the mechanisms by which different oral hygiene products may influence gingival inflammation, thereby validating the use of a biofilm co-culture model.

Porosity of temporary denture soft liners containing antifungal agents.

PubMed

Lima, Jozely Francisca Mello; Maciel, Janaína Gomes; Hotta, Juliana; Vizoto, Ana Carolina Pero; Honório, Heitor Marques; Urban, Vanessa Migliorini; Neppelenbroek, Karin Hermana

2016-01-01

To evaluate the porosity of a tissue conditioner (Softone) and a temporary resilient liner (Trusoft) modified by minimum inhibitory concentrations (MICs) of antifungal agents for Candida albicans biofilm. The porosity was measured by water absorption, based on exclusion of the plasticizer effect. Initially, it was determined by sorption isotherms that the adequate storage solution for specimens (65×10×3.3 mm) of both materials was 50% anhydrous calcium chloride (S50). Then, the porosity factor (PF) was calculated for the study groups (n=10) formed by specimens without (control) or with drug incorporation at MICs (nystatin: Ny-0.032 g, chlorhexidine diacetate: Chx-0.064 g, or ketoconazole: Ke-0.128 g each per gram of soft liner powder) after storage in distilled water or S50 for 24 h, seven and 14 d. Data were statistically analyzed by 4-way repeated measures ANOVA and Tukey's test (α=.05). Ke resulted in no significant changes in PF for both liners in water over 14 days (p>0.05). Compared with the controls, Softone and Trusoft PFs were increased at 14-day water immersion only after addition of Ny and Chx, and Chx, respectively (p<0.05). Both materials showed no significant changes in PF in up to 14 days of S50 immersion, compared with the controls (p>0.05). In all experimental conditions, Softone and Trusoft PFs were significantly lower when immersed in S50 compared with distilled water (p<0.05). The addition of antifungals at MICs resulted in no harmful effects for the porosity of both temporary soft liners in different periods of water immersion, except for Chx and Ny in Softone and Chx in Trusoft at 14 days. No deleterious effect was observed for the porosity of both soft liners modified by the drugs at MICs over 14 days of S50 immersion.

Interaction between Octenidine-based Solution and Sodium Hypochlorite: A Mass Spectroscopy, Proton Nuclear Magnetic Resonance, and Scanning Electron Microscopy-based Observational Study.

PubMed

Thaha, Khaleel Ahamed; Varma, R Luxmi; Nair, Mali G; Sam Joseph, V G; Krishnan, Unni

2017-01-01

Octenisept (OCT; Schülke & Mayr, Nordersdedt, Germany), an antimicrobial, antibiofilm agent and a promising root canal irrigant, can be potentially combined with sodium hypochlorite (NaOCl) during endodontic treatment. The aim of this study was first to identify the precipitate formed on the interaction between OCT and NaOCl and secondly to compare its effect on dentinal tubules with that of precipitate formed on combining chlorhexidine (CHX) and NaOCl. This observational study was conducted in 3 stages. Initially, the color changes and precipitate formation were assessed when the test solution 0.1% OCT and 5.2% NaOCl were mixed. Color changes were compared with those observed when 2% CHX was mixed with 5.2% NaOCl. The residue obtained on combining OCT and NaOCl was subjected to proton nuclear magnetic resonance ( 1 H NMR) and mass spectrometric (MS) analysis. In the final stage, dentinal surfaces irrigated alternatively with OCT and NaOCl were compared using scanning electron microscopy (SEM) with the dentinal surface irrigated with CHX and NaOCl. The OCT-NaOCl mixture changed in color from initial milky white to transparent over time, whereas the CHX-NaOCl mixture showed an immediate peach-brown discoloration. 1 H NMR and MS analysis established that the whitish precipitate obtained on combining OCT and NaOCl solutions correlated with the structure of phenoxyethanol (PE). SEM revealed dense precipitate occluding the dentinal tubules with the CHX and NaOCl group, whereas the precipitate was sparse and partially occluded in the OCT and NaOCl group. The whitish precipitate formed with the OCT-NaOCl mixture was identified as PE, a compound already present in OCT, and it partly occluded the dentinal tubules. Copyright © 2016 American Association of Endodontists. All rights reserved.

Ex vivo vs. in vivo antibacterial activity of two antiseptics on oral biofilm

PubMed Central

Prada-López, Isabel; Quintas, Víctor; Casares-De-Cal, Maria A.; Suárez-Quintanilla, Juan A.; Suárez-Quintanilla, David; Tomás, Inmaculada

2015-01-01

Aim: To compare the immediate antibacterial effect of two application methods (passive immersion and active mouthwash) of two antiseptic solutions on the in situ oral biofilm. Material and Methods: A randomized observer-masked crossover study was conducted. Fifteen healthy volunteers wore a specific intraoral device for 48 h to form a biofilm in three glass disks. One of these disks was used as a baseline; another one was immersed in a solution of 0.2% Chlorhexidine (0.2% CHX), remaining the third in the device, placed in the oral cavity, during the 0.2% CHX mouthwash application. After a 2-weeks washout period, the protocol was repeated using a solution of Essential Oils (EO). Samples were analyzed for bacterial viability with the confocal laser scanning microscope after previous staining with LIVE/DEAD® BacLight™. Results: The EO showed a better antibacterial effect compared to the 0.2% CHX after the mouthwash application (% of bacterial viability = 1.16 ± 1.00% vs. 5.08 ± 5.79%, respectively), and was more effective in all layers (p < 0.05). In the immersion, both antiseptics were significantly less effective (% of bacterial viability = 26.93 ± 13.11%, EO vs. 15.17 ± 6.14%, 0.2% CHX); in the case of EO immersion, there were no significant changes in the bacterial viability of the deepest layer in comparison with the baseline. Conclusions: The method of application conditioned the antibacterial activity of the 0.2% CHX and EO solutions on the in situ oral biofilm. The in vivo active mouthwash was more effective than the ex vivo passive immersion in both antiseptic solutions. There was more penetration of the antiseptic inside the biofilm with an active mouthwash, especially with the EO. Trial registered in clinicaltrials.gov with the number NCT02267239. URL: https://clinicaltrials.gov/ct2/show/NCT02267239. PMID:26191050

Photodynamic antimicrobial effect of safranine O on an ex vivo periodontal biofilm.

PubMed

Voos, Amelia C; Kranz, Stefan; Tonndorf-Martini, Silke; Voelpel, Andrea; Sigusch, Holger; Staudte, Henrike; Albrecht, Volker; Sigusch, Bernd W

2014-03-01

The increasing resistance of oral pathogens against antibiotic measures urgently requires new therapeutic strategies. In this context, antimicrobial photodynamic therapy (aPDT) may play a crucial part in the future. The aim of the present study was to compare the antibacterial efficiency of aPDT using the photosensitizer safranine O with that of chlorhexidine (0.2% CHX) on an ex vivo biofilm. First the antibacterial activity of both measures against planktonic cultures of Streptococcus gordonii ATCC 33399, Streptococcus mutans ATCC 25175, Fusobacterium nucleatum ATCC 10953, Aggregatibacter actinomycetemcomitans ATCC 33384 and Porphyromonas gingivalis ATCC 33277 was observed. Then a patient specific ex vivo biofilm was established from plaque and saliva samples of patients (n = 19) with chronic periodontitis. The antibacterial effects of aPDT and of 0.2% CHX were determined on the ex vivo biofilms cultivated for 24 and 72 hours. After cultivation of the treated samples on blood agar (2 days) the results were quantified by counting the colony forming units (cfu/ml). Photodynamic treatment with safranine O showed a distinct antibacterial effect on F. nucleatum and P. gingivalis. Whereas S. gordonii was suppressed completely by aPDT, treatment with 0.2% CHX caused only a partial reduction. In the ex vivo biofilm model (24-hour biofilm), aPDT caused a significantly higher bacterial killing than treatment with 0.2% CHX. Compared to the untreated control, there was no significant difference on the 72-hour biofilm for both methods. The results show that oral-pathogenic species in planktonic solution can be suppressed significantly by aPDT with safranine O. Especially for bacteria in a 24-hour ex vivo biofilm, this method is more effective than treatment with 0.2% CHX. Both antibacterial treatments did not show any significant effect on the biofilm cultivated for 72 hours. © 2014 Wiley Periodicals, Inc.

The plaque- and gingivitis-inhibiting capacity of a commercially available essential oil product. A parallel, split-mouth, single blind, randomized, placebo-controlled clinical study.

PubMed

Preus, Hans Ragnar; Koldsland, Odd Carsten; Aass, Anne Merete; Sandvik, Leiv; Hansen, Bjørn Frode

2013-11-01

Studies have reported commercially available essential oils with convincing plaque and gingivitis preventing properties. However, no tests have compared these essential oils, i.e. Listerine(®), against their true vehicle controls. To compare the plaque and gingivitis inhibiting effect of a commercially-available essential oil (Listerine(®) Total Care) to a negative (22% hydro-alcohol solution) and a positive (0.2% chlorhexidine (CHX)) control in an experimental gingivitis model. In three groups of 15 healthy volunteers, experimental gingivitis was induced and monitored over 21 days, simultaneously treated with Listerine(®) Total Care (test), 22% hydro-alcohol solution (negative control) and 0.2% chlorhexidine solution (positive control), respectively. The upper right quadrant of each individual received mouthwash only, whereas the upper left quadrant was subject to both rinses and mechanical oral hygiene. Plaque, gingivitis and side-effects were assessed at day 7, 14 and 21. After 21 days, the chlorhexidine group showed significantly lower average plaque and gingivitis scores than the Listerine(®) and alcohol groups, whereas there was little difference between the two latter. Listerine(®) Total Care had no statistically significant effect on plaque formation as compared to its vehicle control.

Staphylococcus aureus and Escherichia coli dual-species biofilms on nanohydroxyapatite loaded with CHX or ZnO nanoparticles.

PubMed

Barros, Joana; Grenho, Liliana; Fontenente, Sílvia; Manuel, Cândida M; Nunes, Olga C; Melo, Luís F; Monteiro, Fernando J; Ferraz, Maria P

2017-02-01

Implant-associated infections are caused by surface-adhering microorganisms persisting as biofilms, resistant to host defense and antimicrobial agents. Given the limited efficacy of traditional antibiotics, novel strategies may rely on the prevention of such infections through the design of new biomaterials. In this work, two antimicrobial agents applied to nanohydroxyapatite materials-namely, chlorhexidine digluconate (CHX) and zinc oxide (ZnO) nanoparticles-were compared concerning their ability to avoid single- or dual-species biofilms of Staphylococcus aureus and Escherichia coli. The resulting biofilms were quantified by the enumeration of colony-forming units and examined by confocal microscopy using both Live/Dead staining and bacterial-specific fluorescent in situ hybridization. The sessile population arrangement was also observed by scanning electron microscopy. Both biomaterials showed to be effective in impairing bacterial adhesion and proliferation for either single- or dual-species biofilms. Furthermore, a competitive interaction was observed for dual-species biofilms wherein E. coli exhibited higher proliferative capacity than S. aureus, an inverse behavior from the one observed in single-species biofilms. Therefore, either nanoHA-CHX or nanoHA-ZnO surfaces appear as promising alternatives to antibiotics for the prevention of devices-related infections avoiding the critical risk of antibiotic-resistant strains emergence. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 105A: 491-497, 2017. © 2016 Wiley Periodicals, Inc.

Effectiveness of Persea major Kopp (Lauraceae) extract against Enterococcus faecalis: a preliminary in vitro study.

PubMed

Volpato, Lusiane; Gabardo, Marilisa Carneiro Leão; Leonardi, Denise Piotto; Tomazinho, Paulo Henrique; Maranho, Leila Teresinha; Baratto-Filho, Flares

2017-03-06

Persea major Kopp (Lauraceae) is a plant with wound healing, antibacterial, and analgesic properties. The aim of this study was to assess the in vitro antibacterial activity of the concentrated crude extract (CCE) and ethyl acetate fraction (EAF) of this plant against Enterococcus faecalis and compare it with calcium hydroxide [Ca(OH) 2 ] paste and 2% chlorhexidine digluconate (CHX). The plant material was collected, and an extract was prepared according to the requirements of the study (CCE and EAF). The minimum inhibitory concentrations (MICs) of CCE, EAF, Ca(OH) 2 , Ca(OH) 2  + CCE, and CHX against E. faecalis were determined using the broth microdilution method RESULTS: The EAF inhibited E. faecalis at concentrations of 166.50, 83.25, and 41.62 mg mL -1 , and 1.00, 0.50, and 0.25% of CHX solutions showed antimicrobial activity. The MICs of Ca(OH) 2 paste were 166.50 and 83.25 mg mL -1 , whereas Ca(OH) 2  + CCE showed antimicrobial activity only at a concentration of 166.50 mg mL -1 . CCE showed no inhibitory effect at any of the concentrations tested CONCLUSIONS: The CCE did not show any antimicrobial activity against E. faecalis; however, the EAF was the most effective among the three highest concentrations tested.

The Effect of Gaseous Ozone in Infected Root Canal

PubMed Central

Ajeti, Nova Nexhmije; Pustina-Krasniqi, Teuta; Apostolska, Sonja

2018-01-01

OBJECTIVES: During the treatment of chronic apical periodontitis and pulp necrosis the main role is to irrigate the root canal. AIM: The aim of this in vivo study was to irrigate with 0.9% NaCl (Natrium Chloride), 2.5 % NaOCl (Sodium Hypochlorite Solution, Sigma Aldrich - Germany) and 2% CHX (Chlorhexidine Digluconate Solution, Sigma Aldrich - Spain) combined with Gaseous Ozone (Prozone WH, Austria). MATERIAL AND METHODS: This study was realised in the University Dentistry Clinical Centre of Kosovo (UDCCK), respectively in the Department of Endodontic and Dental Pathology, Dental Branch, Faculty of Medicine, Prishtina, Kosovo. The 40 subjects involved in this study belonged to both genders, in age between 15 -65 years. The sample selection was randomised. The retroalveolar radiography for each patient was taken in the suspected tooth. As a therapeutic plan the authors decided to disinfect the root canal with the irrigants, as follows: 2.5 % NaOCl, 2 % CHX and gaseous ozone. RESULTS: The statistical analyses were based on Kruskal - Vallis test, X - test, DF = 3, r < 0.01. In the isolated average number of the aerobe and anaerobe bacteria colonies, when gaseous ozone was used, there was the significant statistical difference. CONCLUSIONS: When gaseous ozone was combined with irrigants 0.9%, 2.5 % NaOCl and 2% CHX, it was concluded that the number of colonies of aerobic and anaerobic bacteria was reduced. PMID:29531611

Evaluation of final irrigation regimens with maleic acid for smear layer removal and wettability of root canal sealer.

PubMed

Ballal, Nidambur Vasudev; Ferrer-Luque, Carmen Maria; Sona, Mrunali; Prabhu, K Narayan; Arias-Moliz, Teresa; Baca, Pilar

2018-04-01

To evaluate the smear layer removal and wettability of AH Plus sealer on root canal dentin treated with MA (maleic acid), MA + CTR (cetrimide) and MA + CTR + CHX (chlorhexidine) as final irrigating regimens. For smear layer removal, 40 teeth were instrumented to size F4 and divided into four groups: (1) 7% MA, (2) 7% MA + 0.2% CTR, (3) 7% MA + 0.2% CTR + 2% CHX, (4) distilled water (control). After irrigation, teeth were subjected to SEM analysis. For contact angle analysis, 20 teeth were split longitudinally and divided into four groups similar to smear layer analysis. AH plus sealer was placed on each specimen and contact angle was analysed. In both smear layer (p = .393) and contact angle analysis (p = .961), there was no significant difference between the groups MA and MA + CTR. However, MA + CTR + CHX removed smear layer less effectively (p = .023) and increased the contact angle of the sealer (p = .005). In smear layer analysis, specimens in negative control group were heavily smeared. In case of contact angle analysis, samples in the control group had least contact angle. MA alone or in combination with CTR removed smear layer effectively and increased the wettability of AH plus sealer to root canal dentin.

Vitality of Enterococcus faecalis inside dentinal tubules after five root canal disinfection methods

PubMed Central

Vatkar, Niranjan Ashok; Hegde, Vivek; Sathe, Sucheta

2016-01-01

Aim: To compare the vitality of Enterococcus faecalis within dentinal tubules after subjected to five root canal disinfection methods. Materials and Methods: Dentin blocks (n = 60) were colonized with E. faecalis. After 4 weeks of incubation, the dentin blocks were divided into one control and five test groups (n = 10 each). The root canals of test groups were subjected to one of the disinfection methods, namely, normal saline (NS), sodium hypochlorite (NaOCl), chlorhexidine digluconate (CHX), neodymium-doped yttrium aluminum garnet (Nd: YAG) laser, and diode laser. The effect of disinfection methods was assessed by LIVE/DEAD BacLight stain under the confocal laser scanning microscopy to determine the “zone of dead bacteria” (ZDB). Mean values were calculated for ZDB and the difference between groups was established. Results: Penetration of E. faecalis was seen to a depth of >1000 μm. Viable bacteria were detected with NS irrigation. NaOCl and CHX showed partial ZDB. When the root canals were disinfected with Nd: YAG and diode lasers, no viable bacteria were found. Conclusion: E. faecalis has the ability to colonize inside dentinal tubules to a depth of >1000 μm. In contrast to conventional irrigants, both Nd: YAG and diode lasers were effective in eliminating the vitality of E. faecalis. NS, NaOCl, and CHX showed viable bacteria remaining in dentinal tubules. PMID:27656064

Effect of Chlorhexidine Bathing Every Other Day on Prevention of Hospital-Acquired Infections in the Surgical ICU: A Single-Center, Randomized Controlled Trial.

PubMed

Swan, Joshua T; Ashton, Carol M; Bui, Lan N; Pham, Vy P; Shirkey, Beverly A; Blackshear, Jolene E; Bersamin, Jimmy B; Pomer, Rubie May L; Johnson, Michael L; Magtoto, Audrey D; Butler, Michelle O; Tran, Shirley K; Sanchez, Leah R; Patel, Jessica G; Ochoa, Robert A; Hai, Shaikh A; Denison, Karen I; Graviss, Edward A; Wray, Nelda P

2016-10-01

To test the hypothesis that compared with daily soap and water bathing, 2% chlorhexidine gluconate bathing every other day for up to 28 days decreases the risk of hospital-acquired catheter-associated urinary tract infection, ventilator-associated pneumonia, incisional surgical site infection, and primary bloodstream infection in surgical ICU patients. This was a single-center, pragmatic, randomized trial. Patients and clinicians were aware of treatment-group assignment; investigators who determined outcomes were blinded. Twenty-four-bed surgical ICU at a quaternary academic medical center. Adults admitted to the surgical ICU from July 2012 to May 2013 with an anticipated surgical ICU stay for 48 hours or more were included. Patients were randomized to bathing with 2% chlorhexidine every other day alternating with soap and water every other day (treatment arm) or to bathing with soap and water daily (control arm). The primary endpoint was a composite outcome of catheter-associated urinary tract infection, ventilator-associated pneumonia, incisional surgical site infection, and primary bloodstream infection. Of 350 patients randomized, 24 were excluded due to prior enrollment in this trial and one withdrew consent. Therefore, 325 were analyzed (164 soap and water versus 161 chlorhexidine). Patients acquired 53 infections. Compared with soap and water bathing, chlorhexidine bathing every other day decreased the risk of acquiring infections (hazard ratio = 0.555; 95% CI, 0.309-0.997; p = 0.049). For patients bathed with soap and water versus chlorhexidine, counts of incident hospital-acquired infections were 14 versus 7 for catheter-associated urinary tract infection, 13 versus 8 for ventilator-associated pneumonia, 6 versus 3 for incisional surgical site infections, and 2 versus 0 for primary bloodstream infection; the effect was consistent across all infections. The absolute risk reduction for acquiring a hospital-acquired infection was 9.0% (95% CI, 1.5-16.4%; p = 0.019). Incidences of adverse skin occurrences were similar (18.9% soap and water vs 18.6% chlorhexidine; p = 0.95). Compared with soap and water, chlorhexidine bathing every other day decreased the risk of acquiring infections by 44.5% in surgical ICU patients.

Interaction between lidocaine hydrochloride (with and without adrenaline) and various irrigants: A nuclear magnetic resonance analysis

PubMed Central

Vidhya, Nirmal; Karthikeyan, Balasubramanian Saravana; Velmurugan, Natanasabapathy; Abarajithan, Mohan; Nithyanandan, Sivasankaran

2014-01-01

Background: Interaction between local anesthetic solution, lidocaine hydrochloride (with and without adrenaline), and root canal irrigants such as sodium hypochlorite (NaOCl), ethylene diamine tetra-acetic acid (EDTA), and chlorhexidine (CHX) has not been studied earlier. Hence, the purpose of this in vitro study was to evaluate the chemical interaction between 2% lidocaine hydrochloride (with and without adrenaline) and commonly used root canal irrigants, NaOCl, EDTA, and CHX. Materials and Methods: Samples were divided into eight experimental groups: Group I-Lidocaine hydrochloride (with adrenaline)/3% NaOCl, Group II-Lidocaine hydrochloride (with adrenaline)/17% EDTA, Group III- Lidocaine hydrochloride (with adrenaline)/2% CHX, Group IV-Lidocaine hydrochloride (without adrenaline)/3% NaOCl, Group V-Lidocaine hydrochloride (without adrenaline)/17% EDTA, Group VI-Lidocaine hydrochloride (without adrenaline)/2% CHX, and two control groups: Group VII-Lidocaine hydrochloride (with adrenaline)/deionized water and Group VIII-Lidocaine hydrochloride (without adrenaline)/deionized water. The respective solutions of various groups were mixed in equal proportions (1 ml each) and observed for precipitate formation. Chemical composition of the formed precipitate was then analysed by nuclear magnetic resonance spectroscopy (NMR) and confirmed with diazotation test. Results: In groups I and IV, a white precipitate was observed in all the samples on mixing the respective solutions, which showed a color change to reddish brown after 15 minutes. This precipitate was then analysed by NMR spectroscopy and was observed to be 2,6-xylidine, a reported toxic compound. The experimental groups II, III, V, and VI and control groups VII and VIII showed no precipitate formation in any of the respective samples, until 2 hours. Conclusion: Interaction between lidocaine hydrochloride (with and without adrenaline) and NaOCl showed precipitate formation containing 2,6-xylidine, a toxic compound. PMID:25097652

In vitro treatment of Candida albicans biofilms on denture base material with volume dielectric barrier discharge plasma (VDBD) compared with common chemical antiseptics.

PubMed

Matthes, Rutger; Jablonowski, Lukasz; Koban, Ina; Quade, Antje; Hübner, Nils-Olaf; Schlueter, Rabea; Weltmann, Klaus-Dieter; von Woedtke, Thomas; Kramer, Axel; Kocher, Thomas

2015-12-01

To prevent oral candidiasis, it is crucial to inactivate Candida-based biofilms on dentures. Common denture cleansing solutions cannot sufficiently inactivate Candida albicans. Therefore, we investigated the anticandidal efficacy of a physical plasma against C. albicans biofilms in vitro. Argon or argon plasma with 1 % oxygen admixture was applied on C. albicans biofilms grown for 2, 7, or 16 days on polymethylmethacrylate discs; 0.1 % chlorhexidine digluconate (CHX) and 0.6 % sodium hypochlorite (NaOCl) solutions served as positive treatment controls. In addition, these two solutions were applied in combination with plasma for 30 min to assess potential synergistic effects. The anticandidal efficacy was determined by the number of colony forming units (CFU) in log(10) and expressed as reduction factor (RF, the difference between control and treated specimen). On 2-day-biofilms, plasma treatment alone or combined with 30 min CHX treatment led to significant differences of means of CFU (RF = 4.2 and RF = 4.3), clearly superior to CHX treatment alone (RF = 0.6). Plasma treatment of 7-day-or 16-day-old biofilms revealed no significant CFU reduction. The treatment of 7-day-old (RF = 1.7) and 16-day-old (RF = 1.3) biofilms was slightly more effective with NaOCl alone than with the combined treatment of NaOCl and plasma (RF = 1.6/RF = 1.9). The combination of CHX and plasma increased the RF immaterially. The use of plasma alone and in combination with antiseptics is promising anticandidal regimens for daily use on dentures when biofilms are not older than 2 days. Plasma could help to reduce denture-associated candidiasis.

Antimicrobial activity of a novel adhesive containing chlorhexidine gluconate (CHG) against the resident microflora in human volunteers

PubMed Central

Carty, Neal; Wibaux, Anne; Ward, Colleen; Paulson, Daryl S.; Johnson, Peter

2014-01-01

Objectives To evaluate the antimicrobial activity of a new, transparent composite film dressing, whose adhesive contains chlorhexidine gluconate (CHG), against the native microflora present on human skin. Methods CHG-containing adhesive film dressings and non-antimicrobial control film dressings were applied to the skin on the backs of healthy human volunteers without antiseptic preparation. Dressings were removed 1, 4 or 7 days after application. The bacterial populations underneath were measured by quantitative cultures (cylinder-scrub technique) and compared with one another as a function of time. Results The mean baseline microflora recovery was 3.24 log10 cfu/cm2. The mean log reductions from baseline measured from underneath the CHG-containing dressings were 0.87, 0.78 and 1.30 log10 cfu/cm2 on days 1, 4 and 7, respectively, compared with log reductions of 0.67, −0.87 and −1.29 log10 cfu/cm2 from underneath the control film dressings. There was no significant difference between the log reductions of the two treatments on day 1, but on days 4 and 7 the log reduction associated with the CHG adhesive was significantly higher than that associated with the control adhesive. Conclusions The adhesive containing CHG was associated with a sustained antimicrobial effect that was not present in the control. Incorporating the antimicrobial into the adhesive layer confers upon it bactericidal properties in marked contrast to the non-antimicrobial adhesive, which contributed to bacterial proliferation when the wear time was ≥4 days. PMID:24722839

Antimicrobial activity of a novel adhesive containing chlorhexidine gluconate (CHG) against the resident microflora in human volunteers.

PubMed

Carty, Neal; Wibaux, Anne; Ward, Colleen; Paulson, Daryl S; Johnson, Peter

2014-08-01

To evaluate the antimicrobial activity of a new, transparent composite film dressing, whose adhesive contains chlorhexidine gluconate (CHG), against the native microflora present on human skin. CHG-containing adhesive film dressings and non-antimicrobial control film dressings were applied to the skin on the backs of healthy human volunteers without antiseptic preparation. Dressings were removed 1, 4 or 7 days after application. The bacterial populations underneath were measured by quantitative cultures (cylinder-scrub technique) and compared with one another as a function of time. The mean baseline microflora recovery was 3.24 log10 cfu/cm(2). The mean log reductions from baseline measured from underneath the CHG-containing dressings were 0.87, 0.78 and 1.30 log10 cfu/cm(2) on days 1, 4 and 7, respectively, compared with log reductions of 0.67, -0.87 and -1.29 log10 cfu/cm(2) from underneath the control film dressings. There was no significant difference between the log reductions of the two treatments on day 1, but on days 4 and 7 the log reduction associated with the CHG adhesive was significantly higher than that associated with the control adhesive. The adhesive containing CHG was associated with a sustained antimicrobial effect that was not present in the control. Incorporating the antimicrobial into the adhesive layer confers upon it bactericidal properties in marked contrast to the non-antimicrobial adhesive, which contributed to bacterial proliferation when the wear time was ≥4 days. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy.

Flammability of topical preparations and surgical dressings in cutaneous and laser surgery: a controlled simulation study.

PubMed

Arefiev, Katharine; Warycha, Melanie; Whiting, Dennis; Alam, Murad

2012-10-01

Surgical fires are a rare, but serious complication of dermatologic procedures involving electrosurgical and laser devices. Given the lack of data regarding basic fire safety principles, many dermatologists remain unaware of this potential risk. We evaluated the flammability of topical preparations and surgical drapes commonly encountered in the immediate operative field during cutaneous and laser surgery. Surgical dressings, drapes, and pork belly skin were examined for fire risk upon exposure to isopropyl alcohol, chlorhexidine gluconate, and aluminum chloride under dry, saturated, and damp conditions. Both electrosurgery and a carbon-dioxide laser were used as ignition sources. At least some char was observed in 86 of 126 simulated conditions (68%). Flames occurred in 2 test conditions: dry underpad drapes and cotton balls exposed to the carbon-dioxide laser. In general, drapes and dressings dampened or saturated with isopropyl alcohol failed to ignite with electrofulguration or electrodessication, although sparks and moderate char developed on pork belly skin and the underpad drape. Materials dampened or saturated with chlorhexidine gluconate, which contains isopropyl alcohol, generated less smoke and char compared with materials exposed to aluminum chloride, which does not contain alcohol. Future studies may assess the flammability of materials in the setting of oxygen supplementation. In common cutaneous surgical environments, electrosurgery or ablative laser may lead to char and rarely to fire. Char may be seen in up to two thirds of simulated conditions, and in a minute proportion of conditions, fire is observed. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

Corrosion in Haas expanders with and without use of an antimicrobial agent: an in situ study.

PubMed

Bagatin, Cristhiane Ristum; Ito, Izabel Yoko; Andrucioli, Marcela Cristina Damião; Nelson-Filho, Paulo; Ferreira, José Tarcísio Lima

2011-01-01

The purpose of this study was to evaluate in situ the occurrence of corrosion in the soldering point areas between the wire, silver brazing and band in Haas expanders. Thirty-four 7-12-year-old patients who needed maxillary expansion with a Haas expander were randomly assigned to two groups of 17 individuals each, according to the oral hygiene protocol adopted during the orthodontic treatment: Group I (control), toothbrushing with a fluoride dentifrice and Group II (experimental), toothbrushing with the same dentifrice plus 0.12% chlorhexidine gluconate (Periogard®) mouthrinses twice a week. The appliances were removed after approximately 4 months. Fragments of the appliances containing a metallic band with a soldered wire were sectioned at random for examination by stereomicroscopy, scanning electron microscopy (SEM) and energy dispersive x-ray spectroscopy (EDS). Data were analyzed statistically by Fisher's test at 5% significance level. The analysis by optical microscopy revealed areas with color change suggestive of corrosion in the soldering point areas joining the band and the wire in all specimens of both groups, with no statistically significant difference between the groups (p=1). The peaks of chemical elements (Ni, Fe, Cr, O, C and P) revealed by EDS were also similar in both groups. Color changes and peaks of chemical elements suggestive of corrosion were observed in the soldering point areas between the wire, silver brazing and band in both control and experimental groups, which indicate that the 0.12% chlorhexidine gluconate mouthrinses did not influence the occurrence of corrosion in situ.

Altered healing following mucogingival surgery in a patient with Crohn's disease: a literature review and case report.

PubMed

Andersen, Kari M; Selvig, Knut A; Leknes, Knut N

2003-04-01

Crohn's disease is a chronic inflammatory bowel disease characterized by uncertainty in etiology and pathogenesis occasionally with manifestations in oral mucous membranes. This report reviews the literature on Crohn's disease and presents a patient with Crohn's disease on continuous anti-inflammatory and immunosuppressive medication who showed adverse healing response following surgical treatment of gingival recession type defects. A 28-year-old male in generally good health apart from his bowel disease requested treatment of multiple maxillary gingival recessions due to esthetic concerns and root sensitivity. Following oral hygiene instruction, 3 coronally advanced flap procedures were performed in the maxillary anterior region to cover the defects. In 2 of the surgical areas, the exposed root surfaces were treated by ethylenediaminetetraacetic acid (EDTA) in combination with enamel matrix derivative (EMD) before coronally positioning the buccal flap. Postoperatively, chlorhexidine gluconate was used for oral hygiene control. The first surgical procedure, performed as a coronally advanced flap, showed delayed and altered healing. Two weeks postoperatively, the flapped tissue remained intensely red and swollen. In the following 2 surgical sites where EDTA and EMD were applied the healing was uneventful. Differences in immediate tissue response, however, did not influence the 3-month treatment outcome with respect to root coverage. Patients with Crohn's disease on recommended systemic medications may show a delayed and altered wound healing indicating that periodontal surgery must be closely monitored. Treatment planning should take into account the potential wound healing promoting effects of enamel matrix derivative as well as adverse healing effects of chlorhexidine gluconate administration.

Methicillin-Resistant and Methicillin-Sensitive Staphylococcus aureus Screening and Decolonization to Reduce Surgical Site Infection in Elective Total Joint Arthroplasty.

PubMed

Sporer, Scott M; Rogers, Thea; Abella, Linda

2016-09-01

Deep infection after elective total joint arthroplasty remains a devastating complication. Preoperative nasal swab screening for Staphylococcus aureus colonization and subsequent treatment of colonized patients is one proposed method to identify at-risk patients and decrease surgical site infections (SSIs). The purpose of this study was to determine whether a preoperative staphylococcus screening and treatment program would decrease the incidence of SSI in elective joint arthroplasty patients. Since January 2009, a total of 9690 patients having an elective joint arthroplasty were screened before surgery for Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-sensitive Staphylococcus aureus (MSSA) with nares swabs. All patients with positive nare colonization for MSSA and MRSA were treated with mupirocin and chlorhexidine gluconate showers for 5 days before surgery. MRSA patients received vancomycin preoperatively and were placed in contact isolation. All elective arthroplasty patients used chlorhexidine gluconate antiseptic cloths the evening prior and the day of surgery. Perioperative infection rates were compared from 1 year before implementation to 5 years after implementation of this screening protocol. SSI rates have decreased from 1.11% (prescreening) to 0.34% (nasal screening; P < .05) after initiation of the process. Staphylococcus was identified in 66.7% of the SSI infections before nasal screening and in 33.3% of the SSI after routine screening (P > .05). The addition of MRSA and/or MSSA nares screening along with a perioperative decolonization protocol has resulted in a decreased SSI rate by 69%. Copyright © 2016 Elsevier Inc. All rights reserved.

Antibacterial Efficacy of Several Surgical Hand Preparation Products Used by Veterinary Students.

PubMed

Chou, Po-Yen; Doyle, Aimie J; Arai, Shiori; Burke, Pierre J; Bailey, Trina R

2016-05-01

To compare the antibacterial efficacy of different surgical hand antisepsis protocols used by veterinary students. Prospective, randomized, controlled study. Third year veterinary students (n=45). The participants were randomly assigned to 4 of the following 12 hand preparation product/time combinations: nonabrasive hand scrub method with 4% chlorhexidine gluconate (CH); hand rub with a mixture of 30% 1-propanol and 45% 2-propanol solution (MPS), 70% 2-propanol solution (IPS), or 61% ethanol solution with 1% chlorhexidine gluconate (ES/CH), with a contact time of 1.5, 3, or 5 minutes. Antibacterial efficacy was assessed after surgical hand preparation and at the end of surgery. Log reductions of total bacterial colony forming unit (CFU)/mL and positive aerobic culture rates were compared using multivariable analysis of variance and multivariable logistic regression, respectively. After surgical hand preparation, CH and ES/CH provided significantly higher log CFU reduction and lower positive culture rate for Gram-positive and spore-forming bacteria compared to MPS and IPS. Increase in contact time did not provide significant improvement in bacterial reduction. At the end of surgery, ES/CH provided significantly higher log CFU reduction compared to IPS and lower positive culture rate for Gram-positive bacteria compared to CH, MPS, and IPS. Increase in contact time significantly improved log CFU reduction in ES/CH and MPS groups. In our population of veterinary students ES/CH hand rubs or CH scrubs were more effective in reducing bacterial CFU during surgical hand preparation than MPS or IPS. © Copyright 2016 by The American College of Veterinary Surgeons.

The effect of long-term disinfection procedures on hardness property of resin denture teeth.

PubMed

Campanha, Nara Hellen; Pavarina, Ana Cláudia; Jorge, Janaina Habib; Vergani, Carlos Eduardo; Machado, Ana Lucia; Giampaolo, Eunice Teresinha

2012-06-01

The aim of the study was to evaluate the effect of long-term disinfection procedures on the Vickers hardness (VHN) of acrylic resin denture teeth. Five acrylic resin denture teeth (Vipi Dent Plus-V, Trilux-T, Biolux-B, Postaris-P and Artiplus-A) and one composite resin denture teeth (SR-Orthosit-O) were embedded in heat-polymerised acrylic resin within polyvinylchloride tubes. Specimens were stored in distilled water at 37°C for 48 h. Measurements of hardness were taken after the following disinfection procedures: immersion for 7 days in 4% chlorhexidine gluconate or in 1% sodium hypochlorite (CIm and HIm group, respectively) and seven daily cycles of microwave sterilisation at 650 W for 6 min (MwS group). In the WIm group, specimens were maintained in water during the time used to perform the disinfection procedures (7 days). Data were analysed with anova followed by the Bonferroni procedure (α = 0.01). Microwave disinfection decreased the hardness of all acrylic resin denture teeth (p < 0.001). Immersion for 7 days in 4% chlorhexidine gluconate or distilled water had significant effect on the hardness of the acrylic resin denture teeth A (p < 0.01), and 1% sodium hypochlorite on teeth T (p < 0.01). All disinfection procedures decrease the hardness of the composite resin denture teeth (p < 0.01). Teeth O exhibited the highest and teeth V the lowest hardness values in the control group (p < 0.01). Disinfection procedures changed the hardness of resin denture teeth. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

Corrosion in Haas expanders with and without use of an antimicrobial agent: an in situ study

PubMed Central

BAGATIN, Cristhiane Ristum; ITO, Izabel Yoko; ANDRUCIOLI, Marcela Cristina Damião; NELSON-FILHO, Paulo; FERREIRA, José Tarcísio Lima

2011-01-01

Objectives The purpose of this study was to evaluate in situ the occurrence of corrosion in the soldering point areas between the wire, silver brazing and band in Haas expanders. Material and Methods Thirty-four 7-12-year-old patients who needed maxillary expansion with a Haas expander were randomly assigned to two groups of 17 individuals each, according to the oral hygiene protocol adopted during the orthodontic treatment: Group I (control), toothbrushing with a fluoride dentifrice and Group II (experimental), toothbrushing with the same dentifrice plus 0.12% chlorhexidine gluconate (Periogard®) mouthrinses twice a week. The appliances were removed after approximately 4 months. Fragments of the appliances containing a metallic band with a soldered wire were sectioned at random for examination by stereomicroscopy, scanning electron microscopy (SEM) and energy dispersive x-ray spectroscopy (EDS). Data were analyzed statistically by Fisher's test at 5% significance level. Results The analysis by optical microscopy revealed areas with color change suggestive of corrosion in the soldering point areas joining the band and the wire in all specimens of both groups, with no statistically significant difference between the groups (p=1). The peaks of chemical elements (Ni, Fe, Cr, O, C and P) revealed by EDS were also similar in both groups. Conclusion: Color changes and peaks of chemical elements suggestive of corrosion were observed in the soldering point areas between the wire, silver brazing and band in both control and experimental groups, which indicate that the 0.12% chlorhexidine gluconate mouthrinses did not influence the occurrence of corrosion in situ. PMID:22231004

A prospective comparison between stabilized glutaraldehyde and chlorhexidine gluconate for preoperative skin antisepsis in dogs.

PubMed

Lambrechts, Nicolaas E; Hurter, Karin; Picard, Jackie A; Goldin, Jeremy P; Thompson, Peter N

2004-01-01

To compare the efficacy of 0.3% stabilized glutaraldehyde and alcohol (SG+A), 0.3% SG and water (SG+W), and 4% chlorhexidine gluconate tincture (CG+A), as skin disinfectants in dogs undergoing ovariohysterectomy. Prospective, blinded clinical study. One hundred and twenty-one dogs. Cutaneous bacterial colony forming units (CFU) from the perioperative site after skin preparation, after antisepsis, and after surgery (incisional and paramedian), were quantified. The influence of high initial bacterial counts (> or =150 CFU) and surgical time on antibacterial efficacy was examined and the proportion of dogs from which Staphylococcus intermedius was cultured, determined. Perioperative skin reactions and wound infections were documented. All 3 antiseptic solutions significantly and equally reduced CFU to all post-antisepsis sampling levels irrespective of surgical duration (mean surgical times 151.6, 136.2, and 149.6 minutes for CG+A, SG+A and SG+W, respectively). Median percentage reductions in CFU ranged between 99.3% and 100%. In dogs with initial high counts and disinfected with CG+A and SG+W, the incisional samples had significantly higher counts than the post-antisepsis samples. In the CG+A and SG+W groups, the proportion of post-surgery samples yielding S. intermedius was significantly higher at the incisional than the paramedian sites. Eight mild cutaneous reactions were recorded in equal proportions for the 3 solutions. There were no recorded infections. All 3 preparations had an equal ability to reduce and maintain low CFU counts, with minimal cutaneous reactions. SG solutions are safe and effective preoperative skin antiseptics for elective clean-contaminated surgical procedures.

Preliminary antiplaque efficacy of aloe vera mouthwash on 4 day plaque re-growth model: randomized control trial.

PubMed

Gupta, Rajendra Kumar; Gupta, Devanand; Bhaskar, Dara John; Yadav, Ankit; Obaid, Khursheed; Mishra, Sumit

2014-04-01

Due to increasing resistance to antibiotics and rising incidence of oral diseases, there is a need for alternative treatment modalities to combat oral diseases. The aim of the present study was to access the effect of Aloe vera mouthwash on the dental plaque in the experimental period of 4 days and to compare it with the bench mark control chlorhexidine and placebo (saline water). A total of 300 systemically healthy subjects were randomly allocated into 3 groups: Aloe vera mouthwash group (n=100), control group (=100)-chlorhexidene group and saline water-Placebo (n=100). To begin with, Gingival index (GI) and plaque index (PI) were recorded. Then, baseline plaque scores were brought to zero by professionally cleaning the teeth with scaling and polishing. After randomization of the participants into three groups they were refrained from regular mechanical oral hygiene measures. Subjects were asked to swish with respective mouthwash (Aloe vera mouthwash, 0.2%chlorhexidine gluconate mouthwash, or normal saline) as per therapeutic dose for 4 days. The results showed that Aloe vera mouthrinse is equally effective in reducing plaque as Chlorhexidine compared to placebo over a period of 4 days. There was a significant reduction on plaque in Aloe vera and chlorhexidine groups and no statistically significant difference was observed among them (p>0.05). Aloe vera mouthwash showed no side effects. The results of the present study indicated that Aloe vera may prove an effective mouthwash due to its ability in reducing dental plaque.

Efficacy of disinfecting solutions in removing biofilms from polyvinyl chloride tracheostomy tubes.

PubMed

Silva, Rodrigo C; Carver, Ryan A; Ojano-Dirain, Carolyn P; Antonelli, Patrick J

2013-01-01

Bacterial biofilms are prevalent in pediatric tracheostomy tubes (TTs) and are not completely cleared by standard cleaning with gauze and household detergents. We aimed to examine the effectiveness of different disinfecting solutions to remove Staphylococcus aureus (SA) and Pseudomonas aerginosa (PA) biofilms from TTs. Prospective, controlled, in vitro microbiologic study. Uniform coupons obtained from polyvinyl chloride (PVC) pediatric TTs were briefly exposed to human plasma. The samples were incubated in growth media with either PA or SA for 7 days, and total bacterial growth was monitored by media turbidity. Five sets of 18 coupons each were exposed for 5 minutes to one of five different solutions: 2% aqueous chlorhexidine gluconate solution, 0.3% aqueous sodium hypochlorite, Polident denture cleanser, 3% hydrogen peroxide, or preservative-free phosphate-buffered saline (PBS) as a negative control. Biofilm presence was measured with bacterial counts, and surface integrity was assessed with scanning electron microscopy (SEM). All treatments significantly reduced mean SA counts (P = <.001). Sodium hypochlorite and chlorhexidine were more effective than peroxide and Polident. Chlorhexidine, sodium hypochlorite, and peroxide reduced PA counts (P = .001, .001, and .002, respectively), but Polident tabs had no significant effect. SEM revealed preserved TT surface integrity after exposure to all solutions. Disinfection with sodium hypochlorite or chlorhexidine solutions significantly reduces SA and PA biofilms on PVC TTs. Standard home care of reusable pediatric TTs may be improved by use of these readily available solutions. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Influence of irrigation regimens on the adherence of Enterococcus faecalis to root canal dentin.

PubMed

Kishen, Anil; Sum, Chee-Peng; Mathew, Shibi; Lim, Chwee-Teck

2008-07-01

Enterococcus faecalis is frequently associated with post-treatment endodontic infections. Because adherence of bacteria to a substrate is the earliest stage in biofilm formation, eliciting the factors that links adherence of this bacterium to dentin would help in understanding its association with treatment-failed root canals. This investigation aimed to study the effects of endodontic irrigants on the adherence of E. faecalis to dentin. The bacteria adherence assay was conducted by using fluorescence microscopy, and the adhesion force was measured by using atomic force microscopy. There were significant increases in adherence and adhesion force after irrigation of dentin with ethylenediaminetetraacetic acid (EDTA), whereas sodium hypochlorite (NaOCl) reduced it. With the use of chlorhexidine (CHX), the force of adhesion increased, but the adherence assay showed a reduction in the number of adhering bacteria. The irrigation regimen of EDTA, NaOCl, and CHX resulted in the least number of adhering E. faecalis cells. This study highlighted that chemicals that alter the physicochemical properties of dentin will influence the nature of adherence, adhesion force, and subsequent biofilm formation of E. faecalis to dentin.

ANTIMICROBIAL ACTIVITY OF SODIUM HYPOCHLORITE ASSOCIATED WITH INTRACANAL MEDICATION FOR Candida albicans AND Enterococcus faecalis INOCULATED IN ROOT CANALS

PubMed Central

Valera, Marcia Carneiro; da Silva, Katy Costa Godinho; Maekawa, Lilian Eiko; Carvalho, Cláudio Antonio Talge; Koga-Ito, Cristiane Yumi; Camargo, Carlos Henrique Ribeiro; Silva e Lima, Raphael

2009-01-01

Objective: The purpose of this study was to evaluate the action of sodium hypochlorite (NaOCl) associated with an intracanal medication against Candida albicans and Enterococcus faecalis inoculated in root canals. Material and Methods: Thirty-six human single-rooted teeth with single root canals were used. The canals were contaminated with C. albicans and E. faecalis for 21 days and were then instrumented with 1% NaOCl. The roots were divided into 3 groups (n=12) according to the intracanal medication applied: calcium hydroxide paste, 2% chlorhexidine (CHX) gel, and 2% CHX gel associated with calcium hydroxide. The following collections were made from the root canals: a) initial sample (IS): 21 days after contamination (control), b) S1: after instrumentation, c) S2: 14 days after intracanal medication placement; S3: 7 days after intracanal medication removal. The results were analyzed statistically by the Kruskal-Wallis test at 5% significance level. Results and Conclusions: Both 1% NaOCl irrigation and the intracanal medications were effective in eliminating E. faecalis and C. albicans inoculated in root canals. PMID:20027425

Antimicrobial activity of sodium hypochlorite associated with intracanal medication for Candida albicans and Enterococcus faecalis inoculated in root canals.

PubMed

Valera, Marcia Carneiro; Silva, Katy Costa Godinho da; Maekawa, Lilian Eiko; Carvalho, Cláudio Antonio Talge; Koga-Ito, Cristiane Yumi; Camargo, Carlos Henrique Ribeiro; Lima, Raphael Silva e

2009-01-01

The purpose of this study was to evaluate the action of sodium hypochlorite (NaOCl) associated with an intracanal medication against Candida albicans and Enterococcus faecalis inoculated in root canals. Thirty-six human single-rooted teeth with single root canals were used. The canals were contaminated with C. albicans and E. faecalis for 21 days and were then instrumented with 1% NaOCl. The roots were divided into 3 groups (n=12) according to the intracanal medication applied: calcium hydroxide paste, 2% chlorhexidine (CHX) gel, and 2% CHX gel associated with calcium hydroxide. The following collections were made from the root canals: a) initial sample (IS): 21 days after contamination (control), b) S1: after instrumentation, c) S2: 14 days after intracanal medication placement; S3: 7 days after intracanal medication removal. The results were analyzed statistically by the Kruskal-Wallis test at 5% significance level. Both 1% NaOCl irrigation and the intracanal medications were effective in eliminating E. faecalis and C. albicans inoculated in root canals.

Treatment of Candida albicans biofilms with low-temperature plasma induced by dielectric barrier discharge and atmospheric pressure plasma jet

NASA Astrophysics Data System (ADS)

Koban, Ina; Matthes, Rutger; Hübner, Nils-Olaf; Welk, Alexander; Meisel, Peter; Holtfreter, Birte; Sietmann, Rabea; Kindel, Eckhard; Weltmann, Klaus-Dieter; Kramer, Axel; Kocher, Thomas

2010-07-01

Because of some disadvantages of chemical disinfection in dental practice (especially denture cleaning), we investigated the effects of physical methods on Candida albicans biofilms. For this purpose, the antifungal efficacy of three different low-temperature plasma devices (an atmospheric pressure plasma jet and two different dielectric barrier discharges (DBDs)) on Candida albicans biofilms grown on titanium discs in vitro was investigated. As positive treatment controls, we used 0.1% chlorhexidine digluconate (CHX) and 0.6% sodium hypochlorite (NaOCl). The corresponding gas streams without plasma ignition served as negative treatment controls. The efficacy of the plasma treatment was determined evaluating the number of colony-forming units (CFU) recovered from titanium discs. The plasma treatment reduced the CFU significantly compared to chemical disinfectants. While 10 min CHX or NaOCl exposure led to a CFU log10 reduction factor of 1.5, the log10 reduction factor of DBD plasma was up to 5. In conclusion, the use of low-temperature plasma is a promising physical alternative to chemical antiseptics for dental practice.

The efficacy of amine fluoride/stannous fluoride in the suppression of morning breath odour.

PubMed

Quirynen, Marc; Avontroodt, Pieter; Soers, Catherine; Zhao, Hong; Pauwels, Martine; Coucke, Wim; van Steenberghe, Daniel

2002-10-01

Breath odour is a complaint encountered worldwide, often linked to microbial overload in the oral cavity. This double blind, crossover, randomised study assessed the efficacy of several antiseptic mouthrinses or slurry vs. a control solution in the prevention of morning bad breath during an experimental period of 7 days without mechanical plaque control. Sixteen dental students with a healthy periodontium abolished, after a thorough professional cleaning, all means of mechanical plaque control during five experimental periods of 7 days, interleaved by washout periods of at least 3 weeks. During each experimental period, as the only oral hygiene measure, the students rinsed twice a day with one of the following formulations (in a randomised order): a 0.2% chlorhexidine-alcohol mouthrinse (CHX-Alc), a 0.05% CHX + 0.05% cetylpyridinium chloride + 0.14% zinc lactate mouthrinse (CHX-CPC-Zn), an amine fluoride/stannous fluoride (125 ppm F-/125 ppm F-) containing mouthrinse (AmF/SnF2Mr), a slurry of a tooth paste (AmF/SnF2Sl) containing amine fluoride (350 ppm F-) and stannous fluoride (1050 ppm F-) and a placebo solution (placebo). At days 0, 3 and 7, morning breath was scored via VSC level measurements of the mouth air, and organoleptic ratings of the mouth air and tongue coating. At the same visits both the degree of gingival inflammation and the de novo plaque formation were rated. At the end of each period a questionnaire for subjective ratings was completed and microbiological samples were taken from the tongue dorsum, the saliva and the supragingival plaque for anaerobic and aerobic culturing. Although oral hygiene during the experimental periods was limited to rinsing, bad breath parameters systematically improved (P < 0.001) with the three mouthrinses (CHX-Alc, CHX-CPC-Zn, AmF/SnF2Mr), with a superiority of the CHX-CPC-Zn solution when only VSC values were considered (P < 0.003). The AmF/SnF2 slurry and the placebo solution showed only minor changes with time. The three mouthrinses reduced significantly (P < 0.001) the bacterial load (aerobic & anaerobic) in the saliva (>or= 0.5 log reduction with a superiority (P < 0.005) for the CHX-Alc when compared to the two others). Changes in the bacterial load on the tongue dorsum could only be detected for the CHX-Alc solution (0.5 log). The antibacterial effect of the placebo solution and the slurry were negligible. The composition of microflora on the other hand did not reveal significant changes. The de novo supragingival plaque formation was significantly (P < 0.05) inhibited by the three mouthrinses with a slight superiority for the CHX-Alc solution. The degree of gingival inflammation at day 7 remained low (< 0.16) for all products. The CHX-Alc solution scored significantly worse for the subjective evaluation (questionnaires) concerning taste and sensitivity of tongue). The results of this study demonstrate that morning breath odour can be successfully reduced by the sole twice daily use of CHX-Alc, CHX-CPC-Zn or AmF/SnF2Mr mouthrinses, which all significantly reduced the bacterial load in the saliva and retarded the de novo plaque formation.

Allergic contact reaction to antiseptics in very young children.

PubMed

Darrigade, A S; Léauté-Labrèze, C; Boralevi, F; Taïeb, A; Milpied, B

2018-06-19

Contact dermatitis from topical antiseptic use has been reported mostly in adults but rare cases of chlorhexidine contact dermatitis have also been described in young children. To evaluate contact allergic dermatitis to antiseptics in young children. The children mostly referred for a misdiagnose (cellulitis) were patch tested with a selection of the European baseline series, an antiseptics series and the personal topical products used. 14 children (8 boys, 6 girls) received a diagnosis of contact dermatitis to antiseptics between May 2010 and December 2017. The mean age at diagnosis was 38 months (8 months to 8 years), 3 children only had a personal history of atopy. Chlorhexidine gluconate was positive in 7 cases, benzalkonium chloride in 8 cases, and in 4 cases both allergens were positive. This small case series confirm that both chlorhexidine and benzalkonium chloride are implicated in contact dermatitis from antiseptic use in the pediatric population. We emphasize the initial misdiagnose of these patients, the very young age of the children, and the allergenic potential of common antiseptics in non-atopic children. We hypothesize that the systematic use of antiseptics for umbilical cord care could be responsible for the sensitization in newborns. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Percentage exposure of root dentin collagen after application of two irrigation protocols with manual or rotary instrumentation and two methacrylate resin-based sealers.

PubMed

González-López, Santiago; Martín-Altuve, Ernesto; Bolaños-Carmona, Victoria; Sánchez-Sánchez, Purificación; Rodríguez-Navarro, Alejandro

2013-10-01

To compare the percentage of collagen exposed in dentin root thirds after two irrigation protocols with manual or rotary instrumentation using two methacrylate resin-based sealers. Forty-eight single-root human teeth were prepared with manual (n = 24) or nickeltitanium ProFile rotary (n = 24) instrumentation, using 5% NaOCl between instruments and 5 ml 17% EDTA as final irrigant or 20% citric acid + 2% chlorhexidine (CHX) between instruments and as the final irrigant. RealSeal or EndoREZ were used as filling materials. One 1-mm slice per third was abraded and stained with Masson's trichrome method. Mean exposed collagen values were obtained in four areas from each section (at 60X magnification) and a complete factorial ANOVA was used to analyze the influence of the study variables. Non-parametric Mann-Whitney's test was used to compare groups. Differences with p < 0.05 were considered significant. A significantly higher percentage of collagen was exposed in all thirds with the use of the 20% citric acid + 2% CHX protocol with rotary vs manual instrumentation, but percent collagen exposed did not differ as a function of the filling material. After the 5% NaOCl + 17% EDTA protocol, the percentage of collagen exposed did not differ between rotary and manual instrumentation but was higher with the use of RealSeal. The highest percentage exposure of collagen was with 20% citric acid + 2% CHX using rotary instrumentation, regardless of the filling material.

Metal ion release from silver soldering and laser welding caused by different types of mouthwash.

PubMed

Erdogan, Ayse Tuygun; Nalbantgil, Didem; Ulkur, Feyza; Sahin, Fikrettin

2015-07-01

To compare metal ion release from samples welded with silver soldering and laser welding when immersed into mouthwashes with different ingredients. A total of 72 samples were prepared: 36 laser welded and 36 silver soldered. Four samples were chosen from each subgroup to study the morphologic changes on their surfaces via scanning electron microscopy (SEM). Each group was further divided into four groups where the samples were submerged into mouthwash containing sodium fluoride (NaF), mouthwash containing sodium fluoride + alcohol (NaF + alcohol), mouthwash containing chlorhexidine (CHX), or artificial saliva (AS) for 24 hours and removed thereafter. Subsequently, the metal ion release from the samples was measured with inductively coupled plasma mass spectrometry (ICP-MS). The metal ion release among the solutions and the welding methods were compared. The Kruskal-Wallis and analysis of variance (ANOVA) tests were used for the group comparisons, and post hoc Dunn multiple comparison test was utilized for the two group comparisons. The level of metal ion release from samples of silver soldering was higher than from samples of laser welding. Furthermore, greater amounts of nickel, chrome, and iron were released from silver soldering. With regard to the mouthwash solutions, the lowest amounts of metal ions were released in CHX, and the highest amounts of metal ions were released in NaF + alcohol. SEM images were in accord with these findings. The laser welding should be preferred over silver soldering. CHX can be recommended for patients who have welded appliances for orthodontic reasons.

[Antibacterial effect of self-etching adhesive systems on Streptococcus mutans].

PubMed

Zhang, Lu; Yuan, Chong-yang; Tian, Fu-cong; Wang, Xiao-yan; Gao, Xue-jun

2016-02-18

To investigate the antibacterial effect of different self-etching adhesive systems against Streptococcus mutans (S. mutans). Six reagents Clearfil(TM) SE Bond primer (SP), Clearfil(TM) SE Bond adhesive (SA),Clearfil(TM) Protect Bond primer (PP), which contained antibacterial monomer methacryloyloxydodecylpyridinium bromide (MDPB), ClearfilTM Protect Bond adhesive (PA), positive control chlorhexidine acetate [CHX, 1% (mass fraction)], and negative control phosphate buffer solution (PBS) were selected. They were mixed with S. mutans for 30 s respectively, then colony-forming units (CFU) were counted after incubated for 48 h on brain heart infusion (BHI) agar medium. The 6 reagents were applied to the sterile paper discs, and distributed onto the BHI agar medium with S. mutans and incubated for 24 h, then the inhibition zones were observed. CHX, PBS, PP, and SP were added on the dentin with artificial caries induced by S. mutans and kept for 30 s, then confocal laser scanning microscope (CLSM) was used to observe the live and dead bacteria after staining. The ratio of live to dead bacteria was calculated. PP+PA and SP+SA were applied on the dentin according to the manual and light cured. S. mutans were incubated on the samples for 2 h, ultrasonically treated and incubated on BHI agar medium for 48 h, then CFU was counted. The data were analyzed by non-parametric analysis and one-way ANOVA. Compared with PBS, the PP, SP, PA, SA and CHX showed the antibacterial effect on free S. mutans (P<0.05); SP and PP showed stronger antibacterial effect than PA, SA and CHX (P<0.05). CHX, SP and PP presented inhibition zones, while PBS, SA and PA did not. Compared with PBS, the CHX, SP and PP could lower the ratio of the live to dead bacteria significantly (P<0.05). Cured self-etching adhesive systems did not show any antibacterial effect on the free S. mutans. The primer of self-etching adhesives Clearfil(TM) SE Bond and Clearfil(TM) Protect Bond showed significant antibacterial effect on free and attached S. mutans. The adhesive only showed antibacterial effect on free S. mutans before light-cured polymerization. After being cured, the self-etching adhesive systems did not show antibacterial effect anymore.

Efficacy of chlorhexidine as a final irrigant in one-visit root canal treatment: a prospective comparative study.

PubMed

Miçooğullar Kurt, S; Çalışkan, M K

2018-03-30

To evaluate postoperative pain and radiographic evidence of periapical healing in teeth with apical periodontitis treated in one visit with an additional final irrigation using 2% chlorhexidine (CHX) and to compare the results with conventional two-visit root canal treatment (RCT) with an intracanal calcium hydroxide (CH) dressing as a control group. Ninety asymptomatic maxillary anterior teeth with periapical lesions were treated by a single operator. Root canals were prepared using the step-back technique with manual instrumentation with 2.5% NaOCl and 5% EDTA as irrigants. Half of the teeth were randomly assigned to the one-visit (OV) group and received an additional final rinse with 2% CHX before canal filling. The other teeth were treated in two visits (TV) with a CH paste made by mixing CH powder and distilled water as an interappointment dressing. All patients were recalled and investigated clinically and radiographically for 24 months. Postoperative pain at 24-48 h and changes in apical bone density indicating radiographic healing were evaluated statistically using the Mann-Whitney U-test followed by the Friedman and the Wilcoxon tests (α = 0.05). There were no significant differences between two groups regarding the incidence of postoperative pain at 24 h (OV group 50% no pain, 47.6% mild, 2.4% moderate pain/TV group 55% no pain, 42.5% mild, 2.5% moderate pain) and at 48 h (OV group 95% no pain, 5% mild pain/TV group 98% no pain, 2% mild pain). None of the patients reported severe postoperative pain, swelling and/or flare-ups during the follow-up period. There was no significant difference in the radiographic healing rates (OV group 97.6% PAI 1 and/or PAI 2 and 2.4% PAI 3/TV group 95% PAI 1 and/or PAI 2 and 5% PAI 3; P > 0.05). Both groups provided favourable and similar postoperative pain and periapical healing rates at 24 months. Thus, one-visit RCT with a final rinse with 2% CHX is an acceptable alternative to two-visit RCT with CH as temporary dressing in maxillary anterior teeth. © 2018 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Comparison of the Antibacterial Effect and Smear Layer Removal Using Photon-Initiated Photoacoustic Streaming Aided Irrigation Versus a Conventional Irrigation in Single-Rooted Canals: An In Vitro Study

PubMed Central

Zhu, Xiaofei; Yin, Xingzhe; Chang, Jeffrey W.W.; Wang, Yu; Cheung, Gary S.P.

2013-01-01

Abstract Objective: The Er:YAG laser with photon-induced photoacoustic streaming (PIPS) technique was reported to be effective in root canal disinfection. This study attempted to further investigate the antibacterial efficacy and smear layer removal ability of PIPS in comparison with conventional syringe irrigation in vitro. Methods: For antibacterial analysis, 48 single-rooted human teeth were prepared and inoculated with Enterococcus faecalis, and then divided into six groups of eight roots each. The colony-forming units (CFUs) per milliliter were determined after infection as the baseline. Then, the teeth were subjected to either PIPS plus 3% sodium hypochlorite (PIPS+NaOCl) or conventional syringe irrigation with 0.9% saline, 3% NaOCl, 17% ethylenediaminetetraacetic acid (EDTA), 0.2% chlorhexidine gluconate (CHX), or 3% NaOCl alternating with 17% EDTA. The reduction of CFUs in the individual group was determined. Additionally, scanning electron microscopy (SEM) examination of the canal walls for E. faecalis colonization was performed. For comparing the smear removal efficacy, another 48 single-rooted teeth, assigned to different groups as mentioned, were irrigated after mechanical instrumentation. The presence of a smear layer at different levels of the root canal was scored by SEM examination. Results: No significant differences were found in CFU reduction. No bacteria could be observed by SEM in the NaOCl, NaOCl+EDTA, and PIPS+NaOCl groups. The scores of smear layer of the NaOCl+EDTA and PIPS+NaOCl groups were significantly lower than those of the other groups in the coronal and middle third of the root canal. None of the methods can effectively remove smear layer in the apical third. Conclusions: PIPS system supplied with NaOCl and conventional syringe irrigation with NaOCl+EDTA are comparable in their ability to remove E. faecalis and smear layer in single-rooted canals. PMID:23863104

Porosity of temporary denture soft liners containing antifungal agents

PubMed Central

Lima, Jozely Francisca Mello; Maciel, Janaína Gomes; Hotta, Juliana; Vizoto, Ana Carolina Pero; Honório, Heitor Marques; Urban, Vanessa Migliorini; Neppelenbroek, Karin Hermana

2016-01-01

ABSTRACT Incorporation of antifungals in temporary denture soft liners has been recommended for denture stomatitis treatment; however, it may affect their properties. Objective: To evaluate the porosity of a tissue conditioner (Softone) and a temporary resilient liner (Trusoft) modified by minimum inhibitory concentrations (MICs) of antifungal agents for Candida albicans biofilm. Material and Methods: The porosity was measured by water absorption, based on exclusion of the plasticizer effect. Initially, it was determined by sorption isotherms that the adequate storage solution for specimens (65×10×3.3 mm) of both materials was 50% anhydrous calcium chloride (S50). Then, the porosity factor (PF) was calculated for the study groups (n=10) formed by specimens without (control) or with drug incorporation at MICs (nystatin: Ny-0.032 g, chlorhexidine diacetate: Chx-0.064 g, or ketoconazole: Ke-0.128 g each per gram of soft liner powder) after storage in distilled water or S50 for 24 h, seven and 14 d. Data were statistically analyzed by 4-way repeated measures ANOVA and Tukey's test (α=.05). Results: Ke resulted in no significant changes in PF for both liners in water over 14 days (p>0.05). Compared with the controls, Softone and Trusoft PFs were increased at 14-day water immersion only after addition of Ny and Chx, and Chx, respectively (p<0.05). Both materials showed no significant changes in PF in up to 14 days of S50 immersion, compared with the controls (p>0.05). In all experimental conditions, Softone and Trusoft PFs were significantly lower when immersed in S50 compared with distilled water (p<0.05). Conclusions: The addition of antifungals at MICs resulted in no harmful effects for the porosity of both temporary soft liners in different periods of water immersion, except for Chx and Ny in Softone and Chx in Trusoft at 14 days. No deleterious effect was observed for the porosity of both soft liners modified by the drugs at MICs over 14 days of S50 immersion. PMID:27812615

Efficacy of alcohols and alcohol-based hand disinfectants against human enterovirus 71.

PubMed

Chang, S-C; Li, W-C; Huang, K-Y; Huang, Y-C; Chiu, C-H; Chen, C-J; Hsieh, Y-C; Kuo, C-Y; Shih, S-R; Lin, T-Y

2013-04-01

Human enterovirus 71 (HEV71) infections are a significant public health threat in the Asia-Pacific region and occasionally cause severe neurological complications and even death in children. Although good hand hygiene is important for controlling infection, relevant data regarding the efficacy of widely used hand disinfectants against HEV71 are still lacking. To investigate the virucidal activity of alcohols and alcohol-based hand disinfectants against HEV71. A common alcohol-based hand disinfectant (0.5% chlorhexidine gluconate + 70% isopropanol) as well as different concentrations of isopropanol and ethanol were tested for virucidal activity against HEV71 using the suspension and the fingerpad tests. In suspension tests, 85% and 95% ethanol achieved a mean log10 reduction factor in HEV71 titre of >3 and nearly 6, respectively, within 10 min. By contrast, 70% and 75% ethanol and any concentration of isopropanol (70-95%) produced a factor of <1 in this test after the same exposure time. In fingerpad tests, only 95% ethanol showed a mean log10 reduction factor of >4, while both 75% ethanol and a chlorhexidine gluconate-containing formula were ineffective against HEV71 with a mean log10 reduction factor of <1 after a 30 s exposure time. Widely used alcohol-based hand disinfectants based on 70% ethanol or isopropanol have poor effectiveness against HEV71. Ninety-five percent ethanol is the most effective concentration, but still cannot fully inactivate HEV71 and may be impractical for use in many instances. Hand hygiene with alcohol-based hand disinfectants alone is not recommended for preventing HEV71 transmission. Copyright © 2013 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

The postantifungal effect and phospholipase production of oral Candida albicans from smokers, diabetics, asthmatics, denture wearers and healthy individuals following brief exposure to subtherapeutic concentrations of chlorhexidine gluconate.

PubMed

Ellepola, Arjuna N B; Joseph, Bobby K; Khan, Z U

2014-09-01

Candida albicans is the major aetiological agent of oral candidosis and one of its important virulent factors is the production of extracellular phospholipases, which can be modulated by subtherapeutic concentrations of antifungal agents thus decreasing their pathogenicity. Hence, considering that chlorhexidine gluconate (CG) is a common antimicrobial mouthwash used in dentistry and that its concentration in the mouth reaches subtherapeutic levels during dosage intervals due to the diluent effect of saliva and cleansing effect of the oral musculature, the postantifungal effect (PAFE) and the phospholipase production of oral C. albicans following brief exposure to subtherapeutic concentrations of CG was studied. Fifty C. albicans planktonic oral isolates obtained from smokers, diabetics, asthmatics using steroid inhalers, partial denture wearers and healthy individuals were exposed to three subtherapeutic concentrations of CG (0.005%, 0.0025% and 0.00125%) for 1 h. Isolates unexposed to CG was the control group. Thereafter the antiseptic was removed and the PAFE and phospholipase production was determined by a turbidometric method and a plate assay using an egg yolk agar medium respectively. Mean PAFE (hours) of 50 oral isolates of C. albicans following 1-h exposure to 0.005%, 0.0025% and 0.00125% CG was 6.97, 1.85 and 0.62 respectively. The phospholipase production of these isolates was significantly suppressed with a percentage reduction of 21.68, 18.20 and 14.04% following exposure to 0.005%, 0.0025% and 0.00125% CG respectively. Brief exposure of C. albicans isolates to subtherapeutic concentrations of CG would wield an antifungal effect by suppressing growth and phospholipase production, thereby quelling its pathogenicity. © 2014 Blackwell Verlag GmbH.

Methods for evaluating changes in skin condition due to the effects of antimicrobial hand cleansers: two studies comparing a new waterless chlorhexidine gluconate/ethanol-emollient antiseptic preparation with a conventional water-applied product.

PubMed

Grove, G L; Zerweck, C R; Heilman, J M; Pyrek, J D

2001-12-01

Hand-cleansing products that are milder to the skin of health care personnel are being developed, but the available methodologies to appropriately evaluate these products and quantify differences are not generally being applied in well-controlled studies. Two randomized, blinded, bilateral comparison studies evaluated skin condition during use of 2 antiseptic hand preparation products: a new 1% chlorhexidine gluconate (CHG)/61% wt/wt ethanol antiseptic hand preparation in a unique emollient system for waterless/brushless application and a conventional 4% CHG antimicrobial product that is applied with water and a scrub brush. Trained technicians applied treatments 6 times (for a surgical scrub study) or 24 times (for a personnel handwash study) daily to the hands of healthy volunteers during 5 days of controlled washing. An expert grader evaluated skin for dryness, erythema, and roughness. Subjects completed a self-assessment questionnaire on skin condition. Transepidermal water loss was measured by an evaporimeter, and the skin surface hydration level was measured by an electrical conductance meter. Fifty-eight subjects were enrolled in the 2 studies and received both treatments. In general, skin treated with the waterless CHG/ethanol product scored significantly (P <.004) better on evaluations of visual dryness and erythema and showed greater improvement in the level of hydration (P <.003). In the health care personnel handwash study, transepidermal water loss was less than that for skin treated with the conventional CHG product (P <.002). Subject assessments showed similar results (total score, P <.007). All 3 approaches of expert grader evaluation, subject assessment, and instrumentation were in concordance, demonstrating that the waterless CHG/ethanol product was gentler to skin than the conventional CHG product.

Chlorhexidine gluconate reduces transmission of methicillin-resistant Staphylococcus aureus USA300 among Marine recruits.

PubMed

Whitman, Timothy J; Schlett, Carey D; Grandits, Greg A; Millar, Eugene V; Mende, Katrin; Hospenthal, Duane R; Murray, Patrick R; Tribble, David R

2012-08-01

Methicillin-resistant Staphylococcus aureus (MRSA) pulsed-field type (PFT) USA300 causes skin and soft tissue infections in military recruits and invasive disease in hospitals. Chlorhexidine gluconate (CHG) is used to reduce MRSA colonization and infection. The impact of CHG on the molecular epidemiology of MRSA is not known. To evaluate the impact of 2% CHG-impregnated cloths on the molecular epidemiology of MRSA colonization. Cluster-randomized, double-blind, controlled trial. Marine Officer Candidate School, Quantico, Virginia, in 2007. Military recruits. Thrice-weekly application of CHG-impregnated or control (Comfort Bath; Sage) cloths over the entire body. Baseline and serial (every 2 weeks) nasal and/or axillary swab samples were assessed for MRSA colonization. Molecular analysis was performed with pulsed-field gel electrophoresis. During training, 77 subjects (4.9%) acquired MRSA, 26 (3.3%) in the CHG group and 51 (6.5%) in the control group (P=.004). When analyzed for PFT, 24 subjects (3.1%) in the control group but only 6 subjects (0.8%) in the CHG group (P=.001) had USA300. Of the 167 colonizing isolates recovered from 77 subjects, 99 were recovered from the control group, including USA300 (40.4%), USA800 (38.4%), USA1000 (12.1%), and USA100 (6.1%), and 68 were recovered from the CHG group, including USA800 (51.5%), USA100 (23.5%), and USA300 (13.2%). CHG decreased the transmission of MRSA--more specifically, USA300--among military recruits. In addition, USA300 and USA800 outcompeted other MRSA PFTs at incident colonization. Future studies should evaluate the broad-based use of CHG to decrease transmission of USA300 in hospital settings.

Chlorhexidine Gluconate Reduces Transmission of Methicillin-Resistant Staphylococcus aureus USA300 among Marine Recruits

PubMed Central

Whitman, Timothy J.; Schlett, Carey D.; Grandits, Greg A.; Millar, Eugene V.; Mende, Katrin; Hospenthal, Duane R.; Murray, Patrick R.; Tribble, David R.

2018-01-01

BACKGROUND Methicillin-resistant Staphylococcus aureus (MRSA) pulsed-field type (PFT) USA300 causes skin and soft tissue infections in military recruits and invasive disease in hospitals. Chlorhexidine gluconate (CHG) is used to reduce MRSA colonization and infection. The impact of CHG on the molecular epidemiology of MRSA is not known. OBJECTIVE To evaluate the impact of 2% CHG–impregnated cloths on the molecular epidemiology of MRSA colonization. DESIGN Cluster-randomized, double-blind, controlled trial. SETTING Marine Officer Candidate School, Quantico, Virginia, in 2007. PARTICIPANTS Military recruits. INTERVENTION Thrice-weekly application of CHG-impregnated or control (Comfort Bath; Sage) cloths over the entire body. MEASUREMENTS Baseline and serial (every 2 weeks) nasal and/or axillary swab samples were assessed for MRSA colonization. Molecular analysis was performed with pulsed-field gel electrophoresis. RESULTS During training, 77 subjects (4.9%) acquired MRSA, 26 (3.3%) in the CHG group and 51 (6.5%) in the control group (P = .004). When analyzed for PFT, 24 subjects (3.1%) in the control group but only 6 subjects (0.8%) in the CHG group (P = .001) had USA300. Of the 167 colonizing isolates recovered from 77 subjects, 99 were recovered from the control group, including USA300 (40.4%), USA800 (38.4%), USA1000 (12.1%), and USA100 (6.1%), and 68 were recovered from the CHG group, including USA800 (51.5%), USA100 (23.5%), and USA300 (13.2%). CONCLUSIONS CHG decreased the transmission of MRSA—more specifically, USA300—among military recruits. In addition, USA300 and USA800 outcompeted other MRSA PFTs at incident colonization. Future studies should evaluate the broad-based use of CHG to decrease transmission of USA300 in hospital settings. PMID:22759549

High-level vancomycin resistant Enterococcus faecium related to humans and pigs found in dust from pig breeding facilities.

PubMed

Braga, Teresa M; Pomba, Constança; Lopes, M Fátima Silva

2013-01-25

Environmental dust from animal breeding facilities was never screened for the presence of enterococci, nor of vancomycin-resistant enterococci (VRE), despite the possibility of being a vehicle of transmission of strains and antibiotic resistance genes between food-producing animals and man. Bio-security measures in pig facilities include disinfection with biocides to avoid the dissemination of opportunistic pathogenic bacteria, namely enterococci and in particular VRE. We thus undertook collection of enterococci and VRE in a representative number of breeding pig facilities in Portugal (n=171) and analyzed their susceptibility to benzalkonium chloride (BC) and chlorhexidine (CHX). A prevalence of 15% of VRE was found, with 6% high-level resistance found, and MIC values for CHX and BC were similar to those commonly found among enterococcal isolates from related environments, 8 μg/ml and 4 μg/ml, respectively. Among the isolated high-level vancomycin resistant Enterococcus faecium carrying the vanA genotype, we found multilocus sequence types closely related to pig and human isolates from European countries and Brazil. These results strongly advise constant surveillance of this environment and its inclusion in future epidemiologic studies on VRE. Copyright © 2012 Elsevier B.V. All rights reserved.

Effectiveness of Hypochlorous Acid to Reduce the Biofilms on Titanium Alloy Surfaces in Vitro

PubMed Central

Chen, Chun-Ju; Chen, Chun-Cheng; Ding, Shinn-Jyh

2016-01-01

Chemotherapeutic agents have been used as an adjunct to mechanical debridement for peri-implantitis treatment. The present in vitro study evaluated and compared the effectiveness of hypochlorous acid (HOCl), sodium hypochlorite (NaOCl), and chlorhexidine (CHX) at eliminating Gram-negative (E. coli and P. gingivalis) and Gram-positive (E. faecalis and S. sanguinis) bacteria. The effect of irrigating volume and exposure time on the antimicrobial efficacy of HOCl was evaluated, and a durability analysis was completed. Live/dead staining, morphology observation, alamarBlue assay, and lipopolysaccharide (LPS) detection were examined on grit-blasted and biofilm-contaminated titanium alloy discs after treatment with the three chemotherapeutic agents. The results indicated that HOCl exhibited better antibacterial efficacy with increasing irrigating volumes. HOCl achieved greater antibacterial efficacy as treatment time was increased. A decrease in antimicrobial effectiveness was observed when HOCl was unsealed and left in contact with the air. All the irrigants showed antibacterial activity and killed the majority of bacteria on the titanium alloy surfaces of biofilm-contaminated implants. Moreover, HOCl significantly lowered the LPS concentration of P. gingivalis when compared with NaOCl and CHX. Thus, a HOCl antiseptic may be effective for cleaning biofilm-contaminated implant surfaces. PMID:27447617

Determination of the Apical Sealing Abilities of Mineral Trioxide Aggregate, Portland Cement, and Bioaggregate After Irrigation with Different Solutions.

PubMed

Bayram, H Melike; Saklar, Feridun; Bayram, Emre; Orucoglu, Hasan; Bozkurt, Alperen

2015-06-01

The purpose of this study was to investigate the sealing ability of root-end filling materials such as mineral trioxide aggregate (MTA), Portland cement, and bioaggregate (BA) after irrigation with different solutions. We examined 130 human maxillar central teeth. After cutting the teeth at the cementoenamel junction, the root canals were expanded using nickel-titanium rotary instruments. Root canals were filled with AH-plus and gutta-percha. Then, the roots were cut apically, and 3 mm deep retrograde cavities were prepared. The roots were divided 12 experimental groups, consisting 10 teeth each; the positive and negative control groups contained five teeth each. The retrograde cavities were rinsed using ethylenediaminetetraacetic acid (EDTA), chlorhexidine (CHX), BioPure(™) mixture of a tetracycline isomer, an acid, and a detergent (MTAD), or distilled water. Next, groups 1, 2, 3, and 4 were sealed with MTA; groups 5, 6, 7, and 8 were sealed with Portland cement; and groups 9, 10, 11, and 12 were sealed with BA. Then, apical microleakage was evaluated by using a computerized fluid filtration method. The results of the leakage test were statistically evaluated by the post-hoc Tukey's test. MTA, Portland cement, and BA root-end filling materials showed the least leakage in the CHX and distilled water groups. The highest leakage was observed in the EDTA and MTAD groups. The sealing ability of BA was as good as that of MTA. EDTA and MTAD increased the apical leakage and CHX and distilled water decreased the leakage of the root-end filling materials examined in this study.

Cytotoxic effects of octenidine mouth rinse on human fibroblasts and epithelial cells - an in vitro study.

PubMed

Schmidt, J; Zyba, V; Jung, K; Rinke, S; Haak, R; Mausberg, R F; Ziebolz, D

2016-01-01

This study compared the cytotoxicity of a new octenidine mouth rinse (MR) against gingival fibroblasts and epithelial cells with different established MRs. The following MRs were used: Octenidol (OCT), Chlorhexidine 0.2% (CHX), Listerine (LIS), Meridol (MER), Betaisodona (BET); and control (medium only). Human primary gingiva fibroblasts and human primary nasal epithelial cells were cultivated in cell-specific media (2 × 10(5) cells/ml) and treated with MR for 1, 5, and 15 min. Each test was performed 12 times. Metabolism activity was measured using a cytotoxicity assay. A cellometer analyzed cell viability, cell number, and cell diameter. The data were analyzed by two-way analysis of variance with subsequent Dunnett's test and additional t-tests. The cytotoxic effects of all MRs on fibroblasts and epithelial cells compared to the control depended on the contact time (p < 0.001). OCT and BET showed less influence on cell metabolism in fibroblasts than other MRs. OCT also demonstrated comparable but not significant results in epithelial cells (p > 0.005). Cell numbers of both cell types at all contact times revealed that OCT showed a less negative effect (p > 0.005), especially for epithelial cells compared to CHX after 15 min (p < 0.005). OCT and BET showed the best results for viability in fibroblasts (p > 0.005), but MER showed less influence than OCT in epithelial cells (p < 0.005). OCT is a potential alternative to CHX regarding cytotoxicity because of its lower cell-toxic effect against fibroblasts and epithelial cells.

Antimicrobial Efficacy of Two Surface Barrier Discharges with Air Plasma against In Vitro Biofilms

PubMed Central

Matthes, Rutger; Bender, Claudia; Schlüter, Rabea; Koban, Ina; Bussiahn, René; Reuter, Stephan; Lademann, Jürgen; Weltmann, Klaus-Dieter; Kramer, Axel

2013-01-01

The treatment of infected wounds is one possible therapeutic aspect of plasma medicine. Chronic wounds are often associated with microbial biofilms which limit the efficacy of antiseptics. The present study investigates two different surface barrier discharges with air plasma to compare their efficacy against microbial biofilms with chlorhexidine digluconate solution (CHX) as representative of an important antibiofilm antiseptic. Pseudomonas aeruginosa SG81 and Staphylococcus epidermidis RP62A were cultivated on polycarbonate discs. The biofilms were treated for 30, 60, 150, 300 or 600 s with plasma or for 600 s with 0.1% CHX, respectively. After treatment, biofilms were dispensed by ultrasound and the antimicrobial effects were determined as difference in the number of the colony forming units by microbial culture. A high antimicrobial efficacy on biofilms of both plasma sources in comparison to CHX treatment was shown. The efficacy differs between the used strains and plasma sources. For illustration, the biofilms were examined under a scanning electron microscope before and after treatment. Additionally, cytotoxicity was determined by the MTT (3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide) assay with L929 mouse fibroblast cell line. The cell toxicity of the used plasma limits its applicability on human tissue to maximally 150 s. The emitted UV irradiance was measured to estimate whether UV could limit the application on human tissue at the given parameters. It was found that the UV emission is negligibly low. In conclusion, the results support the assumption that air plasma could be an option for therapy of chronic wounds. PMID:23894661

[Hydrogen peroxide, chloramine T and chlorhexidrine in the disinfection of acrylic resin].

PubMed

Czerwińska, W; Kedzia, A; Kałowski, M

1978-01-01

The effectiveness of 3% h drogen peroxide, 5% chloramine T and 0,5% chlorhexidine gluconate solutions in disinfection of acrylic resine plates massively infected with oral flora was analysed. The acrylic resine plates used for investigations, were infected in vitro with mixed salivary flora characterized by small numbers of yeast-like fungi (1st group), or great number of these microorganisms (2nd group). Infected plates were exposed to solutions of analysed disinfectants during various time periods. After rinsing or inactivation of disinfectant residues, acrylic plates were put into bacteriological medium and incubated during 7 days period in 37 degrees C. The results of this study indicated the effectiveness of acrylic plates disinfection to be dependent on used disinfectant, time of exposition, and microorganisms present on the surface of acrylic resine. The solutions of disinfectants were less active in the cases of plates infected with material containing great numbers of yeast-like microorganisms. Among analysed disinfectants 0,5% solution of chlorhexidine was characterized by most effective and rapid activity, whereas 3% solution of hydrogen peroxide was found to be the least effective.

Chlorhexidine and Mupirocin Susceptibility of Methicillin-Resistant Staphylococcus aureus Isolates in the REDUCE-MRSA Trial.

PubMed

Hayden, Mary K; Lolans, Karen; Haffenreffer, Katherine; Avery, Taliser R; Kleinman, Ken; Li, Haiying; Kaganov, Rebecca E; Lankiewicz, Julie; Moody, Julia; Septimus, Edward; Weinstein, Robert A; Hickok, Jason; Jernigan, John; Perlin, Jonathan B; Platt, Richard; Huang, Susan S

2016-11-01

Whether targeted or universal decolonization strategies for the control of methicillin-resistant Staphylococcus aureus (MRSA) select for resistance to decolonizing agents is unresolved. The REDUCE-MRSA trial (ClinicalTrials registration no. NCT00980980) provided an opportunity to investigate this question. REDUCE-MRSA was a 3-arm, cluster-randomized trial of either screening and isolation without decolonization, targeted decolonization with chlorhexidine and mupirocin, or universal decolonization without screening to prevent MRSA infection in intensive-care unit (ICU) patients. Isolates from the baseline and intervention periods were collected and tested for susceptibility to chlorhexidine gluconate (CHG) by microtiter dilution; mupirocin susceptibility was tested by Etest. The presence of the qacA or qacB gene was determined by PCR and DNA sequence analysis. A total of 3,173 isolates were analyzed; 2 were nonsusceptible to CHG (MICs, 8 μg/ml), and 5/814 (0.6%) carried qacA or qacB At baseline, 7.1% of MRSA isolates expressed low-level mupirocin resistance, and 7.5% expressed high-level mupirocin resistance. In a mixed-effects generalized logistic regression model, the odds of mupirocin resistance among clinical MRSA isolates or MRSA isolates acquired in an ICU in intervention versus baseline periods did not differ across arms, although estimates were imprecise due to small numbers. Reduced susceptibility to chlorhexidine and carriage of qacA or qacB were rare among MRSA isolates in the REDUCE-MRSA trial. The odds of mupirocin resistance were no different in the intervention versus baseline periods across arms, but the confidence limits were broad, and the results should be interpreted with caution. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Comparative antifungal efficacy of light-activated disinfection and octenidine hydrochloride with contemporary endodontic irrigants.

PubMed

Eldeniz, Ayce Unverdi; Guneser, Mehmet Burak; Akbulut, Makbule Bilge

2015-02-01

The aim of this study was to evaluate the antifungal effects of light-activated disinfection (LAD) in comparison with contemporary root canal irrigation solutions: sodium hypochlorite and 2% chlorhexidine gluconate and a new wound antiseptic, octenidine hydrochloride. Seventy extracted teeth having single root canals were contaminated with Candida albicans for 14 days. The samples were divided into five experimental (n = 10) and two control (positive and negative) groups (n = 10): (1) LAD with toluidine blue O, (2) octenidine hydrochloride (OCT), (3) 2.5% sodium hypochlorite (2.5% NaOCl), (4) 5.25% sodium hypochlorite (5.25% NaOCl) and (5) 2% chlorhexidine. Five millilitres of each test solution was applied for 3 min, and irradiation time used for LAD was 30 s. After treatment, the dentin chips were collected from inner canal walls into vials containing phosphate buffered saline, vortexed, serially diluted, seeded on Tryptic Soy Agar plates and incubated (37 °C, 48 h). The number of colony-forming units was then counted. Differences between LAD group and positive control group were statistically significant (P < 0.05). All Candida cells were totally eliminated in root canals irrigated with OCT, 2.5% NaOCl, 5.25% NaOCl and 2% chlorhexidine groups (CFU = 0). Within the limitations of this ex vivo study, LAD had minimal antimicrobial effect on C. albicans when used 30 s, and further modifications in LAD protocol are required to improve its antifungal capability. A new wound antiseptic, octenidine hydrochloride, demonstrated better potential than LAD in elimination of Candida albicans cells and may be a promising alternative to NaOCl and chlorhexidine solutions in future.

Chlorhexidine whole-body washing of patients reduces methicillin-resistant Staphylococcus aureus and has a direct effect on the distribution of the ST5-MRSA-II (New York/Japan) clone.

PubMed

Velázquez-Meza, Maria Elena; Mendoza-Olazarán, Soraya; Echániz-Aviles, Gabriela; Camacho-Ortiz, Adrián; Martínez-Reséndez, Michel Fernando; Valero-Moreno, Vanessa; Garza-González, Elvira

2017-06-01

Methicillin-resistant Staphylococcus aureus (MRSA) colonizes the skin of hospitalized patients and is associated with high morbidity and mortality. To prevent colonization and infection by S. aureus, better disinfection practices are required. Therefore, we evaluated the effect of chlorhexidine whole-body washing on hospital-acquired S. aureus infections among intensive care unit (ICU) patients in a tertiary hospital in Mexico. The study was conducted over 18 months to evaluate the effect of 2 % chlorhexidine gluconate (CXG) whole-body washing of ICU adult patients on chlorhexidine and antibiotic resistance, biofilm production and clonal distribution of S. aureus in a tertiary care hospital. Minimum inhibitory concentrations for CXG, antibiotic susceptibility and biofilm production by S. aureus isolates were determined. Pulsed-field gel electrophoresis, multilocus sequence typing (MLST) and PCR for Panton-Valentine leucocidin (PVL) were used for molecular typing of MRSA isolates.Results/Key findings. We included 158 isolates. A reduction in antibiotic resistance in the study period was observed for clindamycin, levofloxacin, norfloxacin, oxacillin and trimethoprim/sulfamethoxazole. None of the isolates showed reduced susceptibility to CXG. Most of the isolates were non-biofilm producers (147/158). The most commonly identified clone was a descendant of the ST5-MRSA-II (New York/Japan) clone. This clone decreased during the intervention period and reappeared markedly in the post-intervention period. During the post-intervention period, two isolates were related with the clone ST8-MRSA-IV (also known as USA300). Our findings suggest that the CXG bathing favored the reduction of healthcare-associated MRSA isolates and a temporary reduction of the predominant ST5-MRSA-II (New York/Japan) clone.

Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia.

PubMed

Shi, Zongdao; Xie, Huixu; Wang, Ping; Zhang, Qi; Wu, Yan; Chen, E; Ng, Linda; Worthington, Helen V; Needleman, Ian; Furness, Susan

2013-08-13

Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in persons who have received mechanical ventilation for at least 48 hours. VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care (OHC), using either a mouthrinse, gel, toothbrush, or combination, together with aspiration of secretions may reduce the risk of VAP in these patients. To assess the effects of OHC on the incidence of VAP in critically ill patients receiving mechanical ventilation in intensive care units (ICUs) in hospitals. We searched the Cochrane Oral Health Group's Trials Register (to 14 January 2013), CENTRAL (The Cochrane Library 2012, Issue 12), MEDLINE (OVID) (1946 to 14 January 2013), EMBASE (OVID) (1980 to 14 January 2013), LILACS (BIREME) (1982 to 14 January 2013), CINAHL (EBSCO) (1980 to 14 January 2013), Chinese Biomedical Literature Database (1978 to 14 January 2013), China National Knowledge Infrastructure (1994 to 14 January 2013), Wan Fang Database (January 1984 to 14 January 2013), OpenGrey and ClinicalTrials.gov (to 14 January 2013). There were no restrictions regarding language or date of publication. We included randomised controlled trials (RCTs) evaluating the effects of OHC (mouthrinse, swab, toothbrush or combination) in critically ill patients receiving mechanical ventilation. Two review authors independently assessed all search results, extracted data and undertook risk of bias. We contacted study authors for additional information. Trials with similar interventions and outcomes were pooled reporting odds ratios (OR) for dichotomous outcomes and mean differences (MD) for continuous outcomes using random-effects models unless there were fewer than four studies. Thirty-five RCTs (5374 participants) were included. Five trials (14%) were assessed at low risk of bias, 17 studies (49%) were at high risk of bias, and 13 studies (37%) were assessed at unclear risk of bias in at least one domain. There were four main comparisons: chlorhexidine (CHX mouthrinse or gel) versus placebo/usual care, toothbrushing versus no toothbrushing, powered versus manual toothbrushing and comparisons of oral care solutions.There is moderate quality evidence from 17 RCTs (2402 participants, two at high, 11 at unclear and four at low risk of bias) that CHX mouthrinse or gel, as part of OHC, compared to placebo or usual care is associated with a reduction in VAP (OR 0.60, 95% confidence intervals (CI) 0.47 to 0.77, P < 0.001, I(2) = 21%). This is equivalent to a number needed to treat (NNT) of 15 (95% CI 10 to 34) indicating that for every 15 ventilated patients in intensive care receiving OHC including chlorhexidine, one outcome of VAP will be prevented. There is no evidence of a difference between CHX and placebo/usual care in the outcomes of mortality (OR 1.10, 95% CI 0.87 to 1.38, P = 0.44, I(2) = 2%, 15 RCTs, moderate quality evidence), duration of mechanical ventilation (MD 0.09, 95% CI -0.84 to 1.01 days, P = 0.85, I(2) = 24%, six RCTs, moderate quality evidence), or duration of ICU stay (MD -0.21, 95% CI -1.48 to 1.89 days, P = 0.81, I(2) = 9%, six RCTs, moderate quality evidence). There was insufficient evidence to determine whether there is a difference between CHX and placebo/usual care in the outcomes of duration of use of systemic antibiotics, oral health indices, microbiological cultures, caregivers preferences or cost. Only three studies reported any adverse effects, and these were mild with similar frequency in CHX and control groups.From three trials of children aged from 0 to 15 years (342 participants, moderate quality evidence) there is no evidence of a difference between OHC with CHX and placebo for the outcomes of VAP (OR 1.07, 95% CI 0.65 to 1.77, P = 0.79, I(2) = 0%), or mortality (OR 0.73, 95% CI 0.41 to 1.30, P = 0.28, I(2) = 0%), and insufficient evidence to determine the effect on the outcomes of duration of ventilation, duration of ICU stay, use of systemic antibiotics, plaque index, microbiological cultures or adverse effects, in children.Based on four RCTs (828 participants, low quality evidence) there is no evidence of a difference between OHC including toothbrushing (± CHX) compared to OHC without toothbrushing (± CHX) for the outcome of VAP (OR 0.69, 95% CI 0.36 to 1.29, P = 0.24 , I(2) = 64%) and no evidence of a difference for mortality (OR 0.85, 95% CI 0.62 to 1.16, P = 0.31, I(2) = 0%, four RCTs, moderate quality evidence). There is insufficient evidence to determine whether there is a difference due to toothbrushing for the outcomes of duration of mechanical ventilation, duration of ICU stay, use of systemic antibiotics, oral health indices, microbiological cultures, adverse effects, caregivers preferences or cost.Only one trial compared use of a powered toothbrush with a manual toothbrush providing insufficient evidence to determine the effect on any of the outcomes of this review.A range of other oral care solutions were compared. There is some weak evidence that povidone iodine mouthrinse is more effective than saline in reducing VAP (OR 0.35, 95% CI 0.19 to 0.65, P = 0.0009, I(2) = 53%) (two studies, 206 participants, high risk of bias). Due to the variation in comparisons and outcomes among the trials in this group there is insufficient evidence concerning the effects of other oral care solutions on the outcomes of this review. Effective OHC is important for ventilated patients in intensive care. OHC that includes either chlorhexidine mouthwash or gel is associated with a 40% reduction in the odds of developing ventilator-associated pneumonia in critically ill adults. However, there is no evidence of a difference in the outcomes of mortality, duration of mechanical ventilation or duration of ICU stay. There is no evidence that OHC including both CHX and toothbrushing is different from OHC with CHX alone, and some weak evidence to suggest that povidone iodine mouthrinse is more effective than saline in reducing VAP. There is insufficient evidence to determine whether powered toothbrushing or other oral care solutions are effective in reducing VAP.

Three rooted, four canalled mandibular first molar (Radix Entomolaris).

PubMed

Parolia, Abhishek; Kundabala, M; Thomas, M S; Mohan, M; Joshi, N

2009-01-01

A mandibular first molar with two distal roots is an interesting example of anatomic variation. This paper describes case reports of mandibular first molar with three roots (one mesial and two distal) and four canals (two in mesial and one in each distobuccal and distolingual root). The canals were shaped with protaper rotary files and irrigated with 5.25% sodium hyochlorite, 0.2 %w/v of chlorhexidine gluconate and normal saline as the fi nal irrigant. The canals were then obturated with gutta- percha and AH plus sealer. These case reports show an anatomic variation of internal morphology of the tooth and points out the importance of searching for additional canals.

Efficacy of a surgical scrub including 2% chlorhexidine acetate for canine superficial pyoderma.

PubMed

Murayama, Nobuo; Nagata, Masahiko; Terada, Yuri; Shibata, Sanae; Fukata, Tsuneo

2010-12-01

The clinical efficacy of a surgical scrub containing 2% chlorhexidine acetate (2CA; Nolvasan® Surgical Scrub; Fort Dodge Animal Health, USA) was evaluated for the topical management of canine superficial pyoderma. The first study was a randomized, double-blind, controlled trial. The control was a shampoo containing 4% chlorhexidine gluconate (4CG; Skin Clinic Shampoo; CHD MEDICS, Goyang, Korea). Ten dogs with symmetrical lesions of canine superficial pyoderma were allocated to receive either 2CA or the control shampoo applied to either side of the body twice weekly for 1 week. Both the owners and the investigators subjectively scored skin lesions including pruritus, erythema, crusted papules and scales on a scale of 0-3. The 2CA and 4CG resulted in almost the same degree of improvement of skin lesions, and there were no significant differences between the two groups. The second study was an open trial of 2CA monotherapy in eight dogs with cefalexin-resistant Staphylococcus intermedius group-associated superficial pyoderma. The 2CA monotherapy was applied every 2 days for 2 weeks. Five dogs improved with 2CA monotherapy, one partially improved and two did not. No adverse reactions were seen in either trial. This suggests that a 2CA surgical scrub could be a useful and safe topical adjunct therapy for dogs with superficial pyoderma involving cefalexin-resistant Staphylococcus intermedius group. © 2010 The Authors. Journal compilation © 2010 ESVD and ACVD.

Effect of Irrigation Time of Antiseptic Solutions on Bone Cell Viability and Growth Factor Release.

PubMed

Sawada, Kosaku; Nakahara, Ken; Haga-Tsujimura, Maiko; Fujioka-Kobayashi, Masako; Iizuka, Tateyuki; Miron, Richard J

2018-03-01

Antiseptic solutions are commonly utilized to treat local infection in the oral and maxillofacial region. However, surrounding vital bone is also exposed to antiseptic agents during irrigation and may have a potential negative impact on bone survival. The aim of the present study was therefore to investigate the effect of rinsing time with various antiseptic solutions on bone cell viability, as well as their subsequent release of growth factors important for bone regeneration. The bone samples collected from porcine mandible were rinsed in the following commonly utilized antiseptic solutions; povidone-iodine (0.5%), chlorhexidine digluconate (CHX, 0.2%), hydrogen peroxide (1%), and sodium hypochlorite (0.25%) for 1, 5, 10, 20, 30, or 60 minutes and assessed for cell viability and release of growth factors including vascular endothelial growth factor, transforming growth factor beta 1, bone morphogenetic protein 2, receptor activator of nuclear factor kappa-B ligand, and interleukin-1 beta by enzyme-linked immunosorbent assay. It was found in all the tested groups that the long exposure of any of the tested antiseptic solutions drastically promoted higher cell death. Sodium hypochlorite demonstrated the significantly highest cell death and at all time points. Interestingly, bone cell viability was highest in the CHX group post short-term rinsing of 1, 5, or 10 minutes when compared with the other 4 tested groups. A similar trend was also observed in subsequent growth factor release. The present study demonstrated that of the 4 tested antiseptic solutions, short-term CHX rinsing (ideally within 1 minute) favored bone cell viability and growth factor release. Clinical protocols should be adapted accordingly.

Evaluation of corrosion resistance and surface characteristics of orthodontic wires immersed in different mouthwashes.

PubMed

Nalbantgil, Didem; Ulkur, Feyza; Kardas, Gulfeza; Culha, Mustafa

2016-11-25

Patients use mouthwashes in addition to mechanical cleaning during orthodontic treatment. The effects of mouthwashes on the archwires have not been examined yet. To compare the corrosion resistance of four different arch wires and corrosion effects of different mouthwashes to formulate a biocompatible and mechanically useful arch wire and mouthwash combination. Each group comprised of 4 wire samples of 2 cm 0.016 × 0.022 inch. 1st group: ion implanted nickel titanium (INT), 2nd group: nickel titanium, without ion implantation (NT), 3rd group: micro layered esthetic nickel titanium (ENT), 4th group: stainless steel (SS) wires. They were immersed inside 2 ml of artificial saliva solutions (AS) for the control, or AS (9%) combined with 1 of the 3 mouthwashes (91%) for study groups, for 24 hours. These mouthwashes were essential oil (EO), chlorhexidine (CHX), sodium-fluoride (NaF). An electrochemical analyzer was used for electrochemical impedance spectroscopy measurements. High corrosion resistance was obtained for ENT than the other wires. The corrosion potentials are 0.007, -0.042, 0.074 and -0.015 V (Ag/AgCl) for ENT, INT, SS and NT in the artificial salivary, respectively. In NaF containing mouthwash Rp value of ENT is significantly high in comparison to others. The impedance responses of all materials increased significantly in the presence of NaF mouthwash as well as in the CHX mouthwash. Low frequencies are seen at all materials in EO mouthwash. Diameters of loops are 22, 5.9, 5.9 and 3.7 MΩ at ENT, INT, SS and NT. In this study, micro layered esthetic nickel titanium wires are found biocompatible among other wires and NaF and CHX mouthwashes can be recommend for their good corrosion resistance during fixed orthodontic therapy.

Effects of octenidine mouth rinse on apoptosis and necrosis of human fibroblasts and epithelial cells - an in vitro study.

PubMed

Schmidt, J; Zyba, V; Jung, K; Rinke, S; Haak, R; Mausberg, R F; Ziebolz, D

2018-04-01

This study aimed at comparing the cytotoxicity of a new octenidine mouth rinse (MR) on gingival fibroblasts and epithelial cells using different established MRs. Octenidol (OCT), Chlorhexidine 0.2% (CHX), Meridol (MER), Oral B (OB), and control (PBS only) were used. Human primary gingival fibroblasts (HGFIBs) and human primary nasal epithelial cells (HNEPCs) were cultivated in cell-specific media (2 × 10 5 cells/well) and treated with a MR or PBS for 1, 5, and 15 min. All tests were performed in duplicate and repeated 12 times. The apoptosis and necrosis were determined using a Caspase-3/7 assay and LDH assay, respectively. The data were analyzed using two-way analysis of variance with subsequent Mann-Whitney U-test. No significant differences could be found between the incubation times of the MR, neither for apoptosis nor necrosis (p > 0.05). Regarding apoptosis of HGFIBs, MRs had no influence at all. In HNEPCs, OCT induced relevantly lower apoptosis than CHX (p = 0.01). Considering necrosis, MER showed the lowest numbers of necrotic HGFIBs and HNEPCs, whereas OB induced the highest number of necrotic cells. The differences between both MR were statistically relevant (p < 0.01). OCT did neither differ from the other MRs nor from the control (PBS) in induction of necrosis in both cell types. In conclusion, the slightly negative effect of OCT considering apoptosis and necrosis of HGFIBs and HNEPCs is nearly the same or even lower compared to the established MRs included in this study. The results confirm that OCT is a potential alternative to CHX.

An In Vitro Spectroscopic Analysis to Determine Whether para-Chloroaniline is Produced from Mixing Sodium Hypochlorite and Chlorhexidine

PubMed Central

Thomas, John E.; Sem, Daniel S.

2009-01-01

Introduction The purpose of this in vitro study was to determine whether para-chloroaniline (PCA) is formed through the reaction of mixing sodium hypochlorite (NaOCl) and chlorhexidine (CHX). Methods Initially commercially available samples of chlorhexidine acetate (CHXa) and PCA were analyzed with 1H NMR spectroscopy. Two solutions, NaOCl and CHXa, were warmed to 37°C and when mixed they produced a brown precipitate. This precipitate was separated in half and pure PCA was added to one of the samples for comparison before they were each analyzed with 1H NMR spectroscopy. Results The peaks in the 1H NMR spectra of CHXa and PCA were assigned to specific protons of the molecules, and the location of the aromatic peaks in the PCA spectrum defined the PCA doublet region. While the spectrum of the precipitate alone resulted in a complex combination of peaks, upon magnification there were no peaks in the PCA doublet region which were intense enough to be quantified. In the spectrum of the precipitate, to which PCA was added, two peaks do appear in the PCA doublet region. Comparing this spectrum to that of precipitate alone, the peaks in the PCA doublet region are not visible prior to the addition of PCA. Conclusions Based on this in vitro study, the reaction mixture of NaOCl and CHXa does not produce PCA at any measurable quantity and further investigation is needed to determine the chemical composition of the brown precipitate. PMID:20113799

Potentiating the antibacterial effect of silver nanospheres by surface-capping with chlorhexidine gluconate

NASA Astrophysics Data System (ADS)

Priyadarshini, Balasankar Meera; Fawzy, Amr S.

2017-04-01

In this work, the commercial polyvinylpyrrolidone (PVP)-capped silver nanospheres (Ag-NSP) were surface decorated with chlorhexidine gluconate (CHXg) for potentiating the antibacterial properties of Ag-NSP. Different formulations of CHXg-loaded Ag-NSP (Ag-NSP/CHXg) were prepared by varying the incubation times (0.5, 1.5, and 3 h). A thorough characterization of Ag-NSP/CHXg nanospheres has been carried out by dynamic light scattering (DLS), transmission electron microscopy (TEM), energy-dispersive surface elemental composition spectral analysis (SEM/EDX), Fourier transform infrared spectroscopy (FTIR), percentage (%) CHXg loading efficiency (LE), in vitro CHXg and Ag+ ion release, antibacterial/biofilm inhibition assay, and human mesenchymal stem cells (hMSCs) cytotoxicity evaluation. DLS measured nanospheres to be <160 nm and indicated that CHXg treatment drastically shifted the surface charge from negative to high positive values, with homogenous distribution. TEM revealed spherical Ag-NSP/CHXg nanospheres with a clearly visible surface coating of CHXg. FTIR confirmed association of CHXg with Ag-NSP nanospheres, whereas SEM/EDX data verified presence of spectral peaks specific to silver (Ag), CHXg, and PVP. The %LE gradually increased with increasing incubation times. In vitro CHXg release exhibited a bi-phasic fashion showing maximum release of 74.83 ± 20.67% from Ag-NSP/CHXg-3h at 14 days. A slow release of Ag+ ions was detected; however, the surface decoration of Ag-NSP substantially hampered/restricted the liberation of ions. Agar well diffusion, MTS (3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium), and crystal violet assay suggested good antibacterial/antibiofilm activity of Ag-NSP/CHXg that correlated with the increasing %LE of nanospheres. hMSCs cytotoxicity study showed low toxicity properties of all nanosphere formulations, except for Ag-NSP/CHXg-3h, affecting the cell viability at all proposed concentrations and exposure time points. CHXg accentuated the antibacterial properties of Ag-NSP.

Comparison of disinfectants by immersion and spray atomization techniques on the linear dimensional stability of different interocclusal recording materials: An in vitro study

PubMed Central

Gounder, Revathy; Vikas, B. V. J.

2016-01-01

Objective: To evaluate and compare the effect of 0.5% chlorhexidine gluconate, 1% sodium hypochlorite, and 2% glutaraldehyde by immersion and spray atomization technique on the linear dimensional stability of Jet bite, Aluwax and Ramitec interocclusal recording materials. Materials and Methods: Three representative materials: Jet bite (addition silicone), Aluwax and Ramitec (polyether) were mixed according to manufacturer's instructions and then specimens were prepared according to the specifications of ISO 4823. All the specimens except the control (distilled water) were treated with disinfectant solutions (0.5% chlorhexidine gluconate, 1% sodium hypochlorite, and 2% glutaraldehyde) for 30 and 60 min (n = 10) by spray and immersion technique. Once removed from the solutions, the test samples were washed in water for 15 s, dried and measured after 24 h 3 times using a measuring microscope with an accuracy of 0.0001 mm. Two-way ANOVA and Tukey's test with significance level of 5% were used to assess the statistical data (α = 0.05). Result: All groups showed no significant difference statistically, in linear dimension when disinfected for 30 min by spray or immersion technique. Polyether had significantly higher dimensional variation when immersed in sodium hypochlorite for 60 min. Addition silicone showed the least dimensional change which ranged from 0.024% to 0.05%, followed by polyether from 0.004% to 0.171% and Aluwax from 0.146% to 0.228%. Conclusion: To preserve the dimensions and surface of the recording materials and effective microbial elimination, restrictions should be applied in the method of disinfection and time duration. However, using the disinfectants either by spray or immersion technique, the dimensional change was <0.5% which was not clinically significant according to the American Dental Association specification no. 19 criteria within the first 24 h. PMID:27011733

Optimal Irrigation and Debridement of Infected Joint Implants

PubMed Central

Schwechter, Evan M.; Folk, David; Varshney, Avanish K.; Fries, Bettina C.; Kim, Sun Jin; Hirsh, David M.

2014-01-01

Acute postoperative and acute, late hematogenous prosthetic joint infections have been treated with 1-stage irrigation and debridement with polyethylene exchange. Success rates, however, are highly variable. Reported studies demonstrate that detergents are effective at decreasing bacterial colony counts on orthopedic implants. Our hypothesis is that the combination of a detergent and an antiseptic would be more effective than using a detergent alone to decrease colony counts from a methicillin-resistant Staphylococcus aureus biofilm-coated titanium alloy disk simulating an orthopedic implant. In our study of various agents tested, chlorhexidine gluconate scrub (antiseptic and detergent) was the most effective at decreasing bacterial colony counts both prereincubation and postreincubation of the disks; pulse lavage and scrubbing were not more effective than pulse lavage alone. PMID:21641757

Ex-vivoand in-vitro assessment of mucoadhesive patches containing the gel-forming polysaccharide psyllium for buccal delivery of chlorhexidine base.

PubMed

Cavallari, Cristina; Brigidi, Patrizia; Fini, Adamo

2015-12-30

The aim of the present study was to evaluate the gel-forming polysaccharide psyllium in the preparation of mucoadhesive patches for the controlled release of chlorhexidine (CHX) to treat pathologies in the oral cavity, using the casting-solvent evaporation technique. A number of different film-forming semi-synthetic polymers, such as sodium carboxymethyl cellulose (SCMC) and hydroxypropylmethyl cellulose (HPMC) were evaluated for comparison. The patch formulations were characterized in terms of drug content, morphology surface, swelling and mucoadhesive properties, microbiology inhibition assay and in vitro release tests. Three ex-vivo testswere carried out using porcine mucosa: an alternative dissolution test using artificial saliva that allows contemporary measurement of dissolution and mucoadhesion, a permeation test through the mucosa and the measurement of mucoadhesion using a Nouy tensile tester, as the maximum force required for the separation of the patch from the mucosa surface. The patches were also examined for determination of the minimum inhibitory concentration in cultures of Escherichia coli and Staphylococcus aureus. All the patches incorporating psyllium were found suitable in terms of external morphology, mucoadhesion and controlled release of the drug: in the presence of psyllium the drug displays prolonged zero-order release related to slower swelling rate of the system. Copyright © 2015. Published by Elsevier B.V.

The impact of periodontal therapy and the adjunctive effect of antiseptics on breath odor-related outcome variables: a double-blind randomized study.

PubMed

Quirynen, Marc; Zhao, Hong; Soers, Catherine; Dekeyser, Christel; Pauwels, Martine; Coucke, Wim; Steenberghe, Daniel van

2005-05-01

Bad breath is often caused by periodontitis and/or tongue coating. This study followed the impact of initial periodontal therapy on several halitosis-related outcome variables over a 6-month period. Organoleptic ratings are often uncomfortable for the patient and have several disadvantages. They are, for instance, influenced by external parameters (e.g., food intake and cosmetics) and need to be calibrated among researchers worldwide. A second aim was to evaluate the reliability of saliva incubation as an in vitro indirect test for breath recording. In this double-blind, randomized, medium-term, parallel study 45 moderate periodontitis patients without obvious tongue coating were enrolled. Besides a one-stage, full-mouth disinfection and oral hygiene improvement (including daily tongue scraping), patients were instructed to rinse daily for 6 months with one of the following products (randomly allocated): chlorhexidine (CHX) 0.2% + alcohol, CHX 0.05% + cetyl pyridinium chloride (CPC) 0.05% without alcohol (a new formulation), or a placebo solution. At baseline and 3 and 6 months, a series of parameters were recorded including: concentration of volatile sulfide compounds (VSC), tongue coating, and an estimation of the microbial load (at anterior and posterior parts of the tongue, saliva, dental plaque). The intraoral VSC ratings were compared to in vitro VSC recordings and organoleptic evaluations of the headspace air from 1 and 2 hours incubated saliva (0.5 ml, 37 degrees C, anaerobic chamber). Even though the initial VSC values were not high (+/-90 ppb with only 18 patients revealing more than 100 ppb), significant (P <0.05) reductions could be achieved in the CHX and CHX + CPC group, and to a lower extent in the placebo group (P = 0.10). Tongue scraping resulted in a significant reduction (P < or =0.05) of the tongue coating up to month 6 in the placebo and CHX + CPC group, but not in the CHX group (confusion due to staining). The CHX and CHX + CPC group showed, in comparison to baseline, significant (P <0.001) reductions in the number of anaerobic species in the supragingival plaque, in the saliva, and on the anterior part of the tongue. For the posterior part of the tongue the microbial changes remained < or =0.3 log values (P >0.05). For the placebo group, the microbial changes never reached a level of significance (< or =0.3 log values). A strong correlation was found between the intraoral VSC ratings and the 1-hour (r = 0.48, P <0.0001; r = 0.54, P = 0.0003 for baseline data only) and 2-hour (r = 0.43, P <0.0001) VSC production of incubated saliva. The latter also correlated very strongly (r = 0.71) with the number of anaerobic species in the saliva. The VSC values and organoleptic ratings of the incubated saliva also correlated strongly with each other (r = 0.64 for 1-hour and 0.73 for 2-hour incubation). The results of this study indicate that in patients with moderate periodontitis, initial periodontal therapy including tongue scraping did not have a significant effect on the microbial load of the tongue and had only a weak impact on the VSC level, except when combined with a mouthrinse. Saliva incubation can be used as an indirect way to score breath odor. It offers simplicity, objectivity, and is less invasive.

Antimicrobial effects of root canal medicaments against Enterococcus faecalis and Streptococcus mutans.

PubMed

Atila-Pektaş, B; Yurdakul, P; Gülmez, D; Görduysus, O

2013-05-01

To compare the antimicrobial activities of Activ Point (Roeko, Langenau, Germany), Calcium Hydroxide Plus Point (Roeko, Langenau, Germany), calcium hydroxide, 1% chlorhexidine gel and bioactive glass (S53P4) against Enterococcus faecalis and Streptococcus mutans. One hundred and twenty extracted single-rooted human teeth were used. After removing the crowns, root canals were prepared by using the Protaper rotary system. Following autoclave sterilization, root canals were incubated at 37 °C with E. faecalis ATCC 29212 and S. mutans RSHM 676 for 1 week. The specimens, which were divided into five treatment groups for each microorganism according to the intracanal medicament used, were tested in 10 experimental runs. In each experimental run, 10 roots were included as treatment, one root as positive control and one root as sterility control. Sterile paper points were utilized to take samples from root canals after the incubation of teeth in thioglycollate medium at 37 °C for 1 week. Samples taken from teeth by sterile paper points were inoculated onto sheep blood agar, and following an overnight incubation, the colonies grown on sheep blood agar were counted and interpreted as colony-forming units. Results were tested statistically by using Kruskal-Wallis and Conover's nonparametric multiple comparison tests. CHX gel (P < 0.001 and P < 0.001), Activ Point (P = 0.003 and P = 0.002) and Ca(OH)₂ (P = 0.010 and P = 0.005) were significantly more effective against E. faecalis than that of Ca(OH)₂ Plus Point and bioactive glass, respectively. On the other hand, compared with Ca(OH)₂ , CHX gel (P < 0.001), and Activ Point (P < 0.001), bioactive glass (P = 0.014) produced significantly lower colony counts of S. mutans. When compared with the positive control, treatment with Ca(OH)₂ Plus Point (P = 0.085 and P = 0.066) did not produce significantly lower colony counts of E. faecalis and S. mutans, respectively. Compared with the medicaments having an antimicrobial effect because of their alkaline pH, the medicaments containing chlorhexidine were effective against both E. faecalis and S. mutans. © 2012 International Endodontic Journal.

Antimicrobial Activity and Physicochemical Properties of Calcium Hydroxide Pastes Used as Intracanal Medication.

PubMed

Zancan, Rafaela Fernandes; Vivan, Rodrigo Ricci; Milanda Lopes, Marcelo Ribeiro; Weckwerth, Paulo Henrique; de Andrade, Flaviana Bombarda; Ponce, José Burgos; Duarte, Marco Antonio Hungaro

2016-12-01

The aim of the present study was to evaluate the pH, calcium release, solubility, and antimicrobial action against biofilms of calcium hydroxide + saline solution, Calen (SS White Artigos Dentários Ltd, Rio de Janeiro, Brazil) (CH/P), Calen camphorated paramonochlorophenol (CMCP) (CH/CMPC), and calcium hydroxide + chlorhexidine (CH/CHX) pastes. The pH of the pastes was determined with a calibrated pH meter placed in direct contact with each paste. The root canals of acrylic teeth (N = 10) were filled with the previously mentioned intracanal dressings and immersed in ultrapure water to measure hydroxyl (pH meter) and calcium ion release (atomic absorption spectrophotometer) at time intervals of 3, 7, 15, and 30 days. To assess solubility, the root canals of acrylic teeth (N = 10) were filled with the previously mentioned pastes and scanned by micro-computed tomographic imaging before (initial) and after 7, 15, and 30 days of immersion in ultrapure water. The solubility of each specimen was the difference between the initial and final volume scanning. For antimicrobial analysis, monospecies and dual-species biofilms were in vitro induced on dentin blocks (N = 20). Afterward, they were treated with the pastes for 7 days. Live/dead dye and a confocal microscope were used to measure the percentage of living cells. Data were statistically compared (P < .05). The highest OH - ion release values were found in 3 and 30 days. Ca 2+ releases were greater in CH/CMCP. CH/P and CH/CMCP showed a higher percentage of volume loss values. CH/CHX presented the greatest antimicrobial action. CH/P and CH/CMPC showed higher solubility values in the period analyzed. Seven days of contact may be insufficient for calcium hydroxide + saline solution, CH/P, and CH/CMCP pastes to kill bacterial cells in the biofilms studied. Chlorhexidine added to CH favored greater effectiveness against the previously mentioned bacterial biofilms. Copyright © 2016 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Efficacy of various combinations of irrigants and medicaments on Candida albican: An in vitro study.

PubMed

Singh, Mukund; Kasat, Vikrant O

2015-01-01

To evaluate the efficacy of 3% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), calcium hydroxide [Ca (OH)2], and 2% chlorhexidine in various combinations on Candida albicans in root canals for 48 h and 10 days. In this in vitro study, 95 extracted teeth were instrumented. MTCC 183 strain of C. albicans was introduced into the root canals and after 7 days, the average value of colony forming units (CFUs)/ml was determined in all the roots. Then the teeth were randomly divided into three groups: Group I (n = 15) was the control group and only saline was added to it. In group II (n = 40), 3% NaOCl was used as the irrigant and in group III (n = 40), 3% NaOCl and 17% EDTA were used as irrigants. Groups II and III were further divided into two subgroups (A and B) having 20 teeth each. After irrigation, Ca (OH)2 was placed in subgroup A and 2% chlorhexidine digluconate (CHX) solution in subgroup B of both groups as intracanal medicament. After 48 h, the CFUs/ml was determined in 45 teeth (5 from the control group and 10 from each subgroup). After 10 days, the CFUs/ml was determined in the remaining 50 teeth (10 from the control group and 10 from each subgroup). For statistical analysis, Statistical Package for Social Sciences (SPSS version 15, Chicago IL, USA) was used. A decrease in CFUs/ml of C. albicans was noted in all subgroups at 48 h, but the combination of NaOCl, EDTA, and CHX (group IIIB) was the most effective showing value of 0.095 × 10(5) CFUs/ml. On the 10(th) day, the CFUs/ml of C. albicans was further decreased in all subgroups; but again, subgroup IIIB was the most effective showing a value of 0.025 × 10(5) CFUs/ml. There was statistically significant difference in CFUs/ml of C. albicans at 48 h and on 10(th) day in all study groups. The antimicrobial activity of irrigant and intracanal medicament has a positive role in controlling the growth of C. albicans.

Efficacy of various combinations of irrigants and medicaments on Candida albican: An in vitro study

PubMed Central

Singh, Mukund; Kasat, Vikrant O.

2015-01-01

Objective: To evaluate the efficacy of 3% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), calcium hydroxide [Ca (OH)2], and 2% chlorhexidine in various combinations on Candida albicans in root canals for 48 h and 10 days. Materials and Methods: In this in vitro study, 95 extracted teeth were instrumented. MTCC 183 strain of C. albicans was introduced into the root canals and after 7 days, the average value of colony forming units (CFUs)/ml was determined in all the roots. Then the teeth were randomly divided into three groups: Group I (n = 15) was the control group and only saline was added to it. In group II (n = 40), 3% NaOCl was used as the irrigant and in group III (n = 40), 3% NaOCl and 17% EDTA were used as irrigants. Groups II and III were further divided into two subgroups (A and B) having 20 teeth each. After irrigation, Ca (OH)2 was placed in subgroup A and 2% chlorhexidine digluconate (CHX) solution in subgroup B of both groups as intracanal medicament. After 48 h, the CFUs/ml was determined in 45 teeth (5 from the control group and 10 from each subgroup). After 10 days, the CFUs/ml was determined in the remaining 50 teeth (10 from the control group and 10 from each subgroup). For statistical analysis, Statistical Package for Social Sciences (SPSS version 15, Chicago IL, USA) was used. Results: A decrease in CFUs/ml of C. albicans was noted in all subgroups at 48 h, but the combination of NaOCl, EDTA, and CHX (group IIIB) was the most effective showing value of 0.095 × 105 CFUs/ml. On the 10th day, the CFUs/ml of C. albicans was further decreased in all subgroups; but again, subgroup IIIB was the most effective showing a value of 0.025 × 105 CFUs/ml. There was statistically significant difference in CFUs/ml of C. albicans at 48 h and on 10th day in all study groups. Conclusion: The antimicrobial activity of irrigant and intracanal medicament has a positive role in controlling the growth of C. albicans. PMID:26236673

Effects of Diode Laser, Gaseous Ozone, and Medical Dressings on Enterococcus faecalis Biofilms in the Root Canal Ex Vivo

PubMed Central

Vlassakidis, Alexander; Niepel, Mediha; Hoedke, Daniela; Schulze, Julia; Neumann, Konrad; Moter, Annette; Noetzel, Jörn

2017-01-01

The objective was to compare the antibacterial effects of adjunctive disinfection using diode laser and gaseous ozone compared to the medical dressings calcium hydroxide (Ca(OH)2) and chlorhexidine gel (CHX-Gel) on Enterococcus faecalis biofilms in human root canals ex vivo. Root canals of 180 human extracted teeth were infected by E. faecalis and divided into 3 main groups (G): G1, control; G2, instrumentation and irrigation using 0.9% NaCl; G3, instrumentation and irrigation using 1% NaOCl. In each main group, the following treatments were applied: gaseous ozone, diode laser, and medical dressings of Ca(OH)2 or CHX-Gel for 7 days (n = 15). Reduction of colony forming units (CFUs) inside the root canal of planktons and frequencies of adherent bacteria after treatment were calculated. Bacterial reduction was significantly affected by the irrigation protocol (p < 0.0005) and the disinfection method (p < 0.0005), and a significant interaction between both factors could be observed (p < 0.0005; ANOVA). In G3 (instrumentation using 1% NaOCl), no significant effect of disinfection methods could be demonstrated on planktonic bacteria (p = 0.062; ANOVA) and frequencies of adherent bacteria (p > 0.05; chi-square test). Instrumentation and irrigation using NaOCl combined with ozone or laser application resulted in comparable bacterial reduction on E. faecalis to the application of medical dressings. PMID:28567421

Cleaning capacity of octenidine as root canal irrigant: A scanning electron microscopy study.

PubMed

Coaguila-Llerena, Hernán; Stefanini da Silva, Virgínia; Tanomaru-Filho, Mario; Guerreiro Tanomaru, Juliane Maria; Faria, Gisele

2018-06-01

The aim of this study was to assess the cleaning capacity of the octenidine hydrochloride (OCT) used as root canal irrigant by scanning electron microscopy (SEM) analysis. Sixty human unirradicular extracted teeth were randomly distributed in 6 groups (n = 10) according to irrigant solutions which were used during root canal preparation: G1, 0.1% OCT; G2, 2% chlorhexidine (CHX); G3, 2.5% sodium hypochlorite (NaOCl); G4, OCT + 17% ethylenediaminetetraacetic acid (EDTA); G5, 2.5% NaOCl + 17% EDTA and G6, distilled water. All specimens were instrumented with ProTaper system up to F4. Teeth were sectioned and prepared for SEM. The smear layer was evaluated using a 5-score system and the data were analyzed by Kruskal-Wallis and Dunn (α = 0.05). In all root canal thirds there was no significant difference between OCT, CHX, NaOCl, and water groups (p > .05), and these groups showed higher smear layer values than NaOCl + EDTA and OCT + EDTA groups (p < .05). There was no significant difference between NaOCl + EDTA and OCT + EDTA groups (p > .05). It was concluded that OCT used as a single root canal irrigant presented poor cleaning capacity and could be used in association with a final irrigation with EDTA to obtain smear layer removal. © 2018 Wiley Periodicals, Inc.

Effects of sub-minimum inhibitory concentrations of antimicrobial agents on Streptococcus mutans biofilm formation.

PubMed

Dong, Liping; Tong, Zhongchun; Linghu, Dake; Lin, Yuan; Tao, Rui; Liu, Jun; Tian, Yu; Ni, Longxing

2012-05-01

Many studies have demonstrated that sub-minimum inhibitory concentrations (sub-MICs) of antimicrobial agents can inhibit bacterial biofilm formation. However, the mechanisms by which antimicrobial agents at sub-MICs inhibit biofilm formation remain unclear. At present, most studies are focused on Gram-negative bacteria; however, the effects of sub-MICs of antimicrobial agents on Gram-positive bacteria may be more complex. Streptococcus mutans is a major cariogenic bacterium. In this study, the S. mutans growth curve as well as the expression of genes related to S. mutans biofilm formation were evaluated following treatment with 0.5× MIC of chlorhexidine (CHX), tea polyphenols and sodium fluoride (NaF), which are common anticaries agents. The BioFlux system was employed to generate a biofilm under a controlled flow. Morphological changes of the S. mutans biofilm were observed and analysed using field emission scanning electron microscopy and confocal laser scanning microscopy. The results indicated that these three common anticaries agents could significantly upregulate expression of the genes related to S. mutans biofilm formation, and S. mutans exhibited a dense biofilm with an extensive extracellular matrix following treatment with sub-MICs of NaF and CHX. These findings suggest that sub-MICs of anticaries agents favour S. mutans biofilm formation, which might encourage dental caries progression. Copyright © 2012 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

Evaluation of protocol change in burn-care management using the Cox proportional hazards model with time-dependent covariates.

PubMed

Ichida, J M; Wassell, J T; Keller, M D; Ayers, L W

1993-02-01

Survival analysis methods are valuable for detecting intervention effects because detailed information from patient records and sensitive outcome measures are used. The burn unit at a large university hospital replaced routine bathing with total body bathing using chlorhexidine gluconate for antimicrobial effect. A Cox proportional hazards model was used to analyse time from admission until either infection with Staphylococcus aureus or discharge for 155 patients, controlling for burn severity and two time-dependent covariates: days until first wound excision and days until first administration of prophylactic antibiotics. The risk of infection was 55 per cent higher in the historical control group, although not statistically significant. There was also some indication that early wound excision may be important as an infection-control measure for burn patients.

Growth Media Affect Assessment of Antimicrobial Activity of Plant-Derived Polyphenols.

PubMed

Xu, Xin; Ou, Zhen M; Wu, Christine D

2018-01-01

This study aimed to investigate the effects of different microbial growth media on the laboratory assessment of antimicrobial activity of natural polyphenolic compounds. The inhibition of the tea polyphenol EGCG on growth of selected oral microorganisms was evaluated in complex media and a protein-free chemically defined medium (CDM). Other antimicrobial agents (polyphenolic grape seed extract, plant alkaloid berberine, methyl salicylate, and chlorhexidine gluconate) were also tested in the study. The presence of proteins and their effects on the antimicrobial activity of EGCG were investigated by the addition of BSA to the CDM. The MICs of EGCG against test oral microorganisms were 4 to 64 times higher in complex media than in CDM. The polyphenolic grape seed extract exhibited similar discrepancies. However, the MICs of the nonpolyphenolic compounds (berberine, methyl salicylate, and chlorhexidine) were not significantly different between the two growth media. The MIC of EGCG against S. mutans UA159 in CDM with added BSA was 16 times higher than that in CDM alone. Therefore, nonproteinaceous CDM should be used to avoid interference of proteins with the active ingredients when testing the antimicrobial activity of plant-derived polyphenolic compounds against microorganisms. This will also minimize the discrepancies noted in results obtained by different investigators.

Evaluation of antibacterial efficacy of biosynthesized silver nanoparticles derived from fungi against endo-perio pathogens Porphyromonas gingivalis, Bacillus pumilus, and Enterococcus faecalis

PubMed Central

Halkai, Kiran Rahul; Mudda, Jayashree A.; Shivanna, Vasundhara; Rathod, Vandana; Halkai, Rahul S.

2017-01-01

Background: Even after rapid progress in contemporary dental practice, we encounter the failures due to endodontic, periodontal, or combined lesions. Complex anatomy of tooth and resistant microbes demands the development of new treatment strategies. Aim: The aim of this study is to biosynthesize silver nanoparticles (AgNPs) using fungi and determine the antibacterial efficacy against Porphyromonas gingivalis, Bacillus pumilus, and Enterococcus faecalis. Materials and Methods: Fungi isolated from healthy leaves of Withania somnifera were used to biosynthesize AgNPs. The biosynthesized AgNPs were characterized by different methods, and antibacterial efficacy was evaluated by agar well diffusion method measuring the zone of inhibition. Test microorganisms were divided as Group 1: B. pumilus 27142 (American Type Culture Collection [ATCC]), Group 2: E. faecalis 29212 (ATCC), and Group 3: P. gingivalis 33277 (ATCC). Agents used for antibacterial efficacy were grouped as: AgNPs: A (20 μl), B (40 μl), C (60 μl), D (80 μl), E (100 μl), F (0.2% chlorhexidine [CHX]), G (2% CHX), H (Ampicillin), and I (sterile distilled water). Results: Characterization studies showed the color change from colorless to reddish brown color; ultraviolet spectrum showed peak at 420 nm, transmission electron microscope revealed the particles spherical in shape and 10–20 nm size. Fourier transform infrared spectroscopy analysis revealed the presence of functional groups. Data collected for antibacterial efficacy were analyzed using one-way ANOVA and post hoc Tukey's multiple shows no significant difference among three groups (P < 0.0001). AgNPs were as effective as CHX and positive control ampicillin. No zones were seen for I (distilled water). Conclusion: Biosynthesized AgNPs showed efficient antibacterial efficacy. Therefore, it creates a new horizon in the management of endodontic, periodontal, and combined lesions. PMID:29430090

A holistic approach to MRSA eradication in critically ill patients with MRSA pneumonia.

PubMed

Wenisch, C; Laferl, H; Szell, M; Smolle, K H; Grisold, A; Bertha, G; Krause, R

2006-06-01

The number of Methicillin-resistant Staphylococcus aureus (MRSA) pneumonia cases is increasing in many European countries. In this observational study in one medical and three surgical ICUs multiple interventions for the treatment and eradication of nosocomial MRSA-pneumonia were used. Twenty-one critically ill patients (age: 59 +/- 14 years, 15 males/6 females, 18 ventilator-associated, 3 nosocomial, clinical pulmonary infection score > 6 in all patients, APACHE II 18 +/- 5) were enrolled. The patients were treated with a 7-day course of iv linezolid (600 mg bid) plus rifampicin (600 mg bid), endotracheal vancomycin 100 mg qid, thrice daily mouth and throat washing with chlorhexidine 1% fluid and nasal mupirocin ointment, twice daily skin and hair washings with chlorhexidine gluconate 4% and tracheostomy (n = 8) wound care with povidone-iodine spray. Control samples (endotracheal secretions, nose, wound, and pharyngeal swabs) were taken 2, 3, 4, 7 days and 2 months thereafter. Multilobular pneumonia was seen in 16, pleural effusion in 12, and MRSA bacteremia in 4 patients. One patient died during the follow-up period due to cerebral bleeding. In the remaining 20 patients, pneumonia was clinically cured in all patients and all patients were free of MRSA after eradication. Six patients died due to myocardial infarction (n = 3), gram-negative septic shock (n = 2), herpes encephalitis (n = 1) > 7 days after eradication. No MRSA reinfection occurred during the control period. We conclude that in patients with MRSA pneumonia an approach using a 7-day course of intravenous linezolid plus rifampicin, intratracheal vancomycin, nasal mupirocin, cutaneous and oropharyngeal chlorhexidin plus povidone-iodine cures pneumonia and is effective for MRSA eradication.

Evaluation of a waterless, scrubless chlorhexidine gluconate/ethanol surgical scrub for antimicrobial efficacy.

PubMed

Mulberrry, G; Snyder, A T; Heilman, J; Pyrek, J; Stahl, J

2001-12-01

A new waterless surgical hand preparation containing 1% chlorhexidine gluconate (CHG) and 61% ethyl alcohol was evaluated for antimicrobial efficacy in comparison with a standard 4% CHG surgical scrub and a 61% ethyl alcohol control. Clinical studies were based on the Tentative Final Monograph for Health-Care Antiseptic Drug Products (TFM) (proposed rule) and the Standard Test Method for Evaluation of Surgical Hand Scrub Formulations (ASTM E1115-91). Two randomized, blinded, well-controlled clinical studies involving 137 healthy subjects were conducted to evaluate the antimicrobial effectiveness of the CHG/ethanol hand preparation in producing an immediate and persistent reduction in the normal bacterial flora of the hands. The CHG/ethanol hand preparation was applied without scrubbing or the use of water, and a standard 4% CHG reference product was applied with a scrub brush in 2 traditional 3-minute surgical scrubs. In 1 study, a 61% ethanol vehicle control treatment was applied without scrubbing or use of water. During a 5-day period, each study subject performed a series of 11 surgical scrubs with 1 of the test treatments. After the first treatment on days 1, 2, and 5, surgical gloves were worn for 3 or 6 hours. Bacterial samples were taken with the glove-juice technique at 1 minute, 3 hours, and 6 hours after treatment. The immediate bactericidal effect of the CHG/ethanol hand preparation after a single application resulted in a 2.5-log reduction in normal flora. This bactericidal effect persisted throughout the studies and eventually increased to a 3.6-log reduction after the 11th scrub on day 5. The log reductions of the CHG/ethanol hand preparation proved to be significantly better (P <.05) than that of the 4% CHG product at each sampling interval on days 1 and 2 and the sampling at 6 hours on day 5 and significantly better than the 61% ethanol vehicle at all times. The combination of 1% CHG and 61% ethanol had significantly greater microbial reduction than either the 4% CHG (without ethanol) or the 61% ethanol vehicle (without CHG).

Waterless Hand Rub Versus Traditional Hand Scrub Methods for Preventing the Surgical Site Infection in Orthopedic Surgery.

PubMed

Iwakiri, Kentaro; Kobayashi, Akio; Seki, Masahiko; Ando, Yoshiyuki; Tsujio, Tadao; Hoshino, Masatoshi; Nakamura, Hiroaki

2017-11-15

MINI: Fourteen hundred consecutive patients were investigated for evaluating the utility of waterless hand rub before orthopaedic surgery. The risk in the surgical site infection incidence was the same, but costs of liquids used for hand hygiene were cheaper and the hand hygiene time was shorter for waterless protocol, compared with traditional hand scrub. A retrospective cohort study with prospectively collected data. The aim of this study was to compare SSI incidences, the cost of hand hygiene agents, and hand hygiene time between the traditional hand scrub and the waterless hand rub protocols before orthopedic surgery. Surgical site infections (SSI) prolong hospitalization and are a leading nosocomial cause of morbidity and a source of excess cost. Recently, a waterless hand rub protocol comprising alcohol based chlorhexidine gluconate for use before surgery was developed, but no studies have yet examined its utility in orthopedic surgery. Fourteen hundred consecutive patients who underwent orthopedic surgery (spine, joint replacement, hand, and trauma surgeries) in our hospital since April 1, 2012 were included. A total of 712 cases underwent following traditional hand scrub between April 1, 2012 and April 30, 2013 and 688 cases underwent following waterless hand rub between June 1, 2013 and April 30, 2014. We compared SSI incidences within all and each subcategory between two hand hygiene protocols. All patients were screened for SSI within 1 year after surgery. We compared the cost of hand hygiene agents and hand hygiene time between two groups. The SSI incidences were 1.3% (9 of 712) following the traditional protocol (2 deep and 7 superficial infections) and 1.1% (8 of 688) following the waterless protocol (all superficial infections). There were no significant differences between the two groups. The costs of liquids used for one hand hygiene were about $2 for traditional hand scrub and less than $1 for waterless hand rub. The mean hand hygiene time was 264 seconds with the traditional protocol and 160 seconds with the waterless protocol. Waterless hand rub with an alcohol based chlorhexidine gluconate solution can be a safe, quick, and cost-effective alternative to traditional hand scrub. 3.

Comparison of the antimicrobial efficacy of povidone-iodine, povidone-iodine-ethanol and chlorhexidine gluconate-ethanol surgical scrubs.

PubMed

Nishimura, Chieko

2006-01-01

Scrubbing of the hands and forearms with a brush and antiseptic agents has been the standard for surgical practice. However, it has been increasingly recognized that brush scrubbing may provoke side effects and that an alcohol-based hand antiseptic used in conjunction with a scrub agent enhances the effectiveness. In this study, two types of alcohol-based agents were used after a povidone-iodine (PVP-I) scrub and compared for their effectiveness. The study was conducted as a crossover trial with 20 volunteers. After hand rubbing with PVP-I, either PVP-I-ethanol rubbing or chlorhexidine gluconate-ethanol (CHG-ethanol) rubbing was used for surgical hand cleansing. Samples were collected by the modified glove juice method to count bacteria on hands. In both groups, the bacterial count was significantly reduced after handwashing (p < 0.001), and the reduction was still significant after 2 h (p < 0.001 for PVP-I-ethanol and p < 0.002 for CHG-ethanol). The log(10) reduction factor (RF) in the PVP-I-ethanol group was significantly higher than that in the CHG-ethanol group immediately after handwashing (p < 0.001) but significantly lowered after 2 h (p < 0.01) to the level similar to that of CHG-ethanol. Although RF was lower in the CHG-ethanol group immediately after and 2 h after handwashing compared to the PVP-I-ethanol group, it did not decrease with time. Brushless surgical scrubbing with PVP-I-ethanol or CHG-ethanol in conjunction with PVP-I showed antiseptic effects immediately after and 2 h after handwashing. RF immediately after handwashing was significantly higher with PVP-I-ethanol compared to CHG-ethanol, but it was similar in both groups after 2 h. These results suggest that when used in combination with a PVP-I scrub, an alcohol-based hand antiseptic containing the same active agent (PVP-I in this study) has a powerful antiseptic effect; however, when it contains different antiseptic agents (i.e. CHG in this study), it should be selected carefully based on its antiseptic property.

Efficacy of red propolis hydro-alcoholic extract in controlling Streptococcus mutans biofilm build-up and dental enamel demineralization.

PubMed

Martins, Mariana Leonel; Leite, Karla Lorene de França; Pacheco-Filho, Edivaldo Ferreira; Pereira, Adriana Farah de Miranda; Romanos, Maria Teresa Villela; Maia, Lucianne Cople; Fonseca-Gonçalves, Andréa; Padilha, Wilton Wilney Nascimento; Cavalcanti, Yuri Wanderley

2018-05-23

The efficacy of a red propolis hydro-alcoholic extract (RP) in controlling Streptococcus mutans biofilm colonization was evaluated. The effect of RP on dental demineralization was also investigated. Chemical composition was determined by High Performance Liquid Chromatography (HPLC). Minimum Inhibitory and Bactericidal Concentration (MIC and MBC, respectively) were investigated against Streptococcus mutans (ATCC 25175). The cytotoxic potential of 3% RP in oral fibroblasts was observed after 1 and 3 min. Bovine dental enamel blocks (N = 24) were used for S. mutans biofilm formation (48 h), simulating 'feast or famine' episodes. Blocks/biofilms were exposed 2×/day, for 3 days, to a cariogenic challenge with sucrose 10% (5 min) and treated (1 min) with: 0.85% saline solution (negative control), 0.12% Chlorhexidine (CHX, positive control for biofilm colonization), 0.05% Sodium Fluoride (NaF, positive control to avoid demineralization) and 3% RP. Biofilms were assessed for viability (CFU/mL), and to observe the concentration of soluble and insoluble extracellular polysaccharides (SEPS and IEPS). Dental demineralization was assessed by the percentage of surface hardness loss (%SHL) and through polarized light microscopy (PLM). The RP presented 4.0 pH and ºBrix = 4.8. The p-coumaric acid (17.2 μg/mL) and luteolin (15.23 μg/mL) were the largest contents of phenolic acids and flavonoids, respectively. MIC and MBC of RP were 293 μg/mL and 1172 μg/mL, respectively. The 3% RP showed 43% of viably cells after 1 min. Lower number (p < 0.05) of viable bacteria (CFU/mL) was observed after CHX (1.8 × 10 5 ) followed by RP (1.8 × 10 7 ) treatments. The lowest concentration (μg/CFU) of SEPS (12.6) and IEPS (25.9) was observed in CHX (p < 0.05) followed by RP (17.1 and 54.3), and both differed from the negative control (34.4 and 63.9) (p < 0.05). Considering the %SHL, all groups differed statistically (p < 0.05) from the negative control (46.6%); but NaF (13.9%), CHX (20.1%) and RP (20.7%) did not differ among them (p > 0.05). After all treatments, suggestive areas of caries lesions were observed by PLM, which were lower for CHX and NaF. The 3% RP reduced S. mutans colonization, decreased concentration of extracellular polysaccharides and reduced dental enamel demineralization. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cytotoxicity, interaction with dentine and efficacy on multispecies biofilms of a modified salt solution intended for endodontic disinfection in a new in vitro biofilm model.

PubMed

van der Waal, S V; Scheres, N; de Soet, J J; Wesselink, P R; Crielaard, W

2015-02-01

To investigate the cytotoxicity of a modified salt solution (MSS) and evaluate the antimicrobial properties of MSS on in vitro biofilm models. In a metabolic assay, fibroblasts derived from periodontal ligaments (PDL) of human extracted teeth were cultured and challenged with MSS or controls. Then, in active attachment biofilm models, the efficacy of MSS in the presence of dentine powder and in eliminating mature biofilms was investigated. In the dentine assay, a biofilm of Enterococcus faecalis was employed. For the final assay, microorganisms were retrieved from infected root canals and cultured to produce biofilms. After the treatments with MSS or the controls, the biofilms were collected, serially diluted and plated. The colony-forming units were counted. One-way anova was used to analyse the differences between the groups. A P < 0.05 was considered significant. The PDL fibroblasts remained metabolically active after challenges with MSS. Dentine powder did not alter the efficacy of MSS (P > 0.05). In endodontic biofilms, the culturable bacteria were equally reduced by MSS, 2% chlorhexidine (CHX) or 2% sodium hypochlorite (NaOCl) (P > 0.05). Modified salt solution is noncytotoxic in vitro and has good antimicrobial properties equal to CHX and NaOCl. Although the results are promising, ex vivo and in vivo studies are needed before its use as an interappointment root canal dressing can be considered. © 2014 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Antimicrobial Penetration and Efficacy in an In Vitro Oral Biofilm Model ▿ †

PubMed Central

Corbin, Audrey; Pitts, Betsey; Parker, Albert; Stewart, Philip S.

2011-01-01

The penetration and overall efficacy of six mouthrinse actives was evaluated by using an in vitro flow cell oral biofilm model. The technique involved preloading biofilm cells with a green fluorescent dye that leaked out as the cells were permeabilized by a treatment. The loss of green color, and of biomass, was observed by time-lapse microscopy during 60 min of treatment under continuous flow conditions. The six actives analyzed were ethanol, sodium lauryl sulfate, triclosan, chlorhexidine digluconate (CHX), cetylpyridinium chloride, and nisin. Each of these agents effected loss of green fluorescence throughout biofilm cell clusters, with faster action at the edge of a cell cluster and slower action in the cluster center. The time to reach half of the initial fluorescent intensity at the center of a cell cluster, which can be viewed as a combined penetration and biological action time, ranged from 0.6 to 19 min for the various agents. These times are much longer than the predicted penetration time based on diffusion alone, suggesting that anti-biofilm action was controlled more by the biological action time than by the penetration time of the active. None of the agents tested caused any removal of the biofilm. The extent of fluorescence loss after 1 h of exposure to an active ranged from 87 to 99.5%, with CHX being the most effective. The extent of fluorescence loss in vitro, but not penetration and action time, correlated well with the relative efficacy data from published clinical trials. PMID:21537022

Necrotizing Sialometaplasia of the Hard Palate in a Patient Treated with Topical Nonsteroidal Anti-Inflammatory Drug.

PubMed

Gatti, Alessandro; Broccardo, Emanuele; Poglio, Giuseppe; Benech, Arnaldo

2016-01-01

Necrotizing sialometaplasia is a rare, benign, self-limiting, necrotizing process involving the minor salivary glands, mainly the mucoserous glands of the hard palate. It is thought to be the result of an ischemic event of the vasculature supplying the salivary gland lobules. Some predisposing factors such as smoking, use of alcohol, denture wearing, recent surgery, traumatic injuries, respiratory infections, systemic diseases bulimia, and anorexia have been described. Herein we present a case of necrotizing sialometaplasia of the hard palate in a patient without known predisposing factors, in our opinion, resulting from the use of topical anti-inflammatory drug. After diagnosis, the patient underwent treatment with chlorhexidine gluconate and a full palatal acrylic guard to protect the exposed bone from food residues during meals. After the sixth week the lesion regressed.

Combination Effect of Hemostatic and Disinfecting Agents on Micro-leakage of Restorations Bonded with Different Bonding Systems

PubMed Central

H, Farhadpour; F, Sharafeddin; Sc, Akbarian; B, Azarian

2016-01-01

Statement of Problem: Hemostatic agents may affect the micro-leakage of different adhesive systems. Also, chlorhexidine has shown positive effects on micro-leakage. However, their interaction effect has not been reported yet. Objectives: To evaluate the effect of contamination with a hemostatic agent on micro-leakage of total- and self-etching adhesive systems and the effect of chlorhexidine application after the removal of the hemostatic agent. Materials and Methods: Standardized Class V cavity was prepared on each of the sixty caries free premolars at the cemento-enamel junction, with the occlusal margin located in enamel and the gingival margin in dentin. Then, the specimens were randomly divided into 6 groups (n = 10) according to hemostatic agent (H) contamination, chlorhexidine (CHX) application, and the type of adhesive systems (Adper Single Bond and Clearfil SE Bond) used. After filling the cavities with resin composite, the root apices were sealed with utility wax. Furthermore, all the surfaces, except for the restorations and 1mm from the margins, were covered with two layers of nail varnish. The teeth were immersed in a 0.5% basic fuschin dye for 24 hours, rinsed, blot-dried and sectioned longitudinally through the center of the restorations bucco- lingualy. The sections were examined using a stereomicroscope and the extension of dye penetration was analyzed according to a non-parametric scale from 0 to 3. Statistical analysis was performed using Kruskal-Wallis test and Mann-Whitney U-test. Results: While ASB group showed no micro-leakage in enamel, none of the groups showed complete elimination of micro-leakage from the dentin. Regarding micro-leakage at enamel, and dentin margins, there was no significant difference between groups 1 and 2, 1 and 3, and 2 and 3 (p > 0.05). A significantly lower micro-leakage at the enamel and dentin margins was observed in group 3, compared to group 6. No significant difference was observed between groups 4 and 5 in enamel (p = 0.35) and dentin (p = 0.34). Group 6 showed significantly higher micro-leakage, compared to group 4 and 5 (p < 0.05). Conclusions: Hemostatic agent contamination had no significant effect on micro-leakage of total- and self-etching adhesive systems. Application of chlorhexidine after the removal of hemostatic agent increased micro-leakage in self-etching adhesives but did not affect when total-etching was used. PMID:28959756

Accuracy of Turbidimetric Limulus Amebocyte Lysate Assay for the Recovery of Endotoxin Interacted with Commonly Used Antimicrobial Agents of Endodontic Therapy.

PubMed

Marinho, Ariane C S; Polay, Ana R O; Gomes, Brenda P F A

2015-10-01

This study was conducted to investigate whether the interaction between the turbidimetric limulus amebocyte lysate (LAL) substrate for endotoxin measurement and the substances/antimicrobial agents used in endodontic therapy can lead to the inhibition/enhancement of endotoxin recovery. Ten microliters of a suspension of Escherichia coli endotoxin (O55:B55) was inoculated and kept in contact for 1 hour with different substances categorized as follows: group 1: auxiliary chemical substances: 5.25% and 2.5% sodium hypochlorite solutions, 2% chlorhexidine (CHX) (gel and solution), 1% Natrosol gel (Drogal Chemicals and Pharmaceuticals Ltd, Piracicaba, SP, Brazil), 17% EDTA, 10% citric acid, 3% hydrogen peroxide, 5% sodium thiosulfate, and 0.5% Tween 80 associated with 0.07% soy lecithin (Drogal Chemicals and Pharmaceuticals Ltd) and group 2: intracanal medications: neomycin/polymyxin B/hydrocortisone (Otosporin; Glaxo Wellcome, Rio de Janeiro, RJ, Brazil); calcium hydroxide (Ca[OH]2); Ca(OH)2 + 2% CHX gel; Ca(OH)2 + 2% CHX gel + zinc oxide eugenol; Ca(OH)2 + camphorated paramonochlorophenol (Calen; S.S. White, Rio de Janeiro, RJ, Brazil); triple antibiotic paste; mineral trioxide aggregate (MTA); and iodoform. Positive and negative controls consisted of root canal hemorrhagic exudate and pyrogen-free sterile water, respectively. All samples were diluted up to a 10:4 dilution. Each dilution was individually examined by the turbidimetric LAL assay. Collected data were analyzed through performance characteristics of the LAL assay such as linearity, coefficient of variation percentage, and product positive control (PPC) values. Correlation coefficient (≥0.980) and coefficient of variation percentage (<10%) of the standard curve in triplicate showed the tests' linearity. Spike recovery of auxiliary chemical substances achieved PPC values ranging from 50%-197%, showing no interferences with LAL substrate. Conversely, 3% hydrogen peroxide achieved product inhibition in which endotoxin values were underestimated even after the 10:4 dilutions. Regarding intracanal medicaments, neomycin/polymyxin B/hydrocortisone also inhibited endotoxin detection in all dilutions investigated (PPC values <50%). In contrast, Ca(OH)2 + 2% CHX gel + ZOE as well as triple antibiotic paste led to the enhancement of endotoxin detection in which endotoxin values could not be validated by the turbidimetric kinetic LAL assay (PPC value >200%). The performance characteristics of the kinetic turbidimetric assay for endotoxin measurement, such as precision and reproducibility, are modulated by the interaction of the LAL substrate with the substances/antimicrobial agents used in endodontic therapy. Copyright © 2015 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Effect of Twice-Daily Blue Light Treatment on Matrix-Rich Biofilm Development.

PubMed

de Sousa, Denise Lins; Lima, Ramille Araújo; Zanin, Iriana Carla; Klein, Marlise I; Janal, Malvin N; Duarte, Simone

2015-01-01

The use of blue light has been proposed as a direct means of affecting local bacterial infections, however the use of blue light without a photosensitizer to prevent the biofilm development has not yet been explored. The aim of this study was to determine how the twice-daily treatment with blue light affects the development and composition of a matrix-rich biofilm. Biofilms of Streptococcus mutans UA159 were formed on saliva-coated hydroxyapatite discs for 5 days. The biofilms were exposed twice-daily to non-coherent blue light (LumaCare; 420 nm) without a photosensitizer. The distance between the light and the sample was 1.0 cm; energy density of 72 J cm-2; and exposure time of 12 min 56 s. Positive and negative controls were twice-daily 0.12% chlorhexidine (CHX) and 0.89% NaCl, respectively. Biofilms were analyzed for bacterial viability, dry-weight, and extra (EPS-insoluble and soluble) and intracellular (IPS) polysaccharides. Variable pressure scanning electron microscopy and confocal scanning laser microscopy were used to check biofilm morphology and bacterial viability, respectively. When biofilms were exposed to twice-daily blue light, EPS-insoluble was reduced significantly more than in either control group (CHX and 0.89% NaCl). Bacterial viability and dry weight were also reduced relative to the negative control (0.89% NaCl) when the biofilms were treated with twice-daily blue light. Different morphology was also visible when the biofilms were treated with blue light. Twice-daily treatment with blue light without a photosensitizer is a promising mechanism for the inhibition of matrix-rich biofilm development.

The synthetic human beta-defensin-3 C15 peptide exhibits antimicrobial activity against Streptococcus mutans, both alone and in combination with dental disinfectants.

PubMed

Ahn, Ki Bum; Kim, A Reum; Kum, Kee-Yeon; Yun, Cheol-Heui; Han, Seung Hyun

2017-10-01

Streptococcus mutans is a major etiologic agent of human dental caries that forms biofilms on hard tissues in the human oral cavity, such as tooth and dentinal surfaces. Human β-defensin-3 (HBD3) is a 45-amino-acid natural antimicrobial peptide that has broad spectrum antimicrobial activity against bacteria and fungi. A synthetic peptide consisting of the C-terminal 15 amino acids of HBD3 (HBD3-C15) was recently shown to be sufficient for its antimicrobial activity. Thus, clinical applications of this peptide have garnered attention. In this study, we investigated whether HBD3-C15 inhibits the growth of the representative cariogenic pathogen Streptococcus mutans and its biofilm formation. HBD3-C15 inhibited bacterial growth, exhibited bactericidal activity, and attenuated bacterial biofilm formation in a dose-dependent manner. HBD3-C15 potentiated the bactericidal and anti-biofilm activity of calcium hydroxide (CH) and chlorhexidine digluconate (CHX), which are representative disinfectants used in dental clinics, against S. mutans. Moreover, HBD3-C15 showed antimicrobial activity by inhibiting biofilm formation by S. mutans and other dentinophilic bacteria such as Enterococcus faecalis and Streptococcus gordonii, which are associated with dental caries and endodontic infection, on human dentin slices. These effects were observed for HBD3-C15 alone and for HBD3-C15 in combination with CH or CHX. Therefore, we suggest that HBD3-C15 is a potential alternative or additive disinfectant that can be used for the treatment of oral infectious diseases, including dental caries and endodontic infections.

Implant decontamination during surgical peri-implantitis treatment: a randomized, double-blind, placebo-controlled trial.

PubMed

de Waal, Yvonne C M; Raghoebar, Gerry M; Huddleston Slater, James J R; Meijer, Henny J A; Winkel, Edwin G; van Winkelhoff, Arie Jan

2013-02-01

The objective of this randomized, double-blind, placebo-controlled trial was to study the effect of implant surface decontamination with chlorhexidine (CHX)/cetylpyridinium chloride (CPC) on microbiological and clinical parameters. Thirty patients (79 implants) with peri-implantitis were treated with resective surgical treatment consisting of apically re-positioned flap, bone re-contouring and surface debridement and decontamination. Patients were randomly allocated to decontamination with 0.12% CHX + 0.05% CPC (test-group) or a placebo-solution (without CHX/CPC, placebo-group). Microbiological parameters were recorded during surgery; clinical and radiographical parameters were recorded before (pre-) treatment (baseline), and at 3, 6 and 12 months after treatment. Nine implants in two patients in the placebo-group were lost due to severe persisting peri-implantitis. Both decontamination procedures resulted in significant reductions of bacterial load on the implant surface, but the test-group showed a significantly greater reduction than the placebo-group (log 4.21 ± 1.89 versus log 2.77 ± 2.12, p = 0.006). Multilevel analysis showed no differences between both groups in the effect of the intervention on bleeding, suppuration, probing pocket depth and radiographical bone loss over time. Implant surface decontamination with 0.12% CHX + 0.05% CPC in resective surgical treatment of peri-implantitis leads to a greater immediate suppression of anaerobic bacteria on the implant surface than a placebo-solution, but does not lead to superior clinical results. The long-term microbiological effect remains unknown. © 2012 John Wiley & Sons A/S.

The Probable Effect of Irrigation Solution and Time on Bond Strength to Coronal Dentin: An In Vitro Evaluation.

PubMed

Mokhtari, Fatemeh; Anvar, Ehsan; Mirshahpanah, Mostafa; Hemati, Hamidreza; Danesh Kazemi, Alireza

2017-01-01

The aim of this study was to evaluate the effect of root canal irrigants on the microtensile bond strength of 2-step self-etch adhesive to dentin. n this study 36 sound extracted human third molars were used. After grinding 3 mm of occlusal surface, teeth were randomly divided into 6 groups based on irrigation material naming normal saline, 5.25% sodium hypochlorite (NaOCl) and 2% chlorhexidine (CHX) and also irrigation time (5 or 30 min). Next, teeth were restored with Clearfil SE bond adhesive resin system and Z250 composite. The teeth were then thermo cycled by thermo cycling machine, for 500 cycles between 5 º and 55 º C with 60 sec dwell time and 12 sec transfer time. All samples were sectioned into bucco-lingual slabs. The sections were submitted to the micro tensile testing machine at a crosshead speed of 0.5 mm/min until fracture. Data was analyzed using the one-way ANOVA test with the level of significance set at 0.05. Irrigation with normal saline, 5.25% NaOCl and 2% CHX for 5 or 30 min did not significantly change the microtensile bond strength of adhesive to dentin ( P =0.729 for time and P =0.153 for material). However the maximum and minimum microtensile bond strength was attributed to normal saline (44.13 N) and NaOCl (31.29 N) groups, respectively. Iirrigation solution and time have no influence on microtensile bond strength of two-step self-etch adhesive to coronal dentin.

The Probable Effect of Irrigation Solution and Time on Bond Strength to Coronal Dentin: An In Vitro Evaluation

PubMed Central

Mokhtari, Fatemeh; Anvar, Ehsan; Mirshahpanah, Mostafa; Hemati, Hamidreza; Danesh Kazemi, Alireza

2017-01-01

Introduction: The aim of this study was to evaluate the effect of root canal irrigants on the microtensile bond strength of 2-step self-etch adhesive to dentin. Methods and Materials: n this study 36 sound extracted human third molars were used. After grinding 3 mm of occlusal surface, teeth were randomly divided into 6 groups based on irrigation material naming normal saline, 5.25% sodium hypochlorite (NaOCl) and 2% chlorhexidine (CHX) and also irrigation time (5 or 30 min). Next, teeth were restored with Clearfil SE bond adhesive resin system and Z250 composite. The teeth were then thermo cycled by thermo cycling machine, for 500 cycles between 5º and 55ºC with 60 sec dwell time and 12 sec transfer time. All samples were sectioned into bucco-lingual slabs. The sections were submitted to the micro tensile testing machine at a crosshead speed of 0.5 mm/min until fracture. Data was analyzed using the one-way ANOVA test with the level of significance set at 0.05. Results: Irrigation with normal saline, 5.25% NaOCl and 2% CHX for 5 or 30 min did not significantly change the microtensile bond strength of adhesive to dentin (P=0.729 for time and P=0.153 for material). However the maximum and minimum microtensile bond strength was attributed to normal saline (44.13 N) and NaOCl (31.29 N) groups, respectively. Conclusion: Iirrigation solution and time have no influence on microtensile bond strength of two-step self-etch adhesive to coronal dentin. PMID:29225638

Effect of different irrigation protocols on the radicular dentin interface and bond strength with a metacrylate-based endodontic sealer.

PubMed

Gonçalves, Lisandro; Silva-Sousa, Yara Teresinha Correa; Raucci Neto, Walter; Teixeira, Cleonice Silveira; Sousa-Neto, Manoel Damião; Alfredo, Edson

2014-06-01

This study assessed the influence of different endodontic chemical substances on the adhesion of the Epiphany SE/Resilon system (with and without resinous solvent) to radicular dentin walls, using the push-out test and scanning electron microscopy (SEM). Forty-eight root canals of human canines were prepared biomechanically with ProTaper rotary files (crown-down technique) and the radicular dentin was treated with either 17% EDTA, 2% chlorhexidine gel (CHX) or 2.5% NaOCl (control). The root canals were filled with Resilon cones and Epiphany SE sealer with and without resinous solvent. Six groups of eight canals each had their roots sectioned transversally to obtain 1-mm thick slices. Data were subjected to statistical analysis by ANOVA and Tukey's tests. The specimens treated with 17% EDTA (1.59 ± 0.91) presented higher bond strength (P < 0.05) than those treated with 2.5% NaOCl (0.93 ± 0.27) and 2% CHX (0.92 ± 0.22). Significantly higher bond strength (P < 0.05) was observed when the Epiphany SE was prepared with (1.37 ± 0.78) than without (0.92 ± 0.33) solvent. Adhesive failures were predominant in all groups. SEM analysis showed greater homogeneity of the filling mass when the solvent was added to the sealer. Treatment of root canal walls with 17% EDTA, and addition of a resinous solvent to Epiphany SE produced the highest adhesion to radicular dentin. © 2014 Wiley Periodicals, Inc.

Monitoring the effectiveness of root canal procedures on endotoxin levels found in teeth with chronic apical periodontitis

PubMed Central

MARINHO, Ariane Cassia Salustiano; MARTINHO, Frederico Canato; ZAIA, Alexandre Augusto; FERRAZ, Caio Cezar Randi; GOMES, Brenda Paula Figueiredo de Almeida

2014-01-01

Objective: The aim of this study was to monitor the effectiveness of root canal procedures by using different irrigants and intracanal medication on endotoxin levels found in root canals of teeth with chronic apical periodontitis. Material and Methods: Thirty root canals of teeth with pulpal necrosis associated with periapical lesions were selected and randomly divided into groups according to the irrigants used: GI - 2.5% NaOCl, GII - 2% chlorhexidine (CHX) gel, and GIII - saline solution (SS) (all, n=10). Samples were collected with sterile/apyrogenic paper points before (S1) and after root canal instrumentation (S2), after use of 17% ethylenediaminetetraacetic acid (EDTA) (S3), and after 30 days of intracanal medication (Ca(OH)2+SS) (S4). A turbidimetric kinetic Limulus Amebocyte Lysate assay was used for endotoxin measurement. Results: Endotoxins were detected in 100% of the root canals investigated (30/30), with a median value of 18.70 EU/mL. After S2, significant median percentage reduction was observed in all groups, irrespective of the irrigant tested: 2.5% NaOCl (99.65%) (GI), 2% CHX (94.27%) (GII), and SS (96.79%) (GIII) (all p<0.05). Root canal rinse with 17% EDTA (S3) for a 3-minute period failed to decrease endotoxin levels in GI and a slight decrease was observed in GII (59%) and GIII (61.1%) (all p>0.05). Intracanal medication for 30 days was able to significantly reduce residual endotoxins: 2.5% NaOCl (90%) (GI), 2% CHX (88.8%) (GII), and SS (85.7%) (GIII, p<0.05). No differences were found in the endotoxin reduction when comparing s2 and s4 treatment groups. Conclusion: Our findings demonstrated the effectiveness of the mechanical action of the instruments along with the flow and backflow of irrigant enduring root canal instrumentation for the endotoxin removal from root canals of teeth with chronic apical periodontitis. Moreover, the use of intracanal medication for 30 days contributed for an improvement of endotoxin reduction. PMID:25075670

Comparison of ozone gas and sodium hypochlorite/chlorhexidine two-visit disinfection protocols in treating apical periodontitis: a randomized controlled clinical trial.

PubMed

Kist, Stefan; Kollmuss, Maximilian; Jung, Jette; Schubert, Sören; Hickel, Reinhard; Huth, Karin Christine

2017-05-01

In this single-blinded, prospective, randomized, controlled clinical trial, the effectiveness of an ozone gas or NaOCl/CHX disinfection protocol was compared within the root canal treatment of apical periodontitis. Sixty permanent teeth were randomly allocated to one technique. The clinical/radiographic assessment criteria included clinical symptoms, periapical index (PAI), and size of the apical lesion. In both groups, the root canal was mechanically cleaned and irrigated with NaCl and EDTA. Ozone gas (32 g m -3 ) or NaOCl (3 %) was applied followed by a 1-week inter-appointment dressing (Ca(OH) 2 ). As final disinfection, ozone gas (ozone group) or CHX 2 % (NaOCl group) was applied. Microbial samples were taken after preparing the access cavity, after chemo-mechanical treatment and after inter-appointment dressing by sterile paper points. Microbial identification was performed by mass spectroscopy (MALDI-TOF-MS) and 16S-rRNA gene sequencing. The treated teeth were blindly re-evaluated after 6/12 months. Success rates, the decrease in PAI, the size of apical lesions and bacterial reduction were compared between groups (Fischer's exact test, Mann-Whitney U test). There were no significant differences between the success rates (ozone group: 96.2/95.5 % after 6/12 months; NaOCl group: 95.5/95.2 % after 6/12 months). The differences in the decreases in PAI values and apical lesion sizes were also insignificant after 6 and 12 months. The bacterial reduction showed no significant differences between groups after chemo-mechanical treatment and after inter-appointment dressing. The most commonly found bacterial genera were Streptococcus spp., Parvimonas spp. and Prevotella spp. The here used ozone gas and NaOCl/CHX protocols showed no difference in bacterial reduction in the sampled areas of the root canals. Within the limitations of the study, ozone gas seems to be a possible alternative disinfection agent within the root canal treatment of apical periodontitis.

A Biofilm Pocket Model to Evaluate Different Non-Surgical Periodontal Treatment Modalities in Terms of Biofilm Removal and Reformation, Surface Alterations and Attachment of Periodontal Ligament Fibroblasts

PubMed Central

Hägi, Tobias T.; Klemensberger, Sabrina; Bereiter, Riccarda; Nietzsche, Sandor; Cosgarea, Raluca; Flury, Simon; Lussi, Adrian; Sculean, Anton; Eick, Sigrun

2015-01-01

Background and Aim There is a lack of suitable in vitro models to evaluate various treatment modalities intending to remove subgingival bacterial biofilm. Consequently, the aims of this in vitro-study were: a) to establish a pocket model enabling mechanical removal of biofilm and b) to evaluate repeated non-surgical periodontal treatment with respect to biofilm removal and reformation, surface alterations, tooth hard-substance-loss, and attachment of periodontal ligament (PDL) fibroblasts. Material and Methods Standardized human dentin specimens were colonized by multi-species biofilms for 3.5 days and subsequently placed into artificially created pockets. Non-surgical periodontal treatment was performed as follows: a) hand-instrumentation with curettes (CUR), b) ultrasonication (US), c) subgingival air-polishing using erythritol (EAP) and d) subgingival air-polishing using erythritol combined with chlorhexidine digluconate (EAP-CHX). The reduction and recolonization of bacterial counts, surface roughness (Ra and Rz), the caused tooth substance-loss (thickness) as well as the attachment of PDL fibroblasts were evaluated and statistically analyzed by means of ANOVA with Post-Hoc LSD. Results After 5 treatments, bacterial reduction in biofilms was highest when applying EAP-CHX (4 log10). The lowest reduction was found after CUR (2 log10). Additionally, substance-loss was the highest when using CUR (128±40 µm) in comparison with US (14±12 µm), EAP (6±7 µm) and EAP-CHX (11±10) µm). Surface was roughened when using CUR and US. Surfaces exposed to US and to EAP attracted the highest numbers of PDL fibroblasts. Conclusion The established biofilm model simulating a periodontal pocket combined with interchangeable placements of test specimens with multi-species biofilms enables the evaluation of different non-surgical treatment modalities on biofilm removal and surface alterations. Compared to hand instrumentation the application of ultrasonication and of air-polishing with erythritol prevents from substance-loss and results in a smooth surface with nearly no residual biofilm that promotes the reattachment of PDL fibroblasts. PMID:26121365

A Biofilm Pocket Model to Evaluate Different Non-Surgical Periodontal Treatment Modalities in Terms of Biofilm Removal and Reformation, Surface Alterations and Attachment of Periodontal Ligament Fibroblasts.

PubMed

Hägi, Tobias T; Klemensberger, Sabrina; Bereiter, Riccarda; Nietzsche, Sandor; Cosgarea, Raluca; Flury, Simon; Lussi, Adrian; Sculean, Anton; Eick, Sigrun

2015-01-01

There is a lack of suitable in vitro models to evaluate various treatment modalities intending to remove subgingival bacterial biofilm. Consequently, the aims of this in vitro-study were: a) to establish a pocket model enabling mechanical removal of biofilm and b) to evaluate repeated non-surgical periodontal treatment with respect to biofilm removal and reformation, surface alterations, tooth hard-substance-loss, and attachment of periodontal ligament (PDL) fibroblasts. Standardized human dentin specimens were colonized by multi-species biofilms for 3.5 days and subsequently placed into artificially created pockets. Non-surgical periodontal treatment was performed as follows: a) hand-instrumentation with curettes (CUR), b) ultrasonication (US), c) subgingival air-polishing using erythritol (EAP) and d) subgingival air-polishing using erythritol combined with chlorhexidine digluconate (EAP-CHX). The reduction and recolonization of bacterial counts, surface roughness (Ra and Rz), the caused tooth substance-loss (thickness) as well as the attachment of PDL fibroblasts were evaluated and statistically analyzed by means of ANOVA with Post-Hoc LSD. After 5 treatments, bacterial reduction in biofilms was highest when applying EAP-CHX (4 log10). The lowest reduction was found after CUR (2 log10). Additionally, substance-loss was the highest when using CUR (128±40 µm) in comparison with US (14±12 µm), EAP (6±7 µm) and EAP-CHX (11±10) µm). Surface was roughened when using CUR and US. Surfaces exposed to US and to EAP attracted the highest numbers of PDL fibroblasts. The established biofilm model simulating a periodontal pocket combined with interchangeable placements of test specimens with multi-species biofilms enables the evaluation of different non-surgical treatment modalities on biofilm removal and surface alterations. Compared to hand instrumentation the application of ultrasonication and of air-polishing with erythritol prevents from substance-loss and results in a smooth surface with nearly no residual biofilm that promotes the reattachment of PDL fibroblasts.

Propionibacterium acnes Has Low Susceptibility to Chlorhexidine Digluconate.

PubMed

Nakase, Keisuke; Fukushima, Hanae; Yukawa, Tomoko; Nakaminami, Hidemasa; Fujii, Takeshi; Noguchi, Norihisa

2018-04-01

The skin bacterium Propionibacterium acnes has been reported to be responsible for surgical site infections (SSIs). Skin disinfection before surgery therefore is of the utmost importance in the prevention of SSIs caused by skin bacteria. We assessed the susceptibility of clinical isolates of two skin bacteria, P. acnes and Staphylococcus epidermidis, to disinfectants. The range of chlorhexidine digluconate (CHG) minimum inhibitory concentrations (MICs) for P. acnes isolates was 0.25-1 mcg/mL. Furthermore, the minimum bactericidal concentrations (MBCs) for a range of disinfectants were determined to evaluate their rapid bactericidal activity. The MBC range of CHG against the P. acnes isolates was 4,096->32,768 mcg/mL (MBC 80 16,384 mcg/mL) after one minute of exposure and 1,024-32,768 mcg/mL (MBC 80 8,192 mcg/mL) after five minutes, indicating that some strains required a CHG MBC higher than the commercial concentration of 2% (20,000 mcg/mL). In contrast, the MBCs of glutaraldehyde, sodium hypochlorite, povidone-iodine, ethanol, benzalkonium chloride, and olanexidine gluconate were all sufficiently lower than their commercial concentrations. In S. epidermidis, the MBC range of CHG was 128-1,024 mcg/mL at one minute of exposure and 4-8 mcg/mL at five minutes. Different skin bacteria have different susceptibilities to disinfectants. To prevent SSIs, the selected disinfectant agent and the disinfection time should have bactericidal activity toward all the bacteria that pose a risk of infection.

K+ transporter AtCHX17 with its hydrophilic C tail localizes to membranes of the secretory/endocytic system: role in reproduction and seed set.

PubMed

Chanroj, Salil; Padmanaban, Senthilkumar; Czerny, Daniel D; Jauh, Guang-Yuh; Sze, Heven

2013-07-01

The importance of sorting proteins and wall materials to their destination is critical for plant growth and development, though the machinery orchestrating membrane trafficking is poorly understood. Transporters that alter the environment across endomembrane compartments are thought to be important players. Using Escherichia coli and yeast, we previously showed that several Arabidopsis Cation/H(+) eXchanger (AtCHX) members were K(+) transporters with a role in pH homeostasis, though their subcellular location and biological roles in plants are unclear. Co-expression of markers with CHX16, CHX17, CHX18, or CHX19 tagged with a fluorescent protein indicated these transporters associated with plasma membrane (PM) and post-Golgi compartments. Under its native promoter, AtCHX17(1-820)-GFP localized to prevacuolar compartment (PVC) and to PM in roots. Brefeldin A diminished AtCHX17-GFP fluorescence at PM, whereas wortmannin caused formation of GFP-labeled ring-like structures, suggesting AtCHX17 trafficked among PVC, vacuole and PM. AtCHX17(1-472) lacking its carboxylic tail did not associate with PVC or PM in plant cells. Single chx17 mutant or higher-order mutants showed normal root growth and vegetative development. However, quadruple (chx16chx17chx18chx19) mutants were reduced in frequency and produced 50%-70% fewer seeds, indicating overlapping roles of several AtCHX17-related transporters in reproduction and/or seed development. Together, our results suggest that successful reproduction and seed development depend on the ability to regulate cation and pH homeostasis by AtCHX17-like transporters on membranes that traffic in the endocytic and/or secretory pathways.

Management of Cyst-like Periapical Lesions by Orthograde Decompression and Long-term Calcium Hydroxide/Chlorhexidine Intracanal Dressing: A Case Series.

PubMed

Santos Soares, Suelleng Maria Cunha; Brito-Júnior, Manoel; de Souza, Flávia Kelly; Zastrow, Eduardo Von; Cunha, Carla Oliveira da; Silveira, Frank Ferreira; Nunes, Eduardo; César, Carlos Augusto Santos; Glória, José Cristiano Ramos; Soares, Janir Alves

2016-07-01

Cyst-like periapical lesions should be treated initially with conservative nonsurgical procedures. In this case series, we describe the clinical and radiographic outcomes of large cyst-like lesions that were treated by orthograde decompression and long-term intracanal use of calcium hydroxide [Ca(OH)2] mixed with 2% chlorhexidine digluconate. Ten cases of cyst-like periapical lesions involving 15 teeth from 10 patients were selected. Maximal radiographic diameters of the lesions ranged from 11 to 28 mm. Nonsurgical procedures were performed, including apical patency, orthograde puncture of cyst-like exudates, chemomechanical preparation, and placement of intracanal Ca(OH)2/CHX dressings, which were periodically replaced during 6-10 months. The root canals were then filled with gutta-percha and sealer. The follow-up periods ranged from 6 to 24 months, and the outcome was classified as healed, healing, or failure. Nine lesions drained copious exudates after canal patency. One lesion only drained bloody serous exudate after periapical overinstrumentation. In 9 patients, intracanal exudation ceased in the first follow-up visit. At the 24-month follow-up, 6 lesions (60.0%) had healed, and 3 lesions (30.0%) were healing, with the corresponding patients being without clinical signs or symptoms. The case of treatment failure was submitted to surgical treatment. Microscopically, the lesion appeared to be an apical cyst with exuberant extraradicular bacterial biofilms attached to the sectioned root apex. This case series supports the use of nonsurgical methods to resolve larger cyst-like periapical lesions. Published by Elsevier Inc.

CHX14 is a plasma membrane K-efflux transporter that regulates K(+) redistribution in Arabidopsis thaliana.

PubMed

Zhao, Jian; Li, Penghui; Motes, Christy M; Park, Sunghun; Hirschi, Kendal D

2015-11-01

Potassium (K(+) ) is essential for plant growth and development, yet the molecular identity of many K(+) transporters remains elusive. Here we characterized cation/H(+) exchanger (CHX) 14 as a plasma membrane K(+) transporter. CHX14 expression was induced by elevated K(+) and histochemical analysis of CHX14 promoter::GUS transgenic plants indicated that CHX14 was expressed in xylem parenchyma of root and shoot vascular tissues of seedlings. CHX14 knockout (chx14) and CHX14 overexpression seedlings displayed different growth phenotypes during K(+) stress as compared with wild-type seedlings. Roots of mutant seedlings displayed higher K(+) uptake rates than wild-type roots. CHX14 expression in yeast cells deficient in K(+) uptake renders the mutant cells more sensitive to deficiencies of K(+) in the medium. CHX14 mediates K(+) efflux in yeast cells loaded with high K(+) . Uptake experiments using (86) Rb(+) as a tracer for K(+) with both yeast and plant mutants demonstrated that CHX14 expression in yeast and in planta mediated low-affinity K(+) efflux. Functional green fluorescent protein (GFP)-tagged versions of CHX14 were localized to both the yeast and plant plasma membranes. Taken together, we suggest that CHX14 is a plasma membrane K(+) efflux transporter involved in K(+) homeostasis and K(+) recirculation. © 2015 John Wiley & Sons Ltd.

Prevalence of Enterococcus faecalis and Porphyromonas gingivalis in infected root canals and their susceptibility to endodontic treatment procedures: a molecular study.

PubMed

Stojanović, Nikola; Krunić, Jelena; Popović, Branka; Stojičić, Sonja; Zivković, Slavoljub

2014-01-01

Because apical periodontitis is recognizably an infectious disease, elimination or reduction of intracanal bacteria is of utmost importance for optimum treatment outcome. The prevalence of Enterococcus faecalis and Porphyromonas gingivalis in infected root canals was studied Also, the effect of endodontic therapy by using intracanal medicaments, calcium hydroxide paste (CH) or gutta-percha points containing calcium hydroxide (CH-GP) or chlorhexidine (CHX-GP) on these microorganisms was assessed by polymerase chain reaction (PCR) assay. Fifty-one patients with chronic apical periodontitis were randomly allocated in one of the fol- lowing groups according to the intracanal medicament used: CH, CH-GP and CHX-GP group. Bacterial samples were taken upon access (S1), after chemomechanical instrumentation (S2) and after 15-day medication (S3). PCR assay was used to detect the presence of selected bacteria. E. faecalis was detected in 49% (25/51) and P. gingivalis in 17.6% (9/51) of the samples. Samples which showed no bacterial presence at S1 were excluded from further analysis. Overall analysis of all 29 samples revealed significant differences between S1 and S2 (p < 0.001), S2 and S3 (p < 0.05), and S1 and S3 (p < 0.001). When distinction was made between the intracanal medications, there was a significant difference in the number of PCR positive samples between S1 and 52, S1 and S3, but not between S2 and S3 samples. E. faecalis is more prevalent than P. gingivalis in primary endodontic infection. Intracanal medication in conduction with instrumentation and irrigation efficiently eliminates E. faecalis and P. gingivalis from infected root canals.

Effects of Azithromycin, Metronidazole, Amoxicillin, and Metronidazole plus Amoxicillin on an In Vitro Polymicrobial Subgingival Biofilm Model

PubMed Central

Teles, Flavia; Starr, Jacqueline R.; Feres, Magda; Patel, Michele; Martin, Lynn

2015-01-01

Chronic periodontitis is one of the most prevalent human diseases and is caused by dysbiosis of the subgingival microbiota. Treatment involves primarily mechanical disruption of subgingival biofilms and, in certain cases, adjunctive use of systemic antibiotic therapy. In vitro biofilm models have been developed to study antimicrobial agents targeting subgingival species. However, these models accommodate a limited number of taxa, lack reproducibility, and have low throughput. We aimed to develop an in vitro multispecies biofilm model that mimics subgingival plaque, to test antimicrobial agents. Biofilms were cultivated using the Calgary Biofilm Device and were exposed to amoxicillin (AMX), metronidazole (MTZ), azithromycin (AZM), and AMX-MTZ at four different concentrations for 12, 24, or 36 h. Chlorhexidine (CHX) (0.12%) was used as the positive control. The compositions of the biofilms were analyzed by checkerboard DNA-DNA hybridization, and the percent reduction in biofilm metabolic activity was determined using 2,3,5-triphenyltetrazolium chloride and spectrophotometry. Thirty-five of the 40 species used in the inoculum were consistently recovered from the resulting in vitro biofilms. After 36 h of exposure at the 1:27 dilution, AMX-MTZ reduced metabolic activity 11% less than CHX (q = 0.0207) but 54% more than AMX (q = 0.0031), 72% more than MTZ (q = 0.0031), and 67% more than AZM (q = 0.0008). Preliminary evidence of a synergistic interaction between AMX and MTZ was also observed. In summary, we developed reproducible biofilms with 35 subgingival bacterial species, and our results suggested that the combination of AMX and MTZ had greater antimicrobial effects on these in vitro multispecies biofilms than expected on the basis of the independent effects of the drugs. PMID:25733510

Cost-effectiveness of root caries preventive treatments.

PubMed

Schwendicke, Falk; Göstemeyer, Gerd

2017-01-01

With a growing number of individuals retaining their teeth lifelong, often with periodontitis-induced root surface exposure, there is the need for cost-effective management strategies for root caries lesions. The present study aimed to assess the cost-effectiveness of root caries preventive treatments. Patients were simulated over 10 years using a Markov model. Four treatments were compared: No treatment, daily 225-800ppm fluoride rinses, chlorhexidine (CHX) varnish (2×/year), silver diamine fluoride (SDF) varnish (2×/year). Data from a systematic review were submitted to network meta-analysis for inferring relative efficacies of treatments. The health outcome was years of teeth being free of root caries. A mixed public-private payer perspective within 2016 German healthcare was taken, with costs being estimated from fee item catalogues or based on market prices. Populations with different numbers of teeth and tooth-level risks were modelled. Monte-Carlo microsimulations, univariate- and probabilistic sensitivity analyses were performed. In populations with 16 teeth at risk and low tooth-level risk for root caries, providing no preventive treatment was least costly, but also least effective (130 Euro, 144 years). SDF ranked next, being more costly (180 Euro), but also more effective (151 years). Payers willing to invest 8.30 Euro per root caries-free tooth-year found SDF most cost-effective. CHX varnish and fluoride rinse were not cost-effective. In populations with more teeth and high tooth-level risk, SDF was the most effective and least costly option. Root caries preventive treatments (like SDF) are effective and might even be cost-saving in high risk populations. Application of SDF can be recommended as a cost-saving treatment for prevention of root caries in patients with high risk of root caries. Copyright © 2016 Elsevier Ltd. All rights reserved.

Treatment of Oral Multispecies Biofilms by an Anti-Biofilm Peptide.

PubMed

Wang, Zhejun; de la Fuente-Núñez, Cesar; Shen, Ya; Haapasalo, Markus; Hancock, Robert E W

2015-01-01

Human oral biofilms are multispecies microbial communities that exhibit high resistance to antimicrobial agents. Dental plaque gives rise to highly prevalent and costly biofilm-related oral infections, which lead to caries or other types of oral infections. We investigated the ability of the recently identified anti-biofilm peptide 1018 to induce killing of bacterial cells present within oral multispecies biofilms. At 10 μg/ml (6.5 μM), peptide 1018 was able to significantly (p<0.05) prevent biofilm formation over 3 days. The activity of the peptide on preformed biofilms was found to be concentration-dependent since more than 60% of the total plaque biofilm cell population was killed by 10 μg/ml of peptide 1018 in 3 days, while at 5 μg/ml 50% of cells were dead and at 1 μg/ml the peptide triggered cell death in around 30% of the total bacterial population, as revealed by confocal microscopy. The presence of saliva did not affect peptide activity, since no statistically significant difference was found in the ability of peptide 1018 to kill oral biofilms using either saliva coated and non-saliva coated hydroxyapatite surfaces. Scanning electron microscopy experiments indicated that peptide 1018 induced cell lysis in plaque biofilms. Furthermore, combined treatment using peptide 1018 and chlorhexidine (CHX) increased the anti-biofilm activity of each compound compared to when these were used alone, resulting in >50% of the biofilm being killed and >35% being dispersed in only 3 minutes. Peptide 1018 may potentially be used by itself or in combination with CHX as a non-toxic and effective anti-biofilm agent for plaque disinfection in clinical dentistry.

Effect of dentin powder on the antimicrobial properties of hyperpure chlorine-dioxide and its comparison to conventional endodontic disinfecting agents.

PubMed

Herczegh, Anna; Gyurkovics, Milán; Ghidan, Ágoston; Megyesi, Marianna; Lohinai, Zsolt

2014-06-01

Previously we found that the high purity chlorine-dioxide(ClO2) has a very potent disinfectant efficacy on oral pathogenic microorganisms and as a root canal irrigant it is able to eliminate the experimental Enterococcus faecalis(E. faecalis) infection from the root canal system. This study examines whether the presence of dentin powder influences the antibacterial efficacy of ClO 2. In an in vitro dentin powder model the following irrigants were tested against planktonic E. faecalis: 2% chlorhexidine (CHX), 2.5% sodium hypochlorite (NaOCl), 0.12%ClO2 (Solumium) and one local root canal medicament: saturated Ca(OH)2. Survival of bacteria exposed to agents without and with human dentin powder or preincubated with dentin powder was investigated. The effect of the dentin powder on ClO2 concentration was investigated by titrations. Without dentin powder ClO 2 killed all E. faecalis and delivered the best result already after 1 minute; however, after longer contact time with dentin the difference between the disinfectants disappeared. The presence of dentin powder decreased the concentration of ClO 2 and attenuated the antibacterial efficiency of ClO2 and Ca(OH)2, but did not decrease of CHX and NaOCl.Preincubation with dentin powder caused significant loss of antibacterial activity of all investigated agents, ClO2 and Ca(OH)2 having the highest reduction. As the presence of dentin powder had a negative effect on the efficacy of disinfectants, the importance of elimination of dentin scrapings and smear layer from the root canal system during endodontic treatments is highly recommended. ClO 2 can be effective for a final rinse.

PubMed Central

Bédard, S; Desrochers, A; Fecteau, G; Higgins, R

2001-01-01

This study was designed to evaluate 4 preoperative skin preparations, that is, more specifically, to compare the efficacy of chlorhexidine gluconate (CG) and povidone-iodine (PI), as well as 2 hair removal techniques (clipper alone or clipper followed by razor) for preoperative skin preparation in cattle. The 4 protocols resulted in a significant decrease in the number of bacterial colony-forming units (cfu). Group 4 (clipping + shaving + CG) had a significantly lower number of preoperative cfu per gel plate compared with groups 1 (clipping + PI) and 3 (clipping + shaving + PI). Skin reaction frequency was significantly higher in groups 3 and 4 (47.8% for both protocols) than in groups 1 and 2 (clipping + PI or CG) (8.7% for both). Wound infection frequency was 4.3% (4/92) and no significant difference was observed between the 4 treatment groups. The 4 protocols tested were equivalent as to efficacy and satisfactorily decreased skin microflora. Clipping alone was shown to be preferable to clipping plus shaving as a method of hair removal in cattle, with fewer skin reactions and no more wound infections. PMID:11265188

The Effects of Surgical Hand Scrubbing Protocols on Skin Integrity and Surgical Site Infection Rates: A Systematic Review.

PubMed

Liu, Liang Qin; Mehigan, Sinead

2016-05-01

This systematic review aimed to critically appraise and synthesize updated evidence regarding the effect of surgical-scrub techniques on skin integrity and the incidence of surgical site infections. Databases searched include the Cumulative Index to Nursing and Allied Health Literature, MEDLINE, Embase, and Cochrane Central. Our review was limited to eight peer-reviewed, randomized controlled trials and two nonrandomized controlled trials published in English from 1990 to 2015. Comparison models included traditional hand scrubbing with chlorhexidine gluconate or povidone-iodine against alcohol-based hand rubbing, scrubbing with a brush versus without a brush, and detergent-based antiseptics alone versus antiseptics incorporating alcohol solutions. Evidence showed that hand rubbing techniques are as effective as traditional scrubbing and seem to be better tolerated. Hand rubbing appears to cause less skin damage than traditional scrub protocols, and scrub personnel tolerated brushless techniques better than scrubbing using a brush. Copyright © 2016 AORN, Inc. Published by Elsevier Inc. All rights reserved.

The comparison of the effect of endodontic irrigation on cell adherence to root canal dentin.

PubMed

Ring, Karla C; Murray, Peter E; Namerow, Kenneth N; Kuttler, Sergio; Garcia-Godoy, Franklin

2008-12-01

The purpose of this study was to compare the effect of 10 different endodontic irrigation and chelating treatments on dental pulp stem cell (DPSC) attachment to root canal surfaces. Thirty-eight extracted human nondiseased single-canal teeth were cleaned and shaped using ProTaper and ProFile rotary instrumentation (Tulsa Dentsply, Tulsa, OK). The irrigation treatments investigated were 6% sodium hypochlorite, 2% chlorhexidine gluconate, Aquatine Endodontic Cleanser, and Morinda citrifolia juice. The irrigation treatments were used in conjunction with EDTA or MTAD. The instrumented teeth were immediately placed in cell culture with confluent DPSCs for 1 week. The number of attached DPSCs appeared to be correlated with the cytotoxicity of the root canal irrigating solution (analysis of variance, p < 0.0001). The presence or absence of the smear layer had little influence on DPSC activity (chi-square, p > 0.05). The results suggest that biocompatible irrigants are needed to promote DPSC attachment to root canal dentin, which is essential to accomplish some regenerative endodontic therapies.

Isolation and Genetic Characterization of a Mutation Affecting Ribosomal Resistance to Cycloheximide in Tetrahymena

PubMed Central

Ares, Manuel; Bruns, Peter J.

1978-01-01

A dominant mutation at a new locus affecting resistance to cycloheximide has been isolated by exploiting a synergistic relationship with a previously known mutation for cycloheximide resistance in Tetrahymena. The new mutation (ChxB) was induced in a line homozygous for ChxA and was recovered from that background by a new technique termed interrupted genomic exclusion. Segregation data from the interrupted genomic exclusion suggest that ChxA and ChxB are separate, linked loci showing 30% recombination. Minimal lethal doses of cycloheximide for the four possible combinations of the wild-type and mutant alleles of these two genes are: wild type 6 µg/ml, ChxA 125 µg/ml, ChxB 10 µg/ml, ChxA-ChxB 175 µg/ml. PMID:730051

Surface treatment influences electrochemical stability of cpTi exposed to mouthwashes.

PubMed

Beline, Thamara; Garcia, Camila S; Ogawa, Erika S; Marques, Isabella S V; Matos, Adaias O; Sukotjo, Cortino; Mathew, Mathew T; Mesquita, Marcelo F; Consani, Rafael X; Barão, Valentim A R

2016-02-01

The role of surface treatment on the electrochemical behavior of commercially pure titanium (cpTi) exposed to mouthwashes was tested. Seventy-five disks were divided into 15 groups according to surface treatment (machined, sand blasted with Al2O3, and acid etched) and electrolyte solution (artificial saliva — control, 0.12% chlorhexidine digluconate, 0.05% cetylpyridinium chloride, 0.2% sodium fluoride, and 1.5% hydrogen peroxide) (n = 5). Open-circuit-potential and electrochemical impedance spectroscopy were conducted at baseline and after 7 and 14 days of immersion in each solution. Potentiodynamic test and total weight loss of disks were performed after 14 days of immersion. Scanning electron microscopy, energy dispersive spectroscopy, white light interferometry and profilometry were conducted for surface characterization before and after the electrochemical tests. Sandblasting promoted the lowest polarization resistance (Rp) (P b .0001) and the highest capacitance (CPE) (P b .006), corrosion current density (Icorr) and corrosion rate (P b .0001). In contrast, acid etching increased Rp and reduced CPE, independent to the mouthwash; while hydrogen peroxide reduced Rp (P b .008) and increased Icorr and corrosion rate (P b .0001). The highest CPE values were found for hydrogen peroxide and 0.2% sodium fluoride. Immersion for longer period improved the electrochemical stability of cpTi (P b .05). In conclusion, acid etching enhanced the electrochemical stability of cpTi. Hydrogen peroxide and sodium fluoride reduced the resistance to corrosion of cpTi, independent to the surface treatment. Chlorhexidine gluconate and cetylpyridinium chloride did not alter the corrosive behavior of cpTi.

The Incidence of Propionibacterium acnes in Shoulder Arthroscopy.

PubMed

Chuang, Michael J; Jancosko, Jason J; Mendoza, Vivian; Nottage, Wesley M

2015-09-01

To document the skin colonization and deep tissue inoculation rates associated with arthroscopic shoulder surgery and how these rates differ with procedural and demographic factors. We prospectively recruited outpatient shoulder arthroscopy patients who agreed to participate and met the inclusion criteria from February 2013 to May 2014. All patients received routine antibiotic prophylaxis intravenously. Initial cultures were obtained before the skin preparation by swabbing the skin at the 3 standard portal sites: posterior, anterosuperior, and anterolateral. The skin preparation used 4% chlorhexidine scrub and 2% chlorhexidine gluconate/70% isopropyl alcohol paint applied to the entire shoulder. After completion of the arthroscopic procedure, a second culture was obtained through a cannula at the surgical site. All cultures were plated for 21 days using Brucella medium. We enrolled 51 patients over a 15-month period. Cultures showed a 72.5% Propionibacterium acnes superficial colonization rate: 46.1% of female and 81.6% of male patients (P = .027). We identified a deep culture-positive inoculation rate of 19.6%, all with positive P acnes skin colonization. No correlation could be made concerning diagnosis, procedure, suture anchor use, age, or sex. The rate of skin colonization with P acnes is high at arthroscopic portals, especially in men. Despite standard skin preparation and prophylactic antibiotics, the rate of deep tissue inoculation with P acnes in shoulder arthroscopy is much higher than the rate of infection reported in the literature. Shoulder arthroscopy introduces a significant amount of P acnes into the deep tissues. Copyright © 2015 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Delivery, immediate newborn and cord care practices in Pemba Tanzania: a qualitative study of community, hospital staff and community level care providers for knowledge, attitudes, belief systems and practices

PubMed Central

2014-01-01

Background Deaths during the neonatal period account for almost two-thirds of all deaths in the first year of life and 40 percent of deaths before the age of five. Most of these deaths could be prevented through proven cost-effective interventions. Although there are some recent data from sub-Saharan Africa, but there is paucity of qualitative data from Zanzibar and cord care practices data from most of East Africa. We undertook a qualitative study in Pemba Island as a pilot to explore the attitudes, beliefs and practices of the community and health workers related to delivery, newborn and cord care with the potential to inform the main chlorhexidine (CHX) trial. Methods 80 in-depth interviews (IDI) and 11 focus group discussions (FGD) involving mothers, grandmothers, fathers, traditional birth attendants and other health service providers from the community were undertaken. All IDIs and FGDs were audio taped, transcribed and analyzed using ATLAS ti 6.2. Results Poor transportation, cost of delivery at hospitals, overcrowding and ill treatment by hospital staff are some of the obstacles for achieving higher institutional delivery. TBAs and health professionals understand the need of using sterilized equipments to reduce risk of infection to both mothers and their babies during delivery. Despite this knowledge, use of gloves during delivery and hand washing before delivery were seldom reported. Early initiation of breastfeeding and feeding colostrum was almost universal. Hospital personnel and trained TBAs understood the importance of keeping babies warm after birth and delayed baby’s first bath. The importance of cord care was well recognized in the community. Nearly all TBAs counseled the mothers to protect the cord from dust, flies and mosquitoes or any other kind of infections by covering it with cloth. There was consensus among respondents that CHX liquid cord cleansing could be successfully implemented in the community with appropriate education and awareness. Conclusion The willingness of community in accepting a CHX cord care practice was very high; the only requirement was that a MCH worker needs to do and demonstrate the use to the mother. Trial registration ClinicalTrials.gov: NCT01528852 PMID:24885689

Protocol for a randomised controlled trial comparing aqueous with alcoholic chlorhexidine antisepsis for the prevention of superficial surgical site infection after minor surgery in general practice: the AVALANCHE trial.

PubMed

Heal, C F; Charles, D; Hardy, A; Delpachitra, M; Banks, J; Wohlfahrt, M; Saednia, Sabine; Buettner, P

2016-07-07

Surgical site infection (SSI) after minor skin excisions has a significant impact on patient morbidity and healthcare resources. Skin antisepsis prior to surgical incision is used to prevent SSI, and is performed routinely worldwide. However, in spite of the routine use of skin antisepsis, there is no consensus regarding which antiseptic agents are most effective. The AVALANCHE trial will compare Aqueous Versus Alcoholic Antisepsis with Chlorhexidine for Skin Excisions. The study design is a prospective, randomised controlled trial (RCT) with the aim of investigating the impact of two different antiseptic preparations on the incidence of superficial SSI in patients undergoing minor skin excisions. The intervention of 0.5% chlorhexidine gluconate (CHG) in 70% alcohol will be compared with that of 0.5% CHG in aqueous solution. The trial will be conducted in four Australian general practices over a 9-month period, with 920 participants to be recruited. Consecutive patients presenting for minor skin excisions will be eligible to participate. Randomisation will be on the level of the patient. The primary outcome is superficial SSI in the first 30 days following the excision. Secondary outcomes will be adverse effects, including anaphylaxis, skin irritation, contact dermatitis and rash and patterns of antibiotic resistance. The study has been approved by the James Cook University Human Research Ethics Committee (HREC). Findings will be disseminated in conference presentations and journals and through online electronic media. RCTs conducted in general practice differ from hospital-based projects in terms of feasibility, pragmatism and funding. The success of this trial will be cemented in the fact that the research question was established by a group of general practitioners who identified an interesting question which is relevant to their clinical practice and not answered by current evidence. ACTRN12615001045505; Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Alcoholic Chlorhexidine or Alcoholic Iodine Skin Antisepsis (ACAISA): protocol for cluster randomised controlled trial of surgical skin preparation for the prevention of superficial wound complications in prosthetic hip and knee replacement surgery

PubMed Central

Peel, T N; Cheng, A C; Buising, K L; Dowsey, M M; Choong, P F M

2014-01-01

Introduction Wound complications following arthroplasty are associated with significant impact on the patient and healthcare system. Skin cleansing prior to surgical incision is a simple and effective method to prevent wound complications however, the question of which agent is superior for surgical skin antisepsis is unresolved. Methods and analysis This cluster randomised controlled trial aims to compare the incidence of superficial wound complications in patients undergoing elective prosthetic hip or knee replacement surgery receiving surgical skin antisepsis with either: 0.5% chlorhexidine gluconate (CHG) in 70% alcohol or 10% povidone in 70% alcohol. The trial will be conducted at an Australian tertiary, university affiliated hospital over a 3-year period involving 750 participants. Participants will be drawn from the surgical waiting list. Consent for this study will be ‘opt-out’ consent. On a given day, all eligible participants will have skin preparation either with 0.5% chlorhexidine in 70% alcohol or 10% povidone iodine in 70% alcohol. The primary outcome is superficial wound complications (comprised of superficial incisional surgical site infections (SSI) and/or prolonged wound ooze) in the first 30 days following prosthetic joint replacement surgery. Secondary outcomes will include the incidence of wound complications according to the joint replaced, assessment of the causative agents of SSI and cost-effectiveness analysis. The primary analysis is an intention-to-treat analysis including all participants who undergo randomisation and will be performed at the individual level taking into account the clustering effect. Ethics and dissemination The study design and protocol was reviewed and approved by the St Vincent's Hospital Human Research Ethics Committee (HREC-A 016/14 10/3/2014). Study findings will be disseminated in the printed media, and learned forums. A written lay summary will be available to study participants on request. Trial registration number The trial has been registered with the Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614000177651. PMID:24833699

AtCHX13 is a plasma membrane K+ transporter.

PubMed

Zhao, Jian; Cheng, Ning-Hui; Motes, Christy M; Blancaflor, Elison B; Moore, Miranda; Gonzales, Naomi; Padmanaban, Senthilkumar; Sze, Heven; Ward, John M; Hirschi, Kendal D

2008-10-01

Potassium (K+) homeostasis is essential for diverse cellular processes, although how various cation transporters collaborate to maintain a suitable K+ required for growth and development is poorly understood. The Arabidopsis (Arabidopsis thaliana) genome contains numerous cation:proton antiporters (CHX), which may mediate K+ transport; however, the vast majority of these transporters remain uncharacterized. Here, we show that AtCHX13 (At2g30240) has a role in K+ acquisition. AtCHX13 suppressed the sensitivity of yeast (Saccharomyces cerevisiae) mutant cells defective in K+ uptake. Uptake experiments using (86)Rb+ as a tracer for K+ demonstrated that AtCHX13 mediated high-affinity K+ uptake in yeast and in plant cells with a K(m) of 136 and 196 microm, respectively. Functional green fluorescent protein-tagged versions localized to the plasma membrane of both yeast and plant. Seedlings of null chx13 mutants were sensitive to K+ deficiency conditions, whereas overexpression of AtCHX13 reduced the sensitivity to K+ deficiency. Collectively, these results suggest that AtCHX13 mediates relatively high-affinity K+ uptake, although the mode of transport is unclear at present. AtCHX13 expression is induced in roots during K+-deficient conditions. These results indicate that one role of AtCHX13 is to promote K+ uptake into plants when K+ is limiting in the environment.

Ectodomain shedding of TNF receptor 1 induced by protein synthesis inhibitors regulates TNF-{alpha}-mediated activation of NF-{kappa}B and caspase-8

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ogura, Hirotsugu; Tsukumo, Yoshinori; Department of Bioengineering, Tokyo Institute of Technology, 4259 Nagatsuta-cho, Midori-ku, Yokohama 226-8501

2008-04-01

The transcription factor nuclear factor {kappa}B (NF-{kappa}B) plays a major role in the inducible resistance to death receptor-mediated apoptosis. It has been established that the protein synthesis inhibitor cycloheximide (CHX) sensitizes many types of cells to tumor necrosis factor (TNF)-{alpha}-induced apoptosis, mainly due to its ability to block de novo synthesis of cellular FLICE-inhibitory protein (c-FLIP). Nevertheless, we have surprisingly found that CHX, as well as its structural analogue acetoxycycloheximide (Ac-CHX), prevents TNF-{alpha}-mediated activation of NF-{kappa}B and caspase-8 in human lung carcinoma A549 cells. Both CHX and Ac-CHX reduced the expression of cell surface TNF receptor 1 (TNF-R1) in amore » dose-dependent manner, while Ac-CHX was approximately 100-fold more effective than CHX. Consistent with this observation, Ac-CHX induced the proteolytic cleavage of TNF-R1 and its release into the culture medium. CHX and Ac-CHX profoundly decreased constitutive and inducible expression of c-FLIP, whereas these compounds potentiated TNF-{alpha}-induced caspase-8 activation only when metalloprotease inhibitors were present. Thus, our results indicate that ectodomain shedding of TNF-R1 induced by protein synthesis inhibitors regulates TNF-{alpha}-mediated activation of NF-{kappa}B and caspase-8.« less

AtCHX13 Is a Plasma Membrane K+ Transporter1[C][W][OA

PubMed Central

Zhao, Jian; Cheng, Ning-Hui; Motes, Christy M.; Blancaflor, Elison B.; Moore, Miranda; Gonzales, Naomi; Padmanaban, Senthilkumar; Sze, Heven; Ward, John M.; Hirschi, Kendal D.

2008-01-01

Potassium (K+) homeostasis is essential for diverse cellular processes, although how various cation transporters collaborate to maintain a suitable K+ required for growth and development is poorly understood. The Arabidopsis (Arabidopsis thaliana) genome contains numerous cation:proton antiporters (CHX), which may mediate K+ transport; however, the vast majority of these transporters remain uncharacterized. Here, we show that AtCHX13 (At2g30240) has a role in K+ acquisition. AtCHX13 suppressed the sensitivity of yeast (Saccharomyces cerevisiae) mutant cells defective in K+ uptake. Uptake experiments using 86Rb+ as a tracer for K+ demonstrated that AtCHX13 mediated high-affinity K+ uptake in yeast and in plant cells with a Km of 136 and 196 μm, respectively. Functional green fluorescent protein-tagged versions localized to the plasma membrane of both yeast and plant. Seedlings of null chx13 mutants were sensitive to K+ deficiency conditions, whereas overexpression of AtCHX13 reduced the sensitivity to K+ deficiency. Collectively, these results suggest that AtCHX13 mediates relatively high-affinity K+ uptake, although the mode of transport is unclear at present. AtCHX13 expression is induced in roots during K+-deficient conditions. These results indicate that one role of AtCHX13 is to promote K+ uptake into plants when K+ is limiting in the environment. PMID:18676662

Transporters involved in pH and K + homeostasis affect pollen wall formation, male fertility, and embryo development

DOE Office of Scientific and Technical Information (OSTI.GOV)

Padmanaban, Senthilkumar; Czerny, Daniel D.; Levin, Kara A.

Flowering plant genomes encode multiple cation/H + exchangers (CHXs) whose functions are largely unknown. AtCHX17, AtCHX18, and AtCHX19 are membrane transporters that modulate K+ and pH homeostasis and are localized in the dynamic endomembrane system. Loss of function reduced seed set, but the particular phase(s) of reproduction affected was not determined. Pollen tube growth and ovule targeting of chx17chx18chx19 mutant pollen appeared normal, but reciprocal cross experiments indicate a largely male defect. Although triple mutant pollen tubes reach ovules of a wild-type pistil and a synergid cell degenerated, half of those ovules were unfertilized or showed fertilization of the eggmore » or central cell, but not both female gametes. Fertility could be partially compromised by impaired pollen tube and/or sperm function as CHX19 and CHX18 are expressed in the pollen tube and sperm cell, respectively. When fertilization was successful in self-pollinated mutants, early embryo formation was retarded compared with embryos from wild-type ovules receiving mutant pollen. Thus CHX17 and CHX18 proteins may promote embryo development possibly through the endosperm where these genes are expressed. The reticulate pattern of the pollen wall was disorganized in triple mutants, indicating perturbation of wall formation during male gametophyte development. Lastly, as pH and cation homeostasis mediated by AtCHX17 affect membrane trafficking and cargo delivery, these results suggest that male fertility, sperm function, and embryo development are dependent on proper cargo sorting and secretion that remodel cell walls, plasma membranes, and extracellular factors.« less

Transporters involved in pH and K + homeostasis affect pollen wall formation, male fertility, and embryo development

DOE PAGES

Padmanaban, Senthilkumar; Czerny, Daniel D.; Levin, Kara A.; ...

2017-02-23

Flowering plant genomes encode multiple cation/H + exchangers (CHXs) whose functions are largely unknown. AtCHX17, AtCHX18, and AtCHX19 are membrane transporters that modulate K+ and pH homeostasis and are localized in the dynamic endomembrane system. Loss of function reduced seed set, but the particular phase(s) of reproduction affected was not determined. Pollen tube growth and ovule targeting of chx17chx18chx19 mutant pollen appeared normal, but reciprocal cross experiments indicate a largely male defect. Although triple mutant pollen tubes reach ovules of a wild-type pistil and a synergid cell degenerated, half of those ovules were unfertilized or showed fertilization of the eggmore » or central cell, but not both female gametes. Fertility could be partially compromised by impaired pollen tube and/or sperm function as CHX19 and CHX18 are expressed in the pollen tube and sperm cell, respectively. When fertilization was successful in self-pollinated mutants, early embryo formation was retarded compared with embryos from wild-type ovules receiving mutant pollen. Thus CHX17 and CHX18 proteins may promote embryo development possibly through the endosperm where these genes are expressed. The reticulate pattern of the pollen wall was disorganized in triple mutants, indicating perturbation of wall formation during male gametophyte development. Lastly, as pH and cation homeostasis mediated by AtCHX17 affect membrane trafficking and cargo delivery, these results suggest that male fertility, sperm function, and embryo development are dependent on proper cargo sorting and secretion that remodel cell walls, plasma membranes, and extracellular factors.« less

A Chlorhexidine Solution Reduces Aerobic Organism Growth in Operative Splash Basins in a Randomized Controlled Trial.

PubMed

Lindgren, Kevin E; Pelt, Christopher E; Anderson, Mike B; Peters, Christopher L; Spivak, Emily S; Gililland, Jeremy M

2018-01-01

Despite recommendations against the use of splash basins, due to the potential of bacterial contamination, our observation has been that they continue to be used in operating theaters. In hopes of decontaminating the splash basin, we sought to determine if the addition of chlorhexidine gluconate (CHG) would eliminate aerobic bacterial growth within the splash basin. After Institutional Review Board approval, we began enrollment in a randomized controlled trial comparing 2 splash basin solutions. Splash basins (n = 111) were randomized to either the standard of care (control) solution of sterile water or the experimental solution containing 0.05% CHG. One 20 mL aliquot was taken from the basin at the end of the surgical case and delivered to an independent laboratory. Samples were plated on tryptic soy agar (medium) and incubated at 30°C-35°C to encourage growth. After 48-72 hours, the agar plates were examined for growth and a standard plate count of aerobic cultures was performed. The sterile water group was found to have bacterial growth in 9% of samples compared to no growth in the CHG group (P = .045). The organisms included Micrococcus luteus, Staphylococcus hominis, Gram-variable coccobacilli, and unidentifiable Gram-positive rods. Given the safety and efficacy of a concentration of 0.05% CHG in reducing the bacterial contamination in the operative splash basin, it would seem that if the practice of using a splash basin in the operating theater is to be continued, the addition of an antiseptic solution such as that studied here should be considered. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparative Evaluation of Neem Mouthwash on Plaque and Gingivitis: A Double-blind Crossover Study.

PubMed

Jalaluddin, Md; Rajasekaran, U B; Paul, Sam; Dhanya, R S; Sudeep, C B; Adarsh, V J

2017-07-01

The present study aimed at evaluating the impact of neem-containing mouthwash on plaque and gingivitis. This randomized, double-blinded, crossover clinical trial included 40 participants aged 18 to 35 years with washout period of 1 week between the crossover phases. A total of 20 participants, each randomly allocated into groups I and II, wherein in the first phase, group I was provided with 0.2% chlorhexidine gluconate and group II with 2% neem mouthwash. After the scores were recorded, 1-week time period was given to the participants to carry over the effects of the mouthwashes and then the second phase of the test was performed. The participants were instructed to use the other mouthwash through the second test phase. There was a slight reduction of plaque level in the first phase as well as in the second phase. When comparison was made between the groups, no statistically significant difference was seen. Both the groups showed reduction in the gingival index (GI) scores in the first phase, and there was a statistically significant difference in both groups at baseline and after intervention (0.005 and 0.01 respectively). In the second phase, GI scores were reduced in both groups, but there was a statistically significant difference between the groups only at baseline scores (0.01). In the present study, it has been concluded that neem mouthwash can be used as an alternative to chlorhexidine mouthwash based on the reduced scores in both the groups. Using neem mouthwash in maintaining oral hygiene might have a better impact in prevention as well as pervasiveness of oral diseases as it is cost-effective and easily available.

Virucidal agents in the eve of manorapid synergy®

PubMed Central

Galabov, Angel S.

2007-01-01

Virucidal agents are chemical substances that attack and inactivate viral particles outside the cell (virions). In general this is accomplished by damaging their protein shells (capsid) or the substance penetrates the core itself, where it destroys the genetic material. Damage to the virion structure is also possible. These agents are used not only for traditional surface disinfection or sterilization of blood, blood products, and other medicinal products as well as in antiviral chemotherapy. They have also been used in recent times for inactivation of viruses in foodstuffs, detergents or cosmetics. Below is given an overview of the data currently available on the performance of these substances when used for the latter applications (cleaning and cosmetics). These include: hydrogen peroxide, hypochlorites, cupric and ferric ions, per-acids ethanol, parachlorometaxylenol in a sodium C14-16 olefin sulfonate, glutaraldehyde, quaternary ammonium salts, chlorhexidine and chlorhexidine gluconate, curdline sulphate, glycerol, lipids, azodicarbonamide, cicloxolone sodium, dichlorisocyanuric acid (sodium salt), benzalkonium salts, disulfate benzamides and benzisothiazolones, congo red, ascorbic acid, nonoxynol-9, para-aminobenzoic acid, bis(monosuccinamide) derivative of p,p’-bis(2-aminoethyl) diphenlyi-C60) (fullerene). merocyanine, benzoporphyrin derivative monoacid ring A, rose bengal, hypericin, hypocrellin A, anthraquinones extracted from plants, sulfonated anthraquinones and other anthraquinone derivatives gramicidine, gossypol, garlic (Allium sativum) extract and its components: ajoene, diallyl thiosulfinate (allicin), allyl methyl thioulfinate, methyl allyl thiosulfinate, extracts of ledium, motherworth, celandine, black currant, coaberry and bilberry, extract of Cordia salicifolia, steam distillate from Houttuynia cordata (Saururaceae) and its component, 5,6,7-trimethoxyflavone from Calicarpa japonica, isoscullarein (5,7,8,4’-tetrahydroxyflavone) from Scutellaria baikalensis and isoscutellarein-8-methylether, alkaloids and phytosteryl ester compounds. PMID:20200679

21 CFR 184.1199 - Calcium gluconate.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 3 2014-04-01 2014-04-01 false Calcium gluconate. 184.1199 Section 184.1199 Food... GRAS § 184.1199 Calcium gluconate. (a) Calcium gluconate ([CH2OH(CHOH)4COO]2Ca, CAS Reg. No. 299-28-5) is the calcium salt of gluconic acid which may be produced by neutralization of gluconic acid with...

Overproduction of lactimidomycin by cross-overexpression of genes encoding Streptomyces antibiotic regulatory proteins.

PubMed

Zhang, Bo; Yang, Dong; Yan, Yijun; Pan, Guohui; Xiang, Wensheng; Shen, Ben

2016-03-01

The glutarimide-containing polyketides represent a fascinating class of natural products that exhibit a multitude of biological activities. We have recently cloned and sequenced the biosynthetic gene clusters for three members of the glutarimide-containing polyketides-iso-migrastatin (iso-MGS) from Streptomyces platensis NRRL 18993, lactimidomycin (LTM) from Streptomyces amphibiosporus ATCC 53964, and cycloheximide (CHX) from Streptomyces sp. YIM56141. Comparative analysis of the three clusters identified mgsA and chxA, from the mgs and chx gene clusters, respectively, that were predicted to encode the PimR-like Streptomyces antibiotic regulatory proteins (SARPs) but failed to reveal any regulatory gene from the ltm gene cluster. Overexpression of mgsA or chxA in S. platensis NRRL 18993, Streptomyces sp. YIM56141 or SB11024, and a recombinant strain of Streptomyces coelicolor M145 carrying the intact mgs gene cluster has no significant effect on iso-MGS or CHX production, suggesting that MgsA or ChxA regulation may not be rate-limiting for iso-MGS and CHX production in these producers. In contrast, overexpression of mgsA or chxA in S. amphibiosporus ATCC 53964 resulted in a significant increase in LTM production, with LTM titer reaching 106 mg/L, which is five-fold higher than that of the wild-type strain. These results support MgsA and ChxA as members of the SARP family of positive regulators for the iso-MGS and CHX biosynthetic machinery and demonstrate the feasibility to improve glutarimide-containing polyketide production in Streptomyces strains by exploiting common regulators.

Inert Reassessment Document for Gluconic Acid and Sodium Salt

EPA Pesticide Factsheets

Gluconic acid and D-gluconic acid are classified as List 3 inert ingredients, sodium gluconate is classified as a List 4B inert ingredient, and D-gluconic acid, sodium salt has not been categorized as to inert ingredient list classification status.

[The changes of subgingival microbials during periodontal maintenance in patients with gingivitic and wearing fixed orthodontic appliances].

PubMed

Du, Juan; Xie, Yi-yue

2004-07-01

To investigate the microbiological changes of subgingival microbials in patients with gingivitis and wearing fixed orthodontic appliances. 48 subjects (10 to 17 years old) with gingivitis, and wearing fixed orthodontic appliances, were divided randomly into three groups (placebo, NS and CH). Placebo group had normal saline mouthrinse; only and no oral hygiene instruction (OHI). The NS group had OHI and normal saline mouthrinse; The CH group had OHI and 0.12% chlorhexidine gluconate mouthrinse. Bacterial examinations were carried out on baseline, one week, one month and three months after scaling. The bacterial examination was carried out. The percentage of coccus, bacillus and spirochete was calculated. In placebo group and NS group, the percentage of coccus increased up to the third examination then dropped down. The spirochete's percentage changed inversely. CH group maintained an increasing trend in coccus' percentage and decreasing trend in spirochete's percentage. The percentage changes of coccus and bacillus between placebo group and CH group are statistically significant (P < 0.05). During the three-month examination, the CH group had better microbiologic change than the other two groups.

Use of photo-Fenton's reaction by 400-nm LED light for endodontic disinfection: A preliminary in vitro study on Enterococcus faecalis.

PubMed

Lagori, Giuseppe; Fornaini, Carlo; Rocca, Jean-Paul; Merigo, Elisabetta

2017-06-01

One of the biggest challenges in endodontics is the complete disinfection of root canals. In addition to mechanical preparation, the technique traditionally also involves channel disinfection with other agents such as sodium hypochlorite, hydrogen peroxide, chlorhexidine, or a combination of these. Some bacterial species are particularly resistant to eradication. Using Enterococcus faecalis in this preliminary study, we tested the bactericidal effectiveness of the Fenton reaction and the photo-Fenton reaction using an LED light with a 400-nm wavelength. Discs of hydroxyapatite were incubated in brain-heart broth contaminated with Enterococcus faecalis. After 4days, they were decontaminated with different bactericidal agents, including some with proven and well-known efficacy (5% sodium hypochlorite and 3% hydrogen peroxide) and other treatments using solutions of 1.5% hydrogen peroxide and 0.15% iron gluconate (Fenton reaction) plus LED light at a Fluence of 4.0J/cm 2 (photo-Fenton reaction). The photo-Fenton reaction demonstrated comparable performance to that of sodium hypochlorite in eliminating Enterococcus faecalis. Copyright © 2017. Published by Elsevier B.V.

Photodynamic therapy of Curcuma longa extract stimulated with blue light against Aggregatibacter actinomycetemcomitans.

PubMed

Saitawee, Darika; Teerakapong, Aroon; Morales, Noppawan Phumala; Jitprasertwong, Paiboon; Hormdee, Doosadee

2018-06-01

Curcumin, one of an established curcuminoid substances extracted from Curcuma longa, has been used as a photosensitizer (PS) in photodynamic therapy (PDT). Curcuminoid substances has been reported to have benefits in treating dental chronic infection and inflammation diseases, such as chronic periodontitis. The purpose of this study was to find the optimum concentration of Curcuma longa (CL) extract, containing all curcuminoid substances, and the power density of blue light (BL) in photodynamic therapy against periodontally pathogenic bacteria, A. actinomycetemcomitans. Antibacterial activity of various concentrations of CL extract against A. actinomycetemcomitans was determined. Exponentially growing bacteria were combined with 2-fold dilution of CL extract solution ranging from 25 to 0.098 μg/ml. Co-culture bacteria treated with 0.12% chlorhexidine (CHX) served as the positive control. The effect of photostimulation with light emitting diode (LED) 420-480 nm at 16.8 J/cm 2 for 1 min on the selected concentration of CL extract was examined. Bacteria viability was determined by plate counting technique. In addition, production of free radicals was tested by electron spin resonance spectroscope (ESR) with 5,5-dimethyl-1-pyrroline N-oxide (DMPO). The antibacterial activity of CL extract was dose dependent. Without BL, 25 μg/ml CL extract showed 6.03 ± 0.39 log 10 A. actinomycetemcomitans. Interestingly, the combination of BL and 0.78 μg/ml CL extract solution showed complete absence of A. actinomycetemcomitans. Peak signal intensity of hydroxyl radical production was also detected with the combination of BL and CL. CL extract not only had antimicrobial activity but also could be used as an effective PS when stimulated with BL in PDT. The optimal antibacterial effect of CL extract with BL was equal to the standard oral disinfectant, 0.12% CHX. Copyright © 2018 Elsevier B.V. All rights reserved.

Relevance of the clustered regularly interspaced short palindromic repeats of Enterococcus faecalis strains isolated from retreatment root canals on periapical lesions, resistance to irrigants and biofilms

PubMed Central

Tong, Zhongchun; Du, Yu; Ling, Junqi; Huang, Lijia; Ma, Jinglei

2017-01-01

A high prevalence of Enterococcus faecalis (E. faecalis) is observed in teeth with root canal treatment failures. Clustered regularly interspaced short palindromic repeats (CRISPR) are widely distributed in prokaryotes that have adaptive immune systems against mobile elements, including pathogenic genes. The present study investigated the relevance of the CRISPR in E. faecalis strains isolated from retreated root canals on biofilms, periapical lesions and drug resistance. A total of 20 E. faecalis strains were extracted from the root canals of teeth referred for root canal retreatment. CRISPR-Cas loci were identified by two pairs of relevant primers and polymerase chain reaction. The susceptibility of the 20 isolated strains to intracanal irrigants was evaluated by 1- and 5-minute challenges with a mixture of a tetracycline isomer, an acid and a detergent (MTAD), 2% chlorhexidine (CHX) and 5.25% sodium hypochlorite (NaOCl). The microtiter plate assay and crystal violet staining were used to compare the biofilm formation of the E. faecalis isolate strains. Out of the 20 E. faecalis isolate strains, 5 strains that lacked CRISPR-cas determinants exhibited significant periapical lesions. Among the 15 strains containing CRISPR-cas determinants, 8 were isolated from root canals with inadequate fillings and 7 were isolated from root canals without any fillings. The five strains lacking CRISPR-cas loci were observed to be more resistant to MTAD and 2% CHX than the 15 strains that had CRISPR-cas loci. All of the strains exhibited the same susceptibility to 5.25% NaOCl. Furthermore, the 5 strains lacking CRISPR-cas determinants generated more biofilm than the other 15 strains. Thus, the results of the present study suggested that E. faecalis root canal isolates lacking CRISPR-cas exhibit higher resistance to intracanal irrigants, stronger biofilm formation and generate significant periapical lesions. PMID:29285081

Relevance of the clustered regularly interspaced short palindromic repeats of Enterococcus faecalis strains isolated from retreatment root canals on periapical lesions, resistance to irrigants and biofilms.

PubMed

Tong, Zhongchun; Du, Yu; Ling, Junqi; Huang, Lijia; Ma, Jinglei

2017-12-01

A high prevalence of Enterococcus faecalis ( E. faecalis ) is observed in teeth with root canal treatment failures. Clustered regularly interspaced short palindromic repeats (CRISPR) are widely distributed in prokaryotes that have adaptive immune systems against mobile elements, including pathogenic genes. The present study investigated the relevance of the CRISPR in E. faecalis strains isolated from retreated root canals on biofilms, periapical lesions and drug resistance. A total of 20 E. faecalis strains were extracted from the root canals of teeth referred for root canal retreatment. CRISPR-Cas loci were identified by two pairs of relevant primers and polymerase chain reaction. The susceptibility of the 20 isolated strains to intracanal irrigants was evaluated by 1- and 5-minute challenges with a mixture of a tetracycline isomer, an acid and a detergent (MTAD), 2% chlorhexidine (CHX) and 5.25% sodium hypochlorite (NaOCl). The microtiter plate assay and crystal violet staining were used to compare the biofilm formation of the E. faecalis isolate strains. Out of the 20 E. faecalis isolate strains, 5 strains that lacked CRISPR-cas determinants exhibited significant periapical lesions. Among the 15 strains containing CRISPR-cas determinants, 8 were isolated from root canals with inadequate fillings and 7 were isolated from root canals without any fillings. The five strains lacking CRISPR-cas loci were observed to be more resistant to MTAD and 2% CHX than the 15 strains that had CRISPR-cas loci. All of the strains exhibited the same susceptibility to 5.25% NaOCl. Furthermore, the 5 strains lacking CRISPR-cas determinants generated more biofilm than the other 15 strains. Thus, the results of the present study suggested that E. faecalis root canal isolates lacking CRISPR-cas exhibit higher resistance to intracanal irrigants, stronger biofilm formation and generate significant periapical lesions.

Polymorphic Variation in Susceptibility and Metabolism of Triclosan-Resistant Mutants of Escherichia coli and Klebsiella pneumoniae Clinical Strains Obtained after Exposure to Biocides and Antibiotics

PubMed Central

Curiao, Tânia; Marchi, Emmanuela; Viti, Carlo; Oggioni, Marco R.; Baquero, Fernando; Martinez, José Luis

2015-01-01

Exposure to biocides may result in cross-resistance to other antimicrobials. Changes in biocide and antibiotic susceptibilities, metabolism, and fitness costs were studied here in biocide-selected Escherichia coli and Klebsiella pneumoniae mutants. E. coli and K. pneumoniae mutants with various degrees of triclosan susceptibility were obtained after exposure to triclosan (TRI), benzalkonium chloride (BKC), chlorhexidine (CHX) or sodium hypochlorite (SHC), and ampicillin or ciprofloxacin. Alterations in antimicrobial susceptibility and metabolism in mutants were tested using Phenotype MicroArrays. The expression of AcrAB pump and global regulators (SoxR, MarA, and RamA) was measured by quantitative reverse transcription-PCR (qRT-PCR), and the central part of the fabI gene was sequenced. The fitness costs of resistance were assessed by a comparison of relative growth rates. Triclosan-resistant (TRIr) and triclosan-hypersusceptible (TRIhs) mutants of E. coli and K. pneumoniae were obtained after selection with biocides and/or antibiotics. E. coli TRIr mutants, including those with mutations in the fabI gene or in the expression of acrB, acrF, and marA, exhibited changes in susceptibility to TRI, CHX, and antibiotics. TRIr mutants for which the TRI MIC was high presented improved metabolism of carboxylic acids, amino acids, and carbohydrates. In TRIr mutants, resistance to one antimicrobial provoked hypersusceptibility to another one(s). TRIr mutants had fitness costs, particularly marA-overexpressing (E. coli) or ramA-overexpressing (K. pneumoniae) mutants. TRI, BKC, and CIP exposure frequently yielded TRIr mutants exhibiting alterations in AraC-like global regulators (MarA, SoxR, and RamA), AcrAB-TolC, and/or FabI, and influencing antimicrobial susceptibility, fitness, and metabolism. These various phenotypes suggest a trade-off of different selective processes shaping the evolution toward antibiotic/biocide resistance and influencing other adaptive traits. PMID:25824225

Effect of endodontic irrigants on biofilm matrix polysaccharides.

PubMed

Tawakoli, P N; Ragnarsson, K T; Rechenberg, D K; Mohn, D; Zehnder, M

2017-02-01

To specifically investigate the effect of endodontic irrigants at their clinical concentration on matrix polysaccharides of cultured biofilms. Saccharolytic effects of 3% H 2 O 2 , 2% chlorhexidine (CHX), 17% EDTA, 5% NaOCl and 0.9% saline (control) were tested using agarose (α 1-3 and β 1-4 glycosidic bonds) blocks (n = 3) in a weight assay. The irrigants were also applied to three-species biofilms (Streptococcus mutans UAB 159, Streptococcus oralis OMZ 607 and Actinomyces oris OMZ 745) grown anaerobically on hydroxyapatite discs (n = 6). Glycoconjugates in the matrix and total bacterial cell volumes were determined using combined Concanavalin A-/Syto 59-staining and confocal laser-scanning microscopy. Volumes of each scanned area (triplicates/sample) were calculated using Imaris software. Data were compared between groups using one-way anova/Tukey HSD, α = 0.05. The weight assay revealed that NaOCl was the only irrigant under investigation capable of dissolving the agarose blocks. NaOCl eradicated stainable matrix and bacteria in cultured biofilms after 1 min of exposure (P < 0.05 compared to all groups, volumes in means ± standard deviation, 10 -3  mm 3 per 0.6 mm 2 disc; NaOCl matrix: 0.10 ± 0.08, bacteria: 0.03 ± 0.06; saline control matrix: 4.01 ± 1.14, bacteria: 11.56 ± 3.02). EDTA also appeared to have some effect on the biofilm matrix (EDTA matrix: 1.90 ± 0.33, bacteria: 9.26 ± 2.21), whilst H 2 O 2 and CHX merely reduced bacterial cell volumes. Sodium hypochlorite can break glycosidic bonds. It dissolves glycoconjugates in the biofilm matrix. It also lyses bacterial cells. © 2015 International Endodontic Journal. Published by John Wiley & Sons Ltd.

Comparison of the antimicrobial efficacy of photodynamic therapy with two mediators against Lactobacillus acidophilus in vitro.

PubMed

Azizi, Arash; Mousavian, Shiva; Taheri, Soudabeh; Lawaf, Shirin; Gonoudi, Elnaz; Rahimi, Arash

2018-03-01

Lactobacillus is a cariogenic microorganism. Different therapeutic approaches including photodynamic therapy (PDT) have been suggested for treatment of bacterial infection. The purpose of the current study was to compare the effects of PDT with Indocyanine green (ICG) and Methylene blue (MB) photosensitizers (PSs) on Lactobacillus acidophilus (L. acidophilus). In this in-vitro experimental study, 84 samples of L. acidophilus (1 McFarland standard) were compared in 14 experimental groups including: MB, ICG, 660-nm laser, 808-nm laser (pulsed, 74s/continuous-wave, 37s), different combinations of lasers and PSs, Chlorhexidine (CHX) 0.2%, sodium hypochlorite (NaOCl) 2.5%, penicillin 6.3.3 and control groups. The samples were cultured in microplates containing blood agar culture medium. After incubation at 37 °C for 48 h, the colony forming units (CFUs) of L. acidophilus were counted and compared before and after therapeutic interventions. Data were analyzed using SPSS19 software program according to one-way ANOVA test. This study showed that the separate use of ICG, 660- and 808-nm lasers (pulsed, 74s/continuous-wave, 37s), and the combined use of 808-nm laser (pulsed, 74s/continuous-wave, 37s) and ICG have no significant inhibitory effect on L. acidophilus colonies (P > 0.05), whereas the separate use of MB and the combined use of 660-nm laser (continuous-wave, 37s/pulsed, 74s) and MB significantly inhibited the growth of L. acidophilus in comparison with the control group (p < 0.05). Likewise, CHX 0.2%, NaOCl 2.5% and penicillin 6.3.3 significantly inhibited the bacterial growth (p < 0.05). The results showed that separate use of MB and combined use of 660-nm laser and MB have a significant inhibitory effect on L. acidophilus growth. Copyright © 2018 Elsevier B.V. All rights reserved.

Polymorphic variation in susceptibility and metabolism of triclosan-resistant mutants of Escherichia coli and Klebsiella pneumoniae clinical strains obtained after exposure to biocides and antibiotics.

PubMed

Curiao, Tânia; Marchi, Emmanuela; Viti, Carlo; Oggioni, Marco R; Baquero, Fernando; Martinez, José Luis; Coque, Teresa M

2015-01-01

Exposure to biocides may result in cross-resistance to other antimicrobials. Changes in biocide and antibiotic susceptibilities, metabolism, and fitness costs were studied here in biocide-selected Escherichia coli and Klebsiella pneumoniae mutants. E. coli and K. pneumoniae mutants with various degrees of triclosan susceptibility were obtained after exposure to triclosan (TRI), benzalkonium chloride (BKC), chlorhexidine (CHX) or sodium hypochlorite (SHC), and ampicillin or ciprofloxacin. Alterations in antimicrobial susceptibility and metabolism in mutants were tested using Phenotype MicroArrays. The expression of AcrAB pump and global regulators (SoxR, MarA, and RamA) was measured by quantitative reverse transcription-PCR (qRT-PCR), and the central part of the fabI gene was sequenced. The fitness costs of resistance were assessed by a comparison of relative growth rates. Triclosan-resistant (TRI(r)) and triclosan-hypersusceptible (TRI(hs)) mutants of E. coli and K. pneumoniae were obtained after selection with biocides and/or antibiotics. E. coli TRI(r) mutants, including those with mutations in the fabI gene or in the expression of acrB, acrF, and marA, exhibited changes in susceptibility to TRI, CHX, and antibiotics. TRI(r) mutants for which the TRI MIC was high presented improved metabolism of carboxylic acids, amino acids, and carbohydrates. In TRI(r) mutants, resistance to one antimicrobial provoked hypersusceptibility to another one(s). TRI(r) mutants had fitness costs, particularly marA-overexpressing (E. coli) or ramA-overexpressing (K. pneumoniae) mutants. TRI, BKC, and CIP exposure frequently yielded TRI(r) mutants exhibiting alterations in AraC-like global regulators (MarA, SoxR, and RamA), AcrAB-TolC, and/or FabI, and influencing antimicrobial susceptibility, fitness, and metabolism. These various phenotypes suggest a trade-off of different selective processes shaping the evolution toward antibiotic/biocide resistance and influencing other adaptive traits. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

High-Velocity Microsprays Enhance Antimicrobial Activity in Streptococcus mutans Biofilms.

PubMed

Fabbri, S; Johnston, D A; Rmaile, A; Gottenbos, B; De Jager, M; Aspiras, M; Starke, E M; Ward, M T; Stoodley, P

2016-12-01

Streptococcus mutans in dental plaque biofilms play a role in caries development. The biofilm's complex structure enhances the resistance to antimicrobial agents by limiting the transport of active agents inside the biofilm. The authors assessed the ability of high-velocity water microsprays to enhance delivery of antimicrobials into 3-d-old S. mutans biofilms. Biofilms were exposed to a 90° or 30° impact, first using a 1-µm tracer bead solution (10 9 beads/mL) and, second, a 0.2% chlorhexidine (CHX) or 0.085% cetylpyridinium chloride (CPC) solution. For comparison, a 30-s diffusive transport and simulated mouthwash were also performed. Confocal microscopy was used to determine number and relative bead penetration depth into the biofilm. Assessment of antimicrobial penetration was determined by calculating the killing depth detected by live/dead viability staining. The authors first demonstrated that the microspray was able to deliver significantly more microbeads deeper in the biofilm compared with diffusion and mouthwashing exposures. Next, these experiments revealed that the microspray yielded better antimicrobial penetration evidenced by deeper killing inside the biofilm and a wider killing zone around the zone of clearance than diffusion alone. Interestingly the 30° impact in the distal position delivered approximately 16 times more microbeads and yielded approximately 20% more bacteria killing (for both CHX and CPC) than the 90° impact. These data suggest that high-velocity water microsprays can be used as an effective mechanism to deliver microparticles and antimicrobials inside S. mutans biofilms. High shear stresses generated at the biofilm-burst interface might have enhanced bead and antimicrobial delivery inside the remaining biofilm by combining forced advection into the biofilm matrix and physical restructuring of the biofilm itself. Further, the impact angle has potential to be optimized both for biofilm removal and active agents' delivery inside biofilm in those protected areas where some biofilm might remain. © International & American Associations for Dental Research 2016.

Inhibitory effects of acid water prepared by an electrolysis apparatus on early plaque formation on specimens of dentine.

PubMed

Ito, K; Nishida, T; Murai, S

1996-05-01

The aim of this study was to compare the effects of acid water prepared by an electrolysis apparatus with placebo treatment on the ultrastructure of early plaque formed on dentine specimens attached to retainers in the oral cavity. Dentine specimens were taken from 12 healthy extracted human 3rd molars. 4 dentine specimens were placed in the both the right and left buccal flanges of retainers fabricated from self-setting acrylic resin. The retainers were placed on both maxillary buccal sites in 6 subjects. The test solution was acid water (AW) prepared by an electrolysis apparatus with a pH of 2.7 and an oxidation-reduction potential of more than 1100 mV. As a positive control, 0.2% chlorhexidine digluconate (CHX) solution was used and normal saline solution as a negative control. 4 specimens placed in the right and left retainers were randomly allocated to 4 treatments as follows: treatment A, washing with AW; treatment B, washing with CHX solution; treatment C, washing with normal saline; treatment D, no washing. Washing was carried out in a plastic beaker containing 30 ml of each solution for 30s 2X daily over a 7-day period. The specimens were then carefully removed from the retainers, the morphology and thickness of the plaque formed examined by SEM, and the developmental condition of the plaque analyzed statistically. The plaque on the specimens in treatments A and B consisted mainly of coccoid forms. Mature plaque formation with complex flora was seen on the specimens in treatments C and D. The mean thickness of the plaque deposits on the dentin specimens as measured on SEM photographs magnified 2000 times was 8.80 mm for treatment. A, while in treatment B it was 3.90 mm. Plaque thickness for treatment C was 24.97 mm, and for treatment D 25.67 mm. The thickness of plaque formed on the sectioned specimens was significantly less for treatments A and B than for treatments C and D. However, there was no statistically significant difference between treatments A and B, and between treatments C and D (p < 0.0001). The results of this short-term study indicate that AW washing has almost the same potential for inhibition of plaque formation as CHX washing, and is more effective for inhibiting plaque formation than washing with sterile saline. It is therefore concluded that AW may be useful as an anti-plaque agent.

21 CFR 184.1199 - Calcium gluconate.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 3 2012-04-01 2012-04-01 false Calcium gluconate. 184.1199 Section 184.1199 Food... Specific Substances Affirmed as GRAS § 184.1199 Calcium gluconate. (a) Calcium gluconate ([CH2OH(CHOH)4COO]2Ca, CAS Reg. No. 299-28-5) is the calcium salt of gluconic acid which may be produced by...

21 CFR 184.1199 - Calcium gluconate.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 3 2013-04-01 2013-04-01 false Calcium gluconate. 184.1199 Section 184.1199 Food... Specific Substances Affirmed as GRAS § 184.1199 Calcium gluconate. (a) Calcium gluconate ([CH2OH(CHOH)4COO]2Ca, CAS Reg. No. 299-28-5) is the calcium salt of gluconic acid which may be produced by...

Evaluation of microbial profile in dental unit waterlines and assessment of antimicrobial efficacy of two treating agents.

PubMed

Mungara, J; Dilna, N C; Joseph, E; Reddy, N

2013-01-01

The quality of water in a dental unit used for cooling and flushing the high and low speed handpiece, air/water syringes and the scalers is of considerable importance. The present study was carried out to enumerate and identify the microorganisms present in water samples collected from dental unit waterlines of different dental specialty clinics and to find out the efficacy of two treating agents in disinfecting dental unit waterlines. Sample included 70 dental unit waterlines from different speciality dental clinics which were checked for microbial contamination. From these dental units 40 units were randomly selected and divided into two groups of 20 each. Group A, treatment was done in 20 dental units with 0.2% Chlorhexidine gluconate solution and Group B, treatment was done in 20 dental units with 10% Povidone iodine solution and the reduction in the microbial levels were assessed. Five dental units were randomly selected and checked the microbial contamination using mineral water sterile distilled water fresh tap water as a water source in the dental unit reservoir bottles. Also from the test group, five from each group were checked for the duration of efficacy of treating agent for one week by analyzing the water samples collected on 3,5 and 7 day intervals. Most of the identified microorganisms are Gram negative and pseudomonas predominating up to 98.59% of the total isolates. Usage of disinfectants 0.2% Chlorhexidine and 10% Povidone Iodine were found to be very effective in reducing the microbial contamination and 10% Povidone iodine was found to be more efficient (97.13%) and active for a period of 3 days and gradually loosing its efficacy by 7th day. No significant difference were found in microbial contamination of water samples collected from different water outlets such as handpiece outlets, air water syringe outlets, scaler lines. To continue maintaining the sterility of the Dental unit waterlines and to complete the infection control measures adopted in the dental clinics, suitable disinfectants like 0.2% Chlorhexidine on daily basis or 10% Povidone iodine on every 3rd day basis intermittently maintain the sterility of dental unit waterlines it is essential to have a good water source and an effective disinfectant.

Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia.

PubMed

Hua, Fang; Xie, Huixu; Worthington, Helen V; Furness, Susan; Zhang, Qi; Li, Chunjie

2016-10-25

Ventilator-associated pneumonia (VAP) is defined as pneumonia developing in people who have received mechanical ventilation for at least 48 hours. VAP is a potentially serious complication in these patients who are already critically ill. Oral hygiene care (OHC), using either a mouthrinse, gel, toothbrush, or combination, together with aspiration of secretions, may reduce the risk of VAP in these patients. To assess the effects of oral hygiene care on incidence of ventilator-associated pneumonia in critically ill patients receiving mechanical ventilation in hospital intensive care units (ICUs). We searched the following electronic databases: Cochrane Oral Health's Trials Register (to 17 December 2015), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2015, Issue 11), MEDLINE Ovid (1946 to 17 December 2015), Embase Ovid (1980 to 17 December 2015), LILACS BIREME Virtual Health Library (1982 to 17 December 2015), CINAHL EBSCO (1937 to 17 December 2016), Chinese Biomedical Literature Database (1978 to 14 January 2013), China National Knowledge Infrastructure (1994 to 14 January 2013), Wan Fang Database (January 1984 to 14 January 2013) and VIP Database (January 2012 to 4 May 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 17 December 2015. We placed no restrictions on the language or date of publication when searching the electronic databases. We included randomised controlled trials (RCTs) evaluating the effects of OHC (mouthrinse, swab, toothbrush or combination) in critically ill patients receiving mechanical ventilation for at least 48 hours. At least two review authors independently assessed search results, extracted data and assessed risk of bias in included studies. We contacted study authors for additional information. We pooled data from trials with similar interventions and outcomes. We reported risk ratio (RR) for dichotomous outcomes and mean difference (MD) for continuous outcomes, using random-effects models unless there were fewer than four studies. We included 38 RCTs (6016 participants). There were four main comparisons: chlorhexidine (CHX) mouthrinse or gel versus placebo/usual care; toothbrushing versus no toothbrushing; powered versus manual toothbrushing; and comparisons of oral care solutions. We assessed the overall risk of bias as low in five trials (13%), high in 26 trials (68%), and unclear in seven trials (18%). We did not consider the risk of bias to be serious when assessing the quality of evidence (GRADE) for VAP incidence, but we downgraded other outcomes for risk of bias.High quality evidence from 18 RCTs (2451 participants, 86% adults) shows that CHX mouthrinse or gel, as part of OHC, reduces the risk of VAP compared to placebo or usual care from 25% to about 19% (RR 0.74, 95% confidence intervals (CI) 0.61 to 0.89, P = 0.002, I 2 = 31%). This is equivalent to a number needed to treat for an additional beneficial outcome (NNTB) of 17 (95% CI 10 to 33), which indicates that for every 17 ventilated patients in intensive care receiving OHC including chlorhexidine, one outcome of VAP would be prevented. There is no evidence of a difference between CHX and placebo/usual care for the outcomes of mortality (RR 1.09, 95% CI 0.96 to 1.23, P = 0.18, I 2 = 0%, 15 RCTs, 2163 participants, moderate quality evidence), duration of mechanical ventilation (MD -0.09 days, 95% CI -1.73 to 1.55 days, P = 0.91, I 2 = 36%, five RCTs, 800 participants, low quality evidence), or duration of intensive care unit (ICU) stay (MD 0.21 days, 95% CI -1.48 to 1.89 days, P = 0.81, I 2 = 9%, six RCTs, 833 participants, moderate quality evidence). There is insufficient evidence to determine the effect of CHX on duration of systemic antibiotics, oral health indices, caregivers' preferences or cost. Only two studies reported any adverse effects, and these were mild with similar frequency in CHX and control groups.We are uncertain as to the effects of toothbrushing (± antiseptics) on the outcomes of VAP (RR 0.69, 95% CI 0.44 to 1.09, P = 0.11, I 2 = 64%, five RCTs, 889 participants, very low quality evidence) and mortality (RR 0.87, 95% CI 0.70 to 1.09, P = 0.24, I 2 = 0%, five RCTs, 889 participants, low quality evidence) compared to OHC without toothbrushing (± antiseptics). There is insufficient evidence to determine whether toothbrushing affects duration of mechanical ventilation, duration of ICU stay, use of systemic antibiotics, oral health indices, adverse effects, caregivers' preferences or cost.Only one trial (78 participants) compared use of a powered toothbrush with a manual toothbrush, providing insufficient evidence to determine the effect on any of the outcomes of this review.Fifteen trials compared various other oral care solutions. There is very weak evidence that povidone iodine mouthrinse is more effective than saline/placebo (RR 0.69, 95% CI 0.50 to 0.95, P = 0.02, I 2 = 74%, three studies, 356 participants, high risk of bias), and that saline rinse is more effective than saline swab (RR 0.47, 95% CI 0.37 to 0.62, P < 0.001, I 2 = 84%, four studies, 488 participants, high risk of bias) in reducing VAP. Due to variation in comparisons and outcomes among trials, there is insufficient evidence concerning the effects of other oral care solutions. OHC including chlorhexidine mouthwash or gel reduces the risk of developing ventilator-associated pneumonia in critically ill patients from 25% to about 19%. However, there is no evidence of a difference in the outcomes of mortality, duration of mechanical ventilation or duration of ICU stay. There is no evidence that OHC including both antiseptics and toothbrushing is different from OHC with antiseptics alone, and some weak evidence to suggest that povidone iodine mouthrinse is more effective than saline/placebo, and saline rinse is more effective than saline swab in reducing VAP. There is insufficient evidence to determine whether powered toothbrushing or other oral care solutions are effective in reducing VAP. There is also insufficient evidence to determine whether any of the interventions evaluated in the studies are associated with adverse effects.

Production of gluconic acid using Micrococcus sp.: optimisation of carbon and nitrogen sources.

PubMed

Joshi, V D; Sreekantiah, K R; Manjrekar, S P

1996-01-01

A process for production of gluconic acid from glucose by a Micrococcus sp. is described. More than 400 bacterial cultures isolated from local soil were tested for gluconic acid production. Three isolates, were selected on basis of their ability to produce gluconic acid and high titrable acidity. These were identified as Micrococcus sp. and were named M 27, M 54 and M 81. Nutritional and other parameters for maximum production of gluconic acid by the selected isolates were optimised. It was found that Micrococcus sp. isolate M 27 gave highest yield of 8.19 g gluconic acid from 9 g glucose utilised giving 91% conversion effeciency.

21 CFR 582.1199 - Calcium gluconate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Calcium gluconate. 582.1199 Section 582.1199 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Additives § 582.1199 Calcium gluconate. (a) Product. Calcium gluconate. (b) Conditions of use. This...

21 CFR 582.6199 - Calcium gluconate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Calcium gluconate. 582.6199 Section 582.6199 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Calcium gluconate. (a) Product. Calcium gluconate. (b) Conditions of use. This substance is generally...

21 CFR 582.6199 - Calcium gluconate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Calcium gluconate. 582.6199 Section 582.6199 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Calcium gluconate. (a) Product. Calcium gluconate. (b) Conditions of use. This substance is generally...

21 CFR 182.8988 - Zinc gluconate.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 3 2014-04-01 2014-04-01 false Zinc gluconate. 182.8988 Section 182.8988 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) SUBSTANCES GENERALLY RECOGNIZED AS SAFE Nutrients § 182.8988 Zinc gluconate. (a) Product. Zinc gluconate. (b...

21 CFR 182.6757 - Sodium gluconate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 3 2011-04-01 2011-04-01 false Sodium gluconate. 182.6757 Section 182.6757 Food... HUMAN CONSUMPTION (CONTINUED) SUBSTANCES GENERALLY RECOGNIZED AS SAFE Sequestrants 1 § 182.6757 Sodium gluconate. (a) Product. Sodium gluconate. (b) Conditions of use. This substance is generally recognized as...

21 CFR 182.6757 - Sodium gluconate.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 3 2013-04-01 2013-04-01 false Sodium gluconate. 182.6757 Section 182.6757 Food... HUMAN CONSUMPTION (CONTINUED) SUBSTANCES GENERALLY RECOGNIZED AS SAFE Sequestrants 1 § 182.6757 Sodium gluconate. (a) Product. Sodium gluconate. (b) Conditions of use. This substance is generally recognized as...

21 CFR 582.6757 - Sodium gluconate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Sodium gluconate. 582.6757 Section 582.6757 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Sodium gluconate. (a) Product. Sodium gluconate. (b) Conditions of use. This substance is generally...

21 CFR 582.6757 - Sodium gluconate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Sodium gluconate. 582.6757 Section 582.6757 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Sodium gluconate. (a) Product. Sodium gluconate. (b) Conditions of use. This substance is generally...

21 CFR 582.6757 - Sodium gluconate.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Sodium gluconate. 582.6757 Section 582.6757 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Sodium gluconate. (a) Product. Sodium gluconate. (b) Conditions of use. This substance is generally...

21 CFR 582.6757 - Sodium gluconate.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Sodium gluconate. 582.6757 Section 582.6757 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Sodium gluconate. (a) Product. Sodium gluconate. (b) Conditions of use. This substance is generally...

21 CFR 582.6757 - Sodium gluconate.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Sodium gluconate. 582.6757 Section 582.6757 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Sodium gluconate. (a) Product. Sodium gluconate. (b) Conditions of use. This substance is generally...

21 CFR 182.6757 - Sodium gluconate.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 3 2012-04-01 2012-04-01 false Sodium gluconate. 182.6757 Section 182.6757 Food... HUMAN CONSUMPTION (CONTINUED) SUBSTANCES GENERALLY RECOGNIZED AS SAFE Sequestrants 1 § 182.6757 Sodium gluconate. (a) Product. Sodium gluconate. (b) Conditions of use. This substance is generally recognized as...

21 CFR 182.6757 - Sodium gluconate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Sodium gluconate. 182.6757 Section 182.6757 Food... HUMAN CONSUMPTION (CONTINUED) SUBSTANCES GENERALLY RECOGNIZED AS SAFE Sequestrants 1 § 182.6757 Sodium gluconate. (a) Product. Sodium gluconate. (b) Conditions of use. This substance is generally recognized as...

21 CFR 582.6199 - Calcium gluconate.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 6 2014-04-01 2014-04-01 false Calcium gluconate. 582.6199 Section 582.6199 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Calcium gluconate. (a) Product. Calcium gluconate. (b) Conditions of use. This substance is generally...

21 CFR 582.6199 - Calcium gluconate.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 6 2013-04-01 2013-04-01 false Calcium gluconate. 582.6199 Section 582.6199 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Calcium gluconate. (a) Product. Calcium gluconate. (b) Conditions of use. This substance is generally...

21 CFR 582.6199 - Calcium gluconate.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 6 2012-04-01 2012-04-01 false Calcium gluconate. 582.6199 Section 582.6199 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL... Calcium gluconate. (a) Product. Calcium gluconate. (b) Conditions of use. This substance is generally...

21 CFR 582.5988 - Zinc gluconate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Zinc gluconate. 582.5988 Section 582.5988 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS... 1 § 582.5988 Zinc gluconate. (a) Product. Zinc gluconate. (b) Conditions of use. This substance is...

21 CFR 522.2690 - Zinc gluconate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Zinc gluconate. 522.2690 Section 522.2690 Food and..., FEEDS, AND RELATED PRODUCTS IMPLANTATION OR INJECTABLE DOSAGE FORM NEW ANIMAL DRUGS § 522.2690 Zinc gluconate. (a) Specifications. Each milliliter of solution contains 13.1 milligrams zinc as zinc gluconate...

21 CFR 182.8988 - Zinc gluconate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 3 2010-04-01 2009-04-01 true Zinc gluconate. 182.8988 Section 182.8988 Food and... CONSUMPTION (CONTINUED) SUBSTANCES GENERALLY RECOGNIZED AS SAFE Nutrients § 182.8988 Zinc gluconate. (a) Product. Zinc gluconate. (b) Conditions of use. This substance is generally recognized as safe when used...

21 CFR 522.2690 - Zinc gluconate.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Zinc gluconate. 522.2690 Section 522.2690 Food and..., FEEDS, AND RELATED PRODUCTS IMPLANTATION OR INJECTABLE DOSAGE FORM NEW ANIMAL DRUGS § 522.2690 Zinc gluconate. (a) Specifications. Each milliliter of solution contains 13.1 milligrams zinc as zinc gluconate...

21 CFR 182.8988 - Zinc gluconate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 3 2011-04-01 2011-04-01 false Zinc gluconate. 182.8988 Section 182.8988 Food and... CONSUMPTION (CONTINUED) SUBSTANCES GENERALLY RECOGNIZED AS SAFE Nutrients § 182.8988 Zinc gluconate. (a) Product. Zinc gluconate. (b) Conditions of use. This substance is generally recognized as safe when used...

21 CFR 582.5988 - Zinc gluconate.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 6 2011-04-01 2011-04-01 false Zinc gluconate. 582.5988 Section 582.5988 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) ANIMAL DRUGS... 1 § 582.5988 Zinc gluconate. (a) Product. Zinc gluconate. (b) Conditions of use. This substance is...

21 CFR 182.6757 - Sodium gluconate.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 3 2014-04-01 2014-04-01 false Sodium gluconate. 182.6757 Section 182.6757 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) SUBSTANCES GENERALLY RECOGNIZED AS SAFE Sequestrants 1 § 182.6757 Sodium gluconate. (a) Product. Sodium gluconate. (b...

A comparative evaluation of the chelators H4octapa and CHX-A″-DTPA with the therapeutic radiometal (90)Y.

PubMed

Price, Eric W; Edwards, Kimberly J; Carnazza, Kathryn E; Carlin, Sean D; Zeglis, Brian M; Adam, Michael J; Orvig, Chris; Lewis, Jason S

2016-09-01

To compare the radiolabeling performance, stability, and practical efficacy of the chelators CHX-A″-DTPA and H4octapa with the therapeutic radiometal (90)Y. The bifunctional chelators p-SCN-Bn-H4octapa and p-SCN-Bn-CHX-A″-DTPA were conjugated to the HER2-targeting antibody trastuzumab. The resulting immunoconjugates were radiolabeled with (90)Y to compare radiolabeling efficiency, in vitro and in vivo stability, and in vivo performance in a murine model of ovarian cancer. High radiochemical yields (>95%) were obtained with (90)Y-CHX-A″-DTPA-trastuzumab and (90)Y-octapa-trastuzumab after 15min at room temperature. Both (90)Y-CHX-A″-DTPA-trastuzumab and (90)Y-octapa-trastuzumab exhibited excellent in vitro and in vivo stability. Furthermore, the radioimmunoconjugates displayed high tumoral uptake values (42.3±4.0%ID/g for (90)Y-CHX-A″-DTPA-trastuzumab and 30.1±7.4%ID/g for (90)Y-octapa-trastuzumab at 72h post-injection) in mice bearing HER2-expressing SKOV3 ovarian cancer xenografts. Finally, (90)Y radioimmunotherapy studies performed in tumor-bearing mice demonstrated that (90)Y-CHX-A″-DTPA-trastuzumab and (90)Y-octapa-trastuzumab are equally effective therapeutic agents, as treatment with both radioimmunoconjugates yielded substantially decreased tumor growth compared to controls. Ultimately, this work demonstrates that the acyclic chelators CHX-A″-DTPA and H4octapa have comparable radiolabeling, stability, and in vivo performance, making them both suitable choices for applications requiring (90)Y. Copyright © 2016 Elsevier Inc. All rights reserved.

CHX14 is a plasma membrane K-efflux transporter that regulates K+ redistribution in "Arabidopsis thaliana"

USDA-ARS?s Scientific Manuscript database

Potassium (K(+)) is essential for plant growth and development, yet the molecular identity of many K(+) transporters remains elusive. Here we characterized cation/H(+) exchanger (CHX) 14 as a plasma membrane K(+) transporter. "CHX14" expression was induced by elevated K(+) and histochemical analysis...

Chronic hypoxia suppresses the CO2 response of solitary complex (SC) neurons from rats.

PubMed

Nichols, Nicole L; Wilkinson, Katherine A; Powell, Frank L; Dean, Jay B; Putnam, Robert W

2009-09-30

We studied the effect of chronic hypobaric hypoxia (CHx; 10-11% O(2)) on the response to hypercapnia (15% CO(2)) of individual solitary complex (SC) neurons from adult rats. We simultaneously measured the intracellular pH and firing rate responses to hypercapnia of SC neurons in superfused medullary slices from control and CHx-adapted adult rats using the blind whole cell patch clamp technique and fluorescence imaging microscopy. We found that CHx caused the percentage of SC neurons inhibited by hypercapnia to significantly increase from about 10% up to about 30%, but did not significantly alter the percentage of SC neurons activated by hypercapnia (50% in control vs. 35% in CHx). Further, the magnitudes of the responses of SC neurons from control rats (chemosensitivity index for activated neurons of 166+/-11% and for inhibited neurons of 45+/-15%) were the same in SC neurons from CHx-adapted rats. This plasticity induced in chemosensitive SC neurons by CHx appears to involve intrinsic changes in neuronal properties since they were the same in synaptic blockade medium.

Effects of cycloheximide on extinction in an appetitively motivated operant conditioning task depend on re-exposure duration.

PubMed

Mierzejewski, Pawel; Olczak, Mieszko; Rogowski, Artur; Kostowski, Wojciech; Samochowiec, Jerzy; Filip, Malgorzata; Przegalinski, Edmund; Bienkowski, Przemyslaw

2008-08-29

Little is known about the role of new protein synthesis in extinction of operant responding for natural and chemical reinforcers. In the present study, the authors investigated whether the effects of a protein synthesis inhibitor, cycloheximide (CHX) on extinction of operant responding for sweet reward depended on the duration of re-exposure sessions. In addition, the authors investigated whether the effects of CHX on extinction could generalize to relapse of saccharin seeking induced by discrete cues. CHX injected after short re-exposure sessions (5min) accelerated extinction of non-reinforced responding. In contrast, the drug injected after long re-exposure sessions (30min) partially inhibited extinction. Reinstatement of saccharin seeking induced by the saccharin-paired discrete cues was not altered by the previous treatment with CHX. Concluding, the results of the present study indicate that: (i) the protein synthesis inhibitor, CHX can alter extinction of operant responding for sweet reward in rats; (ii) the effects of CHX on extinction critically depend on the duration of re-exposure/extinction sessions and do not generalize to relapse of saccharin seeking induced by discrete cues.

OsCHX14 is Involved in the K+ Homeostasis in Rice (Oryza sativa) Flowers.

PubMed

Chen, Yi; Ma, Jingkun; Miller, Anthony J; Luo, Bingbing; Wang, Mei; Zhu, Zhen; Ouwerkerk, Pieter B F

2016-07-01

Previously we showed in the osjar1 mutants that the lodicule senescence which controls the closing of rice flowers was delayed. This resulted in florets staying open longer when compared with the wild type. The gene OsJAR1 is silenced in osjar1 mutants and is a key member of the jasmonic acid (JA) signaling pathway. We found that K concentrations in lodicules and flowers of osjar1-2 were significantly elevated compared with the wild type, indicating that K + homeostasis may play a role in regulating the closure of rice flowers. The cation/H + exchanger (CHX) family from rice was screened for potential K + transporters involved as many members of this family in Arabidopsis were exclusively or preferentially expressed in flowers. Expression profiling confirmed that among 17 CHX genes in rice, OsCHX14 was the only member that showed an expression polymorphism, not only in osjar1 mutants but also in RNAi (RNA interference) lines of OsCOI1, another key member of the JA signaling pathway. This suggests that the expression of OsCHX14 is regulated by the JA signaling pathway. Green fluorescent protein (GFP)-tagged OsCHX14 protein was preferentially localized to the endoplasmic reticulum. Promoter-β-glucuronidase (GUS) analysis of transgenic rice revealed that OsCHX14 is mainly expressed in lodicules and the region close by throughout the flowering process. Characterization in yeast and Xenopus laevis oocytes verified that OsCHX14 is able to transport K + , Rb + and Cs + in vivo. Our data suggest that OsCHX14 may play an important role in K + homeostasis during flowering in rice. © The Author 2016. Published by Oxford University Press on behalf of Japanese Society of Plant Physiologists. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Protein architecture and core residues in unwound α-helices provide insights to the transport function of plant AtCHX17

DOE Office of Scientific and Technical Information (OSTI.GOV)

Czerny, Daniel D.; Padmanaban, Senthilkumar; Anishkin, Andriy

Using Arabidopsis thaliana AtCHX17 as an example, we combine structural modeling and mutagenesis to provide insights on its protein architecture and transport function which is poorly characterized. This approach is based on the observation that protein structures are significantly more conserved in evolution than linear sequences, and mechanistic similarities among diverse transporters are emerging. Two homology models of AtCHX17 were obtained that show a protein fold similar to known structures of bacterial Na +/H + antiporters, EcNhaA and TtNapA. The distinct secondary and tertiary structure models highlighted residues at positions potentially important for CHX17 activity. Mutagenesis showed that asparagine-N200 andmore » aspartate-D201 inside transmembrane5 (TM5), and lysine-K355 inside TM10 are critical for AtCHX17 activity. We reveal previously unrecognized threonine-T170 and lysine-K383 as key residues at unwound regions in the middle of TM4 and TM11 α-helices, respectively. Mutation of glutamate-E111 located near the membrane surface inhibited AtCHX17 activity, suggesting a role in pH sensing. The long carboxylic tail of unknown purpose has an alternating β-sheet and α-helix secondary structure that is conserved in prokaryote universal stress proteins. Here, these results support the overall architecture of AtCHX17 and identify D201, N200 and novel residues T170 and K383 at the functional core which likely participates in ion recognition, coordination and/or translocation, similar to characterized cation/H + exchangers. The core of AtCHX17 models according to EcNhaA and TtNapA templates faces inward and outward, respectively, which may reflect two conformational states of the alternating access transport mode for proteins belonging to the plant CHX family.« less

Protein architecture and core residues in unwound α-helices provide insights to the transport function of plant AtCHX17

DOE PAGES

Czerny, Daniel D.; Padmanaban, Senthilkumar; Anishkin, Andriy; ...

2016-05-11

Using Arabidopsis thaliana AtCHX17 as an example, we combine structural modeling and mutagenesis to provide insights on its protein architecture and transport function which is poorly characterized. This approach is based on the observation that protein structures are significantly more conserved in evolution than linear sequences, and mechanistic similarities among diverse transporters are emerging. Two homology models of AtCHX17 were obtained that show a protein fold similar to known structures of bacterial Na +/H + antiporters, EcNhaA and TtNapA. The distinct secondary and tertiary structure models highlighted residues at positions potentially important for CHX17 activity. Mutagenesis showed that asparagine-N200 andmore » aspartate-D201 inside transmembrane5 (TM5), and lysine-K355 inside TM10 are critical for AtCHX17 activity. We reveal previously unrecognized threonine-T170 and lysine-K383 as key residues at unwound regions in the middle of TM4 and TM11 α-helices, respectively. Mutation of glutamate-E111 located near the membrane surface inhibited AtCHX17 activity, suggesting a role in pH sensing. The long carboxylic tail of unknown purpose has an alternating β-sheet and α-helix secondary structure that is conserved in prokaryote universal stress proteins. Here, these results support the overall architecture of AtCHX17 and identify D201, N200 and novel residues T170 and K383 at the functional core which likely participates in ion recognition, coordination and/or translocation, similar to characterized cation/H + exchangers. The core of AtCHX17 models according to EcNhaA and TtNapA templates faces inward and outward, respectively, which may reflect two conformational states of the alternating access transport mode for proteins belonging to the plant CHX family.« less

Monitoring flux through the oxidative pentose phosphate pathway using [1-14C]gluconate.

PubMed

Garlick, Andrew P; Moore, Catherine; Kruger, Nicholas J

2002-12-01

The aim of this work was to examine the metabolism of exogenous gluconate by a 4-day-old cell suspension culture of Arabidopsis thaliana (L.) Heynh. Release of (14)CO(2) from [1-(14)C]gluconate was dependent on the concentration in the medium and could be resolved into a substrate-saturable component (apparent K(m) of approximately 0.4 mM) and an unsaturable component. At an external concentration of 0.3 mM, the rate of decarboxylation of applied gluconate was 0.2% of the rate of oxygen consumption by the cells. There was no effect of 0.3 mM gluconate on the rate of oxygen consumption, or on the rate of (14)CO(2) release from either [1-(14)C]glucose or [6-(14)C]glucose by the culture. The following observations argue that gluconate taken up by the cells is metabolised by direct phosphorylation to 6-phosphogluconate and subsequent decarboxylation through 6-phosphogluconate dehydrogenase. First, more than 95% of the label released from [1-(14)C]gluconate during metabolism by the cell culture was recovered as (14)CO(2). Secondly, inhibition of the oxidative pentose phosphate pathway (OPPP) by treatment with 6-aminonicotinamide preferentially inhibited release of (14)CO(2) from [1-(14)C]gluconate relative to that from [1-(14)C]glucose. Thirdly, perturbation of glucose metabolism by glucosamine did not affect (14)CO(2) from [1-(14)C]gluconate. Fourth, stimulation of the OPPP by phenazine methosulphate stimulated release of (14)CO(2) from [1-(14)C]gluconate to a far greater extent than that from [1-(14)C]glucose. It is proposed that measurement of (14)CO(2) from [1-(14)C]gluconate provides a simple and sensitive technique for monitoring flux through the OPPP pathway in plants.