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PubMedDate not supplied

Susceptibility of some oral microorganisms to chlorhexidine and paramonochlorophenol.

Since the use of antimicrobial agents is required in endodontic therapies, this study aimed at determining the minimum inhibitory concentrations (MICs) of chlorhexidine digluconate and paramonochlorophenol (PMC) against microorganisms commonly found in endodontic infections. Both agents were tested by agar dilution tests against Pseudomonas aeruginosa, Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Candida albicans, Prevotella intermedia, Porphyromonas gingivalis, Porphyromonas endodontalis, Prevotella denticola and Prevotella melaninogenica. The MIC of chlorhexidine ranged from 2.67 to 80.00 microg/ml, and the MIC of PMC from 46.67 to 213.33 microg/ml. The highest MIC value of PMC was detected for E. faecalis whereas E. coli was the most susceptible microorganism to this agent. The highest MIC values of chlorhexidine were observed for P. aeruginosa whereas E. coli and P. denticola were the most susceptible microorganisms to this agent. Since the MIC values observed are much lower than the concentrations currently used in the endodontic therapy, it is suggested that both agents are effective in reducing the microbiota in the root canal.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Effect of rotary instrumentation and of the association of calcium hydroxide and chlorhexidine on the antisepsis of the root canal system in dogs.

This study aimed at evaluating the antisepsis of the root canal system (RCS) and periapical region (PR) provided by rotary instrumentation associated with chlorhexidine + calcium hydroxide as intracanal medicament. Chronic periapical lesions were induced in 26 pre-molar roots in two dogs. After microbiological sampling, automatic instrumentation using the Profile system and irrigation with 5.25% sodium hypochlorite solution, with a final rinse of 14.3% EDTA followed by profuse irrigation with physiological saline were carried out in 18 root canals. After drying the canals, a paste based on calcium hydroxide associated with a 2% chlorhexidine digluconate solution was placed inside them. After 21 days, the medication was removed, leaving the root canals empty and coronally sealed. After 96 hours, a final microbiological sample was obtained, followed by histomicrobiological processing by the Brown & Brenn method. Eight untreated root canals represented the control group (C-G). Based on the Mann-Whitney test at a confidence level of 5% (p < 0.05), the procedures of antisepsis used offered significant efficacy (p < 0.05) resulting in 100.0% of the canals free of microorganisms. In the C-G, an elevated incidence of various microbial morphotypes was confirmed in all sites of the RCS, with the presence of microbial colonies in the periapical region. In contrast, the experimental group showed a similar pattern of infection in the RCS, although less intense and a reduced level of periapical infection (p < 0.05). It was concluded that adequate instrumentation followed by the application of calcium hydroxide + chlorhexidine offered significant elimination of microorganisms.

Animals↗
PubMed1977

Prolongation of antibacterial activity of chlorhexidine adsorbed to teeth. Effect of sulfates.

The results suggest that the effectiveness of sulfates in prolonging the antibacterial activity of teeth treated with chlorhexidine gluconate is related to the acidity and concentration of the sulfate solutions. The acidity may contribute to the effectiveness by modifying the tooth surface for enhanced reaction with sulfate ions. It is suggested that during the priming process bonded crystals of calcium sulfate develop which become transformed by treatment with chlorhexidine gluconate to relatively insoluble chlorhexidine sulfate.

Acid Etching, Dental↗
PubMed1977

Cytopathologic effects of chlorhexidine on human cells.

Exposure of human cells in culture to chlorhexidine at concentrations equal to or greater than 0.004% resulted in impaired cellular function and/or cell death. Release of membrane bound 51Cr, inhibition of protein synthesis as measured by incorporation of 3H-leucine into protein-like material, and staining by trypan blue were seen as sequellae to exposure to 0.006% chlorhexidine for 3 hours. Lower doses were capable of inhibiting protein synthesis and releasing 51Cr, but did not result in staining of cells by trypan blue. Exposure of cells to 0.2% chlorhexidine for 30 seconds produced maximal suppression of protein synthesis and release of 51Cr.

Amino Acids↗
PubMed1978

The effect of chlorhexidine gluconate on the formation of experimental granulation tissue.

The aim of the study was to investigate the effect of chlorhexidine gluconate on the connective tissue formation. Granulation tissue was produced with a method in which sponges were inserted beneath the back skin of rats. Dry sterilized sponges were impregnated either with 0.45% NaCl solution (control) or or 0.2% chlorhexidine solution [test]. The sponges were removed after 3, 5, 7, 10, 14, 19 and 23 days. The content of hydroxyproline, hexosamines, DNA and RNA was estimated from the sponges. The acid glycosaminoglycans were further purified and analyzed. The results of the study indicate that chlorhexidine had a clear delaying effect on the formation of granulation tissue.

Animals↗
PubMed1978

Effect of chlorhexidine gluconate on acute nonmicrobial inflammation reaction.

The effects of chlorhexidine on the appearance of leukocytes and some hydrolytic enzymes were studied in an experimental acute nonmicrobial inflammation reaction caused by implanation of viscose sponge beneath the backskin. The results showed that chlorhexidine gluconate decreased the number of leukocytes in the inflammatory exudate. The drug used had no measurable effect on the distribution of different types of leukocytes. Chlorhexidine has a clear inhibitory effect on the appearance of phosphatases, glycosidases and peptidases. On the other hand the effect on proteinases was small.

Animals↗
PubMed1980

Pathogenicity testing of Macaca arctoides subgingival plaque following chlorhexidine treatment.

POTENTIAL INFECTIVITY of subgingival plaque of Macaca arctoides in guinea pig leg muscle was examined before, during, and after chlorhexidine treatment. The regime of chlorhexidine administration did not appear to alter the monkey subgingival microflora markedly and had no demonstrable effects on the pathogenicity of the subgingival plaque. These data confirm previous suggestions that chlorhexidine essentially does not penetrate into the deeper part of periodontal pockets following a supragingival mode of administration.

Abscess↗
PubMed1986

Effects of chlorhexidine gel in a group of maintenance-care patients with poor oral hygiene.

An intraindividual double-blind crossover study was designed in order to see if a 1% chlorhexidine gel used twice a day could substitute for ordinary toothpaste in group of maintenance-care patients with poor oral hygiene. Twenty patients from a student clinic participated, each with a long history of maintenance-care problems. A 4-week test period with chlorhexidine gel or placebo gel was followed by an intermediate period with ordinary toothpaste, and then by another 4-week test period. Plaque-covered surfaces (%), bleeding sites (%) and extraneous staining (color slides) were recorded at each sitting. The results demonstrated that brushing with chlorhexidine gel significantly influenced both the oral hygiene level and the gingival inflammation. The only adverse effect observed was a marked increase in the amount of brown staining, especially on the facial surfaces of the nonsmokers. In this short-term study, the staining was not considered cosmetically unacceptable by the patients. The total amount of staining was always greater in smokers than in nonsmokers.

Adult↗
PubMed1986

Inhibition of superoxide generation by human polymorphonuclear leukocytes with chlorhexidine. Its possible relation to periodontal disease.

During the acute phase of periodontal disease, as many as 60% of the cells of the junctional epithelium may be accounted for by polymorphonuclear cells (PMNs). It is generally accepted that these cells play a dominant role in the destruction of connective tissue by virtue of the proteinases they release and the free oxygen radicals they generate. Modulation of the proteolytic activity and free radical production seems to be essential for the inhibition of tissue destruction. We have therefore studied the effect of chlorhexidine on the generation of free oxygen radicals and luminol-dependent chemiluminescence (LDCL) by stimulated human PMNs. Nontoxic chlorhexidine concentrations (0.1-1 microgram/ml) were found to inhibit superoxide production but did not affect LDCL. We therefore suggest that in addition to its antiseptic effect, chlorhexidine may also modulate the generation of free radicals by activated PMN cells in the inflamed gingiva.

Acute Disease↗
PubMed1989

Clinical enhancement of post-periodontal surgical therapy by a 0.12% chlorhexidine gluconate mouthrinse.

Previous studies have demonstrated the potential beneficial effects of post-surgical rinsing with 0.2% chlorhexidine. In the present investigation a new chlorhexidine formulation (Peridex) (CHx) and concentration (0.12%) was evaluated clinically to determine if similar effects could be detected from the use of the new product and treatment regimen. A double blind, randomized, placebo-controlled study was carried out in 40 patients during a 6 week period. Patients who had moderate periodontitis (AAP Class III) received osseous periodontal surgery in one quadrant. Each surgical site received periodontal dressing and patients were given a placebo or CHx mouthrinse to be used twice each day. Compared to placebo, CHx significantly reduced plaque at all examinations (54.4% reduction over placebo at 6 weeks, P less than 0.05). Visible plaque (PlI greater than 2) in the CHx group was reduced by 99% over the placebo group at 6 weeks and at 4 weeks post-surgical, gingival inflammation scores were significantly lower in the CHx group (17% reduction over the placebo at 4 weeks, P less than 0.05). Gingival bleeding scores (GI greater than 2) were significantly lower in the CHx group at 4 and 6 weeks (41% and 40% reduction over the placebo group, P less than 0.05). Probing pocket depth and attachment level changes were not significantly different between both groups. Epithelialization rates and pain assessment demonstrated consistently better results in the CHx group, although differences were not statistically significant. Use of 0.12% chlorhexidine immediately following periodontal surgery, for 6 weeks, has been shown to be a clinically effective adjunct providing enhancement of the post-surgical management of periodontal surgical patients.

Chlorhexidine↗
PubMed1989

Effect of 0.12% chlorhexidine on bacterial recolonization following periodontal surgery.

Bacterial plaque accumulation following periodontal surgery has been directly associated with delayed and altered surgical wound healing. Successful antimicrobial treatment following periodontal surgery depends upon the elimination and suppression of wound associated microorganisms. Highly effective antimicrobials should also prevent recolonization of periodontopathogens. In this investigation, the antimicrobial effect of a 0.12% chlorhexidine gluconate mouthrinse (Peridex) on bacterial recolonization after periodontal surgery was determined. A double-blind, randomized, placebo-controlled study was carried out on 40 patients for 6 weeks. Patients with moderate periodontitis (AAP Class III) underwent osseous periodontal flap surgery in one quadrant. Subgingival and marginal plaque samples from the surgery area were taken prior to surgery and 2 and 6 weeks postoperatively. General descriptive bacteriological cultural analysis and assays for specific microbial populations were carried out. During the 6 weeks of mouthrinse use, patients using chlorhexidine had significant reductions over placebo (P less than 0.05) in the number of total Gram-positive facultative cocci, streptococci (85.8%); Gram-positive facultative rods, primarily Actinomyces (91.7%); Capnocytophaga (97.6%) and Gram-negative anaerobic rods (94.5%). Few black pigmented Bacteroides or Actinobacillus actinomycetemcomitans were found prior to surgery or any time postoperatively. In the chlorhexidine group, 6 weeks post surgery, streptococci were the predominant bacterial group in the sampled plaque. Quantitatively, the distribution of bacteria, after 2 and 6 weeks of mouthrinse use, was consistent with a young, less mature plaque. A previous study demonstrated that this plaque was associated with clinical health.

Adult↗
PubMed1992

Effect of subgingival irrigation with chlorhexidine during ultrasonic scaling.

This study examines the effect of a chlorhexidine irrigant during ultrasonic scaling and root planning and compares clinical results with those obtained using a water irrigant. The irrigant was delivered either through a conventional or a recently-introduced ultrasonic scaler, which allows the irrigant solution to be passed through the inside of the scaler tip. The study utilizes a split-mouth design and contrasts the effectiveness of both instruments in improving periodontal health, as measured by standard clinical indices. A preliminary investigation of patient tolerance to treatment performed throughout the clinical trial was also undertaken. Statistical analysis at the 3 and 6 month post-treatment stage revealed no significant differences between the 4 experimental groups in respect of probing attachment levels (P > 0.5), bleeding index (P > 0.1), or plaque index (P > 0.05). Clinical attachment gain assessed by probing ranged from 0.6 to 0.9 mm. Chlorhexidine increased patient tolerance in 77% of cases and the new model ultrasonic scaler was favored over the traditional model in 70% of cases. The magnitude of the tolerance differences was however not statistically significant. The possible potential of the new scaler and of chlorhexidine as an irrigant to reduce patient discomfort is worthy of further investigation than was possible in this study.

Adult↗
PubMed1992

Comparison of a 0.12% chlorhexidine mouthrinse and an essential oil mouthrinse on oral health in institutionalized, mentally handicapped adults: one-year results.

The purpose of this study was to compare the efficacy of a 0.12% chlorhexidine mouthrinse and an essential oil mouthrinse on plaque accumulation and gingivitis in mentally handicapped adults over a one-year period. Twenty-seven institutionalized mentally handicapped adults participated. Gingival index (GI), plaque index (PI), and probing depths (PD) were recorded and an ultrasonic scaling was performed (Baseline 1). GI, PI, and PD were again recorded after 2 weeks (Baseline 2). Patients were then assigned to either the chlorhexidine or essential oil mouthrinse group. The patients rinsed twice daily under supervision with their assigned mouthrinse while maintaining their attempts at daily brushing. GI and PI were recorded at monthly intervals for 12 months, while the PD was recorded only at Baseline 1 and 2 and at 12 months. A paired t-test was used to compare differences between the parameters at Baseline 1 and Baseline 2. A 2-factor repeated measure ANOVA was performed on each parameter after the Baseline 2 evaluation. A statistically significant decrease in the probing depth occurred as a result of ultrasonic scaling; however, no significant changes in the PI or GI occurred. Both mouthrinses produced a significant improvement in the GI after one month. Despite the improvement, the GI was still indicative of disease. Over the 12 months no further significant improvement in the GI occurred. A statistically significant improvement in the PI occurred in the chlorhexidine group at month 1, but returned to Baseline 2 levels over the 12 months. No improvement in the PI occurred in the essential oil group. The probing depths remained the same over the 12 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1996

A comparison of chlorhexidine, cetylpyridinium chloride, triclosan, and C31G mouthrinse products for plaque inhibition.

There are a large number of mouthrinse products available to the general public for use as adjuncts to oral hygiene. Many have not been evaluated and relatively few comparisons of products have been made. This study compared 4 mouthrinse products containing cetylpyridinium chloride (CPC), chlorhexidine, C31G, or triclosan with saline rinse included as a placebo control. Twenty dentate volunteers took part in this 4-day plaque regrowth study which had a single blind, randomized cross-over design balanced for residual effects. On day 1 of each study period, volunteers were rendered plaque free by a professional prophylaxis, suspended normal oral hygiene measures, and rinsed twice daily for 1 minute with 15 mL of the allocated rinse. On day 5, subjects were scored for disclosed plaque by plaque index and plaque area. By both measures the order of decreasing product efficacy was chlorhexidine, CPC and triclosan, C31G, and saline. All the differences in favor of the chlorhexidine product were highly significant as were those in favor of the other rinses compared to saline. It is concluded that the findings of this study reflect the actual chemical benefits of the products divorced from the indeterminate variable of toothbrushing.

Adult↗
PubMed2005

Influence of additional active ingredients on the effectiveness of non-alcoholic chlorhexidine mouthwashes: a randomized controlled trial.

BACKGROUND: Non-alcoholic chlorhexidine mouthwashes are equally effective and have fewer potential risks than hydroalcoholic solutions. Nowadays, other active ingredients are added to these mouthwashes in an attempt to improve their effectiveness and reduce side effects. Following an experimental gingivitis model, this study examined three non-alcoholic commercial mouthwashes having 0.12% chlorhexidine digluconate (CHX) in common. METHODS: Using a double masked, cross-over design, 30 subjects underwent three consecutive experimental phases with three mouthwashes: CHX, CHX + 0.05% sodium fluoride (CHXNaF), and CHX + 0.05% cetylpyridinium chloride (CHX-CPC). In each one of these 21-day phases, the subjects discontinued all oral hygiene measures and were treated exclusively with the experimental mouthwash randomly assigned (an oral rinse twice a day). Each experimental phase was preceded by a 14-day washout period. Levels of gingivitis, dental plaque, supragingival calculus, and dental staining were assessed at baseline and end (day 21) of experimental phases. RESULTS: The evolution of gingival and dental staining indices did not show statistically significant differences between the treatments. Differences were noticed in the plaque index (P = 0.0002), with CHX-NaF the treatment with the greatest increase. Differences were also observed in the supragingival calculus index (P = 0.0136), with CHX-CPC showing a smaller increase. Tongue staining was more frequent with CHX-CPC (P = 0.0141). CONCLUSION: In non-alcoholic 0.12% chlorhexidine mouthwashes, the addition of other active ingredients does not produce beneficial effects, but may even reduce the antiplaque effectiveness or increase tongue staining.

Adult↗
PubMed2006

Long-term clinical effects of a chlorhexidine varnish implemented treatment strategy for chronic periodontitis.

BACKGROUND: Scaling and root planing in combination with oral hygiene monitoring are still considered the therapeutic standards for periodontitis. Although this treatment concept customarily results in satisfactory clinical improvements, treatment outcome may become less favorable predominantly when full access to periodontal defects is compromised, thereby leaving accretions behind. The purpose of this study was to investigate, over a 9-month period, the clinical benefits of a treatment strategy for chronic periodontitis based on a combination of sequential scaling and root planing and subgingival chlorhexidine varnish administration. METHODS: This randomized controlled, single blind, parallel trial included 26 volunteers with chronic periodontitis. The control group received oral hygiene instructions and was scaled and root planed in two sessions. The test group received the same instructions and treatment; however, all pockets were additionally disinfected using a highly concentrated chlorhexidine varnish. Clinical response parameters were recorded at baseline and at 1, 3, 6, and 9 months. The impact of the initial strategy on the decision-making process for supplementary therapy at 9 months was investigated based on treatment decisions made by five independent clinicians. RESULTS: Both treatment strategies showed significant reductions in probing depth and gains in clinical attachment at study termination in comparison with baseline (P<0.001). However, combination therapy resulted in a significant additional pocket reduction of 0.62 mm (P<0.001). Initially deep pockets (>or=7 mm) around multirooted teeth seemed to benefit most from the combination strategy, resulting in an additive pocket reduction of 1.06 mm (P=0.009) and a clinical attachment gain of 0.54 mm (P=0.048) in comparison to scaling and root planing alone. A trend toward a reduction of surgical treatment needs following the varnish-implemented strategy was found (P=0.076). CONCLUSION: These findings suggest that the outcome of initial periodontal therapy may benefit from the adjunctive subgingival administration of a highly concentrated chlorhexidine varnish.

Adult↗
PubMed2006

Antimicrobial effectiveness of a highly concentrated chlorhexidine varnish treatment in teenagers with fixed orthodontic appliances.

OBJECTIVE: To evaluate the recolonization pattern of Mutans streptococci (ms) on densely colonized teeth with fixed orthodontic appliances after treatment with a highly concentrated (36%) chlorhexidine varnish. MATERIALS AND METHODS: Healthy subjects (n = 19) with fixed orthodontic appliances and high bacterial ms counts in saliva were recruited. In order to establish a baseline registration, plaque adjacent to brackets was sampled and cultivated on Dentocult strips. Following professional tooth cleaning, chlorhexidine varnish was applied on all teeth for 8 minutes. The degree of recolonization with ms was assessed 2 weeks after varnish application in plaque around the brackets. For statistical analysis, the data were subjected to a repeated measures design. RESULTS: After 2 weeks, ms counts were reduced as compared to baseline values. However, the reduction only weakly met statistical significance (P = .049). CONCLUSIONS: The application of a highly concentrated chlorhexidine varnish in patients with fixed orthodontic appliances does not result in a distinct reduction of ms numbers 2 weeks after treatment.

Adolescent↗
PubMed1975

Denture stomatitis. Effects of chlorhexidine and amphotericin B on the mycotic flora.

In 100 patients with denture stomatitis cultures and direct smears were used to evaluate 5 treatments, including sucking of chlorhexidine, amphotericin B or placebo tablets combined with denture soaking in 0.2% chlorhexidine or water. After 14 days of treatment the amphotericin B lozenges had brought about a significant reduction in the quantity of fungus on the oral mucosa, whereas they barely affected the large amount present on the fitting surface of the upper denture. Denture immersion in chlorhexidine significantly reduced the number of organisms both on the mucous membrane and on the denture. It therefore seems at least as important to treat the denture as the patient in denture stomatitis. Fourteen days after withdrawal of the drugs the mycotic flora was largely re-established.

Amphotericin B↗