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PubMed1981

The effects of the incorporation of chlorhexidine acetate on some physical properties of polymerized and plasticized acrylics.

The effects on the water uptake and weight loss of the incorporation of chlorhexidine acetate in heat cured acrylic and an acrylic gel soft liner was determined. Hardness and transverse bend measurement were similarly made for admixtures to heat and cold cured acrylics. Following soaking in water for 87 days the heat cured test specimens demonstrated an initial weight gain followed by a progressive loss, the soft liner test specimens however all showed weight gains. Drying back specimens to constant weight revealed significantly greater weight losses in test compared to control specimens for both the cured acrylic and gel liner. However these weight losses were less than the chlorhexidine content for 5 and 10% admixtures. Hardness and moduli of elasticity measurements were significantly reduced for heat and cold cured acrylics containing chlorhexidine. The property changes observed in the materials would be consistent with the pattern of incorporation of chlorhexidine into the matrix. However, these do not negate the carriage of medicaments in these materials for prolonged delivery within the oral cavity, if employed as rebase or reline materials in existing prostheses.

Acrylates↗
PubMed1983

Antibacterial and mechanical properties of restorative materials combined with chlorhexidines.

Chorhexidine gluconate or chlorhexidine dihydrochloride were added to a composite resin and a glass ionomer restorative material in concentrations of 0, 1, 2, 3, 5, and 10% by weight. Antibacterial activity was measured by inhibition of growth of S. viridans, S. pyogenes, S. mutans, L. acidophilus, and E. coli, for 4 days. Compressive, tensile, and restorative material-enamel adhesive shear strength tests were performed. The addition of chlorhexidine gluconate or chlorhexidine dihydrochloride increased the antibacterial activity of the composite resin and the glass ionomer restorative material and changed the mechanical properties of the restorative materials. The addition of chlorhexidine dihydrochloride resulted in mechanical properties closest to controls.

Bacteria↗
PubMed1986

Dentine hypersensitivity: effect of interactions between metal salts, fluoride and chlorhexidine on the uptake by dentine.

A large number of compounds may be applied to the teeth for preventive or therapeutic purposes, most notably in dentine hypersensitivity. The uptake of any one compound by tooth substances may clearly be affected by another to produce synergistic, additive or antagonistic effects. This study determined whether uptake interactions occurred between fluoride, chlorhexidine, strontium, tin and zinc. All compounds, in particular tin, showed considerable affinity for dentine. Fluoride reduced the uptake of zinc but not tin, strontium or chlorhexidine. Chlorhexidine increased the uptake of zinc, but not tin, strontium or fluoride. Zinc and tin decreased fluoride uptake but strontium had no such effect. Finally, chlorhexidine uptake was increased by zinc and tin but not by fluoride or strontium. Based on the theories proposed for the reaction of these various compounds with calcified tissues, explanations for the interactions can be made. The results appear relevant to some reported clinical effects of combinations of these compounds and indicate that such interactions may have advantageous or disadvantageous consequences depending on the basis for treatment.

Chlorhexidine↗
PubMed2005

Inhibition of the growth in vitro of Trichophyton mentagrophytes, Trichophyton erinacei and Microsporum persicolor by miconazole and chlorhexidine.

An agar dilution technique was used to assess the minimum inhibitory concentrations (MICs) of miconazole, chlorhexidine and a 1:1 combination of both agents for 9 isolates of Trichophyton mentagrophytes, 9 isolates of Trichophyton erinacei and 5 isolates of Microsporum persicolor. MICs of chlorhexidine did not vary significantly between the three dermatophyte species tested, but the MICs of miconazole alone and in combination with chlorhexidine for T. erinacei were significantly greater that those for T. mentagrophytes and M. persicolor. A synergistic drug interaction was noted with one isolate of T. erinacei and one isolate of M. persicolor. An additive effect was demonstrated for 13 isolates (5 T. mentagrophytes, 6 T. erinacei, 2 M. persicolor), and indifference was noted in 8 isolates (4 T. mentagrophytes, 2 T. erinacei, 2 M. persicolor). Although synergy was less often seen when compared with a previous study of Microsporum canis, the synergistic or additive effects seen with the majority (15 out of 23) of isolates studied in vitro provides a rationale for the combined use of miconazole and chlorhexidine in the adjunctive topical therapy of dermatophytosis caused by T. mentagrophytes, T. erinacei and M. persicolor.

Animals↗
PubMed1980

Stabilization of whole molecules of gastropodan haemocyanins by chlorhexidine.

Chlorhexidine diacetate 0.01% stabilized the whole molecules of Helix pomatia alpha-haemocyanin under dissociating conditions; in 1 M NaCl and in 1.42 M sucrose. Dissociation at low ionic strength (10 mM) of the haemocyanin of Pila leopoldvillensis was likewise prevented by chlorhexidine. After dissociation into half molecules of H. pomatia alpha-haemocyanin in 1.42 M sucrose and of P. leopoldvillensis haemocyanin by lowering the ionic strength, whole molecules were formed on introduction by dialysis of chlorhexidine diacetate to a concentration of 0.01%. This stabilization points to the binding of the two chlorophenyl groups in hydrophobic regions of the protein and an ensuing cross-linking of the half molecules of gastropodan haemocyanins. Chlorguanide, which almost corresponds to one half chlorhexidine, even at a concentration of 0.1%, only slightly stabilized the whole molecules.

Animals↗
PubMed1995

Mechanism of inhibition of glycolysis in Streptococcus mutans NCIB 11723 by chlorhexidine.

Inhibition of the rate of acid production from glucose by the cells of Streptococcus mutans NCIB 11723 was directly related to the concentrations of 0.075 to 0.20 mM chlorhexidine. Lactate production was inhibited to a greater extent than acetate and formate. Quantification of glycolytic intermediates revealed that the steps in glycolysis inhibited by chlorhexidine were the reactions catalyzed by phosphofructokinase and glyceraldehyde 3-phosphate dehydrogenase and/or phosphoglycerate kinase. However, the activities of these enzymes were not decreased in cells treated with the inhibitor. It was demonstrated that chlorhexidine caused leakage of metabolites from the cells. Our results indicate that the decreased rate of glycolysis caused by chlorhexidine is due to the leakage of metabolic intermediates and not to direct effects on enzymes involved in glycolysis by S. mutans NCIB 11723.

Acetates↗
PubMed1996

Susceptibility of biofilms of Streptococcus sanguis to chlorhexidine gluconate and cetylpyridinium chloride.

Biofilms of Streptococcus sanguis and planktonic cells of the organism were exposed to chlorhexidine gluconate and cetylpyridinium chloride, at concentrations used clinically, and survivors enumerated. S. sanguis exhibited a lower susceptibility to both antiseptics when it comprised a biofilm than when the organism was in the planktonic form. No viable bacteria were detectable after 5 min of exposure of planktonic cells to 0.2% (w/v) chlorhexidine gluconate or 0.05% (w/v) cetylpyridinium chloride, whereas viable bacterial survived in biofilms of S. sanguis even after exposure to these agents for 4 h. Older biofilms (7 days old) had similar susceptibilities to the antiseptics as younger biofilms (4 days old). Chlorhexidine achieved kills corresponding to approximately a 2 log10 reduction in the viable count of biofilms, containing approximately 10(7) colony-forming units after 5 min of incubation, whereas the corresponding kills achieved by cetylpyridinium chloride amounted to approximately a 1 log10 reduction. However, on a molar basis, cetylpyridinium chloride was the more effective of the two antiseptics. Minimum inhibitory concentration determinations showed chlorhexidine gluconate to be more effective against S. sanguis than cetylpyridinium chloride. The results of this study have revealed that the minimum inhibitory concentration is not a reliable predictor of the relative effectiveness of antimicrobial agents against S. sanguis biofilms.

Anti-Infective Agents, Local↗
PubMed2006

Lignocaine and chlorhexidine toxicity in children resulting from mouth paint ingestion: a bottling problem.

BACKGROUND: A pharmaceutical product was marketed in Australia for 'teething' in an almost identical container to a popular paediatric paracetamol preparation. The product contained lignocaine and chlorhexidine. The similarity of the packaging resulted in large number of therapeutic errors in which the 'teething' preparation was given in error for paracetamol. As the exact dose of the erroneously administered mouth paint was known this provided an opportunity for outcome assessment of lignocaine ingestion. METHODS: Calls to two state poison information centres regarding this product were prospectively followed up. Information collected included: demographics, type of exposure, details of the exposure and adverse effects. A systematic review of the literature was used to identify all previous reported cases of lignocaine and chlorhexidine ingestion. RESULTS: There were 28 cases with complete follow up where the product was given in therapeutic errors (10 girls and 18 boys; median age 11 months; range 2 months-4 years). The mean ingested dose of lignocaine was 2.7 mg/kg (standard deviation 1.3 mg) and chlorhexidine was 0.06 mg/kg (standard deviation 0.03 mg). The largest ingested lignocaine dose was 5.9 mg/kg. Two children developed minor symptoms: one vomited twice and the other was reported to have increased salivation and difficulty with solid food for 20 min. No other adverse effects were reported. The literature review suggested that severe effects occurred with doses more than 15 mg/kg. CONCLUSION: No major adverse effects occurred with lignocaine ingestions of less than 6 mg/kg and it would be appropriate to observe these patients at home. Chlorhexidine did not appear to cause clinical effects in this low concentration.

Administration, Oral↗
PubMed1997

Flow cytometric analysis of chlorhexidine action.

The mechanism by which chlorhexidine kills bacteria is still ill defined. We have investigated the action of chlorhexidine on Escherichia coli JM101/psb311 using a combination of flow cytometry and traditional methods. Chlorhexidine-induced uptake by E. coli cells of bis-(1,3-dibutylbarturic acid) trimethine oxonol and propidium iodide, which monitor membrane potential and membrane integrity respectively, was shown to be concentration dependent for the range 0.003-0.3 mmol-1. In addition, cells in log phase growth were more susceptible to 0.03 mmol-1 chlorhexidine than those in stationary phase. There was, however, no direct correlation between dye uptake and decline in colony forming units.

Anti-Infective Agents, Local↗
PubMed2004

Microbiological and clinical effects of chlorhexidine enclosed in fixtures of 3I-Titamed implants.

This double-blind study used a split-mouth design to investigate the microbiological and clinical effects of 0.2% chlorhexidine enclosed in fixtures. Twelve patients had 46 fixtures implanted. At second-stage surgery, a microbiological sample (baseline sample) of the inner parts of the fixtures was taken. Then, a 0.2% chlorhexidine solution was applied into the inner space of 23 fixtures (test group), and in 23 fixtures saline was applied (control group). Abutments were installed and gingival index, plaque index and crevicular fluid flow were monitored weekly. After 6 weeks, a second microbiological sample of the inner part of the fixtures was taken. At baseline, viable bacteria were detected within 46% of the fixtures. After weeks, bacteria were found in 87% of the fixtures. The numbers of bacteria in the control group were significantly higher than those in the test group. The results indicate that, after first-stage surgery, contamination of the inner spaces of the fixtures is commonplace. Application of a 0.2% chlorhexidine solution at second-stage surgery inhibits growth or acquisition of bacteria in the fixtures. In both test and control groups, the crevicular fluid flow as well as the gingival index decreased during the experimental period. At 4, 5, and 6 weeks after chlorhexidine application, these values in the test group appeared lower, but did not attain statistical significance.

Anti-Infective Agents, Local↗
PubMed1975

Effect of chlorhexidine on dental plaque formation under periodontal pack.

In a first experiment, no appreciable differences in plaque formation under periodontal packs were observed in subjects rinsing with and without 0.2% chlorhexidine digluconate. In a second experiment, one gram periodontal packs were coated with 15 to 20 mg of chlorhexidine dihydrochloride powder prior to application and allowed to remain in situ for 4 days. Significantly less plaque formed under periodontal packs with chlorhexidine powder than with control packs. Chlorhexidine dihydrochloride powder may be recommended under periodontal packs for reduction of microbial plaque.

Biguanides↗
PubMed1981

Optimal dosage of chlorhexidine digluconate in chemical plaque control when applied by the oral irrigator.

Chlorhexidine digluconate for chemical plaque control was tested in different concentrations using a fractionated jet oral irrigator. The inhibition of plaque formation and the prevention of gingival inflammation were evaluated in a double-blind study. During a 10-day period of abstinence from any mechanical oral hygiene procedures, the pattern of plaque formation and gingivitis development under the influence of chemical plaque control was analyzed. As a positive control, one group rinsed twice daily with 30 ml of a 0.2% chlorhexidine solution while a group applying 600 ml of a placebo solution served as a negative control. Forty dental students and assistants with plaque-free dentitions and healthy gingival tissues were divided into four groups. After a 10-day period of no oral hygiene, a recovery period of 11 days with perfect oral hygiene was again instituted. This experiment was repeated three times so that a total of 10 concentrations in the irrigator, the control rinsing and the placebo control could be evaluated. Daily application of 600 ml of a 0.001% (6 mg), 0.0033% (20 mg), 0.005% (30 mg), 0.01% (60 mg), 0.02% (120 mg), 0.05% (300 mg) and 0.1% (600 mg) and 400 ml of a 0.015% (60 mg), twice 400 ml of a 0.015% (120 mg) and 400 ml of a 0.02% (80 mg) solution of chlorhexidine was tested. At the start of each experimental period (day 0), after 3, 7 and 10 days and 11 days following reassuming oral hygiene procedures, the plaque accumulations were determined using the Plaque Index System (Silness & Löe 1964) and the development of gingivitis was evaluated according to the criteria of the Gingival Index System (Löe & Silness 1963). The results suggested that one daily irrigator application of 400 ml of a 0.02% chlorhexidine solution was the optimal and lowest concentration and dose to be used for complete inhibition of dental plaque.

Adult↗
PubMed1981

Comparison of the bisbiguanide antiseptics alexidine and chlorhexidine. I. Effect on plaque accumulation and salivary bacteria.

A blind crossover trial was carried out to compare the effects of a 0.2% chlorhexidine gluconate mouthrinse and a 0.035% alexidine mouthrinse on plaque accumulation and salivary bacteria in a group of volunteers. The subjects refrained from all forms of oral hygiene during two 10-day periods and rinsed twice a day with the mouthwash randomly allocated to the respective period. Prerinse, day 4 and day 10 total salivary aerobic and anaerobic bacterial counts were determined during each period. Plaque scores were recorded at the end of each 10-day period. Significantly more plaque accumulated in subjects rinsing with alexidine when compared with chlorhexidine. Significant and comparable reductions in salivary bacterial counts were observed with both chlorhexidine and alexidine on day 4 and day 10 when compared with pre-rinse counts. Although at the concentrations used alexidine was less effective than chlorhexidine, it may be of value as a short-term adjunct to oral hygiene.

Adult↗
PubMed1981

Plaque-inhibiting effect of two flavored chlorhexidine mouth rinses.

An experimental study was designed for assessement of whether two recently marketed flavored chlorhexidine mouthrinses, Hibitane Dental (ICI) and Plak-Out (Hawe), have a good plaque-inhibiting effect as the 0.2% aqueous solution of chlorhexidine gluconate. Thirteen dental students used in different sequences each one of the three rinses fro 1 week by rinsing twice daily for 1 min. During the rinsing periods no other oral hygiene measures were allowed. Between two rinsing periods the subjects cleaned their teeth mechanically for 1 week. At the start of each test and control period, the teeth were professionally cleaned with rubber cups and an abrasive paste. At the end of the five 1-week periods the mesial, lingual and facial aspects of the teeth in the right halves of the jaws of each participant were scored for the Plaque Index by the same investigator. After the mechanical cleaning, higher PII scores were recorded than after the chlorhexidine rinses. No difference could be observed among the PII scores after rinsing with the aqueous or the two flavored chlorhexidine solutions.

Chlorhexidine↗
PubMed1982

Plaque control with chlorhexidine and D-301, a quaternary ammonium compound.

Eighteen female dental hygiene students took part in a double-blind, crossover clinical trial of equimolar (2.2 mmol) rinsing solutions of D-301, a quaternary ammonium compound and chlorhexidine digluconate, Rinsings were partly supervised, test periods were 7 days (5 days without oral hygiene) with a 1-week interval. Plaque formation was significantly reduced by both test solutions versus the control; on not precleaned tooth surfaces plaque formation was equally inhibited by the chlorhexidine and D-301 mouthrinses. On precleaned surfaces D-301 significantly inhibited plaque formation compared with the control rinse, but was less effective than chlorhexidine. There was no significant change in the PBI, a measure of gingival inflammation, during any of the test period. Staining of teeth and tongue was judged as equal after chlorhexidine and D-301 use. Reports of taste and gastric disturbances were minimal but more frequent during the D-301 test period.

Benzalkonium Compounds↗
PubMed1984

Subgingival metronidazole in dialysis tubing and subgingival chlorhexidine irrigation in the control of chronic inflammatory periodontal disease.

The present investigation compared subgingival metronidazole in dialysis tubing and subgingival chlorhexidine irrigation in the control of chronic inflammatory periodontal disease. 10 patients with 4 mm or deeper periodontal pockets were divided into 2 groups. Both received baseline scaling, root planing, subcontact area cleaning and instruction in the Bass technique of tooth brushing, but not in interdental cleaning. One group with 80 pockets received 0.2% chlorhexidine subgingival irrigation for 28 days and the other with 86 pockets received 0.5% metronidazole solution incorporated in subgingivally placed dialysis tubing. The tubings were replaced with freshly filled ones at days 7, 14 and 21. Active treatment ceased at day 28. Plaque Index, Sulcus Bleeding Index, pocket depth and gingival shrinkage were recorded at days 0, 7, 14, 21, 28, 56 and 84. Subgingival 0.5% metronidazole in dialysis tubing and 0.2% chlorhexidine irrigation were found to be equally effective in reducing chronic periodontitis. Metronidazole reduced Plaque Index less but pocket depth more than chlorhexidine. Improvements were maintained significantly below baseline levels for at least 8 weeks after the end of the 4-week treatment period.

Administration, Topical↗
PubMed1987

Prevention of plaque growth with chewing gum containing chlorhexidine acetate.

The purpose of the study was to assess the anti-plaque effect of chlorhexidine (CHX) in chewing gum. The 0.80 g pieces of test gum contained 5 mg chlorhexidine acetate with or without a hydrogen peroxide releasing agent. The gum base with flavouring agents but containing neither CHX nor H2O2 was used as a control. 12 dental hygiene students volunteered to participate in the 3 x crossed-over double blind clinical trial. During the 4-day test periods, no other oral hygiene measures were allowed than chewing 2 pieces of gum at the time for approximately 10 min, 5 times daily. Between test periods, meticulous mechanical oral hygiene measures were practised for 3 days. At the beginning and at the end of each test period, the quantity of plaque was assessed using the plaque index, plaque wet weight, and the area of plaque on the tooth surface as criteria. The results indicated that both CHX gums completely inhibited the increase in plaque index and plaque weight. With regard to area of plaque, the difference between the 2 test gums and the control gum was less marked but still present. The test persons subjectively assessed the gum base to have a poor cleansing effect but also the least unpleasant taste. It was concluded that use of both the chlorhexidine gum and the gum-containing chlorhexidine in addition to the hydrogen peroxide releasing agent had an excellent plaque growth inhibiting effect during the 4-day test periods.

Chewing Gum↗
PubMed1989

Pulsated jet subgingival irrigation with 0.1% chlorhexidine, simplified oral hygiene and chronic periodontitis.

This study investigated the efficacy of a 0.1% chlorhexidine preparation as an aid to a basic oral hygiene programme comprising only baseline root and crown debridement, instruction in bass brushing without emphasis on interdental cleaning, and pulsated mono-jet subgingival irrigation. Baseline data for plaque index, papilla bleeding index and probeable pocket depth were similar in both test and control groups. Mean values for all 3 parameters were clearly lower in the chlorhexidine group, both at the end of the period of active treatment and up to 2 months thereafter. These differences were statistically significant for P1I at day 28, PBI at day 56 and PPD at days 56 and 84, but not at day 168. Proportionately more sites generally showed improvement in the chlorhexidine group at all times. It was concluded that 0.1% chlorhexidine significantly enhances the effects of the practical oral hygiene regime described.

Adult↗