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PubMed1996

0.1%/0.2% commercial chlorhexidine solutions as subgingival irrigants in chronic periodontitis.

This study compared 2 proprietary chlorhexidine (CH) products, Corsodyl (CO-0.2% CH, then ICI, U.K.) and Eludril (EL-0.1% CH, Pierre Fabre, France) as subgingival irrigants adjunctive to Simplified Oral Hygiene. 19 subjects, 8M, 11F, aged 30-57 years, mean 44 years, took part. Probing pocket depth (PPD) ranged from 5-10 mm, mean 6.5 mm (CO and EL), with 60 CO and 65 EL sites. After oral hygiene instruction, without stress on interdental cleaning, patients received on visit supra- and subgingival debridement, and instruction in subgingival irrigation using the Max-I-Probe system (Smith & Nephew MPL, USA). For baseline, days 28 (end of irrigation), 56 and 84, data were respectively: GI (medians): 1.7, 1.2, 1.2, 1.0 (CO), 1.9, 1.5, 1.3, 1.0 EL); BOP (medians): 1.2, 0.4, 0.7, 0.4 (CO), 1.5, 0.6, 0.6, 0.25 (EL); PPD (mm) (means): 6.3, 4.8, 4.2, 4.5 (CO), 6.8, 5.2, 5.3, 4.7 (EL); PAL (mm) (means-change relative to day 0): 0.6, 0.5, 0.8 (CO), 0.8, 0.8, 1.5 (EL). By Wilcoxon for non-parametric and t-tests for parametric data, both groups showed significant improvement for all variables at all times relative to baseline, with only one significant difference between the groups, in favour of EL, for PAL at day 84 (p < 0.05). This pilot study indicates that both simplified oral hygiene regimes are effective in periodontitis, but that there was no difference between the 2 commercial irrigants as adjunctives.

Adult↗
PubMed1992

Influence of irrigation and intracanal dressing on the healing process of dogs' teeth with apical periodontitis.

Dogs' teeth with apical periodontitis were treated endodontically, Dakin's solution being used in an experimental group as the irrigation solution, and camphorated paramonochlorophenol as an intracanal dressing. For a second group of teeth, the irrigation solution used was physiologic saline, dry cotton only being placed into the pulpal chamber to take the place of an intracanal dressing. In a second visit, overinstrumentation and a new application of the same kind of dressing were performed, the root canals being then filled with gutta-percha cones and zinc oxide-eugenol cement. Other specimens were treated, in one visit, where physiologic saline or Dakin's solution were the irrigation solutions. The animals were sacrificed 6 months after the obturation of the root canals. Histologic exams showed better results for the experimental group where Dakin's solution and camphorated paramonochlorophenol had been used, with signs of repair characterized by newly formed cementum and bone tissue, as well as a marked reduction in size of the periapical lesions. No differences were seen in the results with physiologic saline or Dakin's solution as irrigants.

Animals↗
PubMed2003

Irrigational therapy of a dentigerous cyst in a geriatric patient: a case report.

Dentigerous cysts are recognized as one of the most common lesions of the jaws. Although surgical enucleation is usually the preferred treatment method, it is not always the best choice for elderly patients who have other medical complications. With cyst irrigational therapy, repeated irrigation allows bone regeneration around the cyst to progress more rapidly than that around a cyst treated operatively with marsupialization. We used irrigational therapy to treat a dentigerous cyst in a 72-year-old man who did not agree to surgery because he had no symptoms associated with the cyst, and he had other medical complications. After one year, remarkable bone regeneration was observed. We conclude that irrigational therapy appears to be an effective, less-invasive alternative to surgery for geriatric patients.

Aged↗
PubMed2026

Alleviation of CO2-Induced Reductions in Tomato Photosynthesis Under Deficit Irrigation by Purple Nonsulfur Photosynthetic Bacteria.

The stimulatory effect of elevated CO2 (eCO2) on photosynthesis in most C3 crops under water deficit often declines over time due to photosynthetic acclimation. An exception occurs in plants inoculated with symbiotic nitrogen-fixing bacteria. Photosynthetic bacteria (PSB), specifically anoxygenic purple nonsulfur bacteria (Rhodopseudomonas palustris in this study), a group of nitrogen-fixing bacteria, are effective in enhancing crop photosynthesis. Therefore, this study investigated the synergistic effects of PSB and eCO2 in alleviating the effects of deficit irrigation and enhancing photosynthetic capacity in tomato plants during prolonged exposure. Our results showed that photosynthetic efficiency was significantly reduced in noninoculated plants under eCO2, and this reduction was more pronounced under water deficit. Proteomic analysis revealed that in eCO2-treated plants, the downregulation of cell wall proteins increased mesophyll resistance to CO2 diffusion, while the suppression of the photosynthetic apparatus impaired electron transport capacity, ultimately reducing CO2 assimilation efficiency. In contrast, these negative effects were alleviated by PSB inoculation. PSB promoted the upregulation of proteins involved in photosynthesis under deficit irrigation, as well as proteins related to chlorophyll biosynthesis, components of photosystem I and II, and light-harvesting complex proteins. These proteins contributed to improved photosynthetic efficiency during deficit irrigation and photosynthetic acclimation. Physiological analyses further confirmed that PSB inoculation enhanced nitrogen content, electron transport capacity, chlorophyll biosynthesis, and overall photosynthetic performance under eCO2 and deficit irrigation, resulting in improved plant growth. These findings suggest that PSB inoculation is a promising strategy to sustain and enhance the CO2 fertilization effect on crop productivity under water-limited conditions.

Photosynthesis↗
PubMed1990

Irrigation-aspiration for culturing draining decubitus ulcers: correlation of bacteriological findings with a clinical inflammatory scoring index.

Biopsy of infected decubitus ulcers for culture disrupts tissues and may disseminate infection. Antimicrobial prophylaxis to prevent dissemination of infection may adversely affect biopsy culture results. Irrigation-aspiration to obtain submarginal specimens from draining decubitus ulcers was studied as an atraumatic, noninvasive culturing technique to serve as an alternative to biopsy in research activities. Two aspirates were obtained serially from 32 subjects; in 12 subjects, biopsies were also performed immediately. A median of 4.5 bacterial species was recovered per ulcer by irrigation-aspiration. Recent antimicrobial treatment had no evident effect on the recovery of bacterial species in general or, specifically, on the recovery of Bacteroides species. Concordance of results for both aspirates was 97.6% for aerobes and 91.8% for anaerobes, indicating no interactive methodological effect of the first irrigation-aspiration on the second. Compared with biopsy isolates for one aspirate, the sensitivity was 93% and the specificity was 99.0%; for another aspirate, the sensitivity was 94.7% and the specificity was 99.5%. The positive predictive value for either aspirate was greater than or equal to 93.9%. A weighted clinical index to score inflammatory ulcer characteristics was devised (score range, 0 to 15). In the absence of anaerobes in 15 subjects, the mean score was 6.1 +/- 3.5; in the presence of anaerobes in 17 subjects, the mean score was 9.4 +/- 3.2 (P = 0.008). The presence of aerobic gram-positive or gram-negative species did not significantly affect scores. Irrigation-aspiration for culture and clinical scoring of inflammation should permit independent serial measures of bacteriological and clinical courses of draining decubitus ulcers without patient risk or discomfort.

Aged↗
PubMed1981

Comparison between irrigation and conventional treatment for empyema and pneumonectomy space infection.

A new method of treating pleural empyema or pneumonectomy space infection by irrigation was evaluated in 11 patients. The infected cavities were filled with an antibiotic or antiseptic solution for three hours, and allowed to drain for one hour. This cycle was repeated every four hours for seven to 10 days. When cultures of the infected cavity became sterile the irrigation tube was removed and the wound sealed. Using this method, infection was eradicated after an average of 11 days in five of six patients with pleural empyema and in all five patients treated for an infected pneumonectomy space, including one with a bronchopleural fistula. The results of treating 58 similar cases of intrapleural sepsis over a 10-year period by the standard methods of aspiration, open drainage, decortication, or thoracoplasty were compared with the results of irrigation. In general, cyclical irrigation resulted in a shorter hospital stay and a shorter period of wound drainage than other methods.

Adolescent↗
PubMed1982

Transurethral resection of the prostate with and without continuous irrigation.

Four hundred patients undergoing transurethral resection of the prostate have been studied. An intermittent irrigation resectoscope was used in 200, and a continuous irrigation resectoscope in the remainder. The merits and demerits of continuous irrigation resection are discussed in the light of the results of these operations. The conclusion reached is that the continuous irrigation resectoscope has considerable advantages over the intermittent flow instrument. These advantages are most evident in the difficult operation, or in operations on the larger prostate, as well as in the tuition and demonstration of endoscopic surgery.

Adult↗
PubMed1988

Effect of continuously warmed irrigating solution during transurethral resection.

The effects of a continuously warmed irrigating solution on body temperature during transurethral resection of the prostate and of bladder tumours were studied in forty patients. Anaesthesia was spinal and deep body temperatures of the forehead and lower abdomen were measured, using a deep body thermometry system. Both forehead and lower abdominal deep body temperatures decreased significantly in the patients who underwent transurethral resection of the prostate with an irrigating solution at operating room temperature, but did not decrease in the patients who received a continuously warmed irrigating solution. The same results were obtained for the patients who underwent transurethral resection of bladder tumour. Our results indicate that a continuously warmed irrigating solution could prevent the fall in body temperature during transurethral resection, especially prostate resection, under spinal anaesthesia.

Aged↗
PubMed2005

Debridement and continuous irrigation for the treatment of pyogenic arthritis caused by the use of intra-articular injection in the osteoarthritic knee: indications and outcomes.

PURPOSE: To discuss the indications and therapeutic outcomes of synovectomy, debridement, and continuous irrigation for the treatment of pyogenic arthritis caused by intra-articular injection used in the treatment of osteoarthritis of the knee. METHODS: Records of 41 patients with infectious arthritis of the knee who presented to our hospital from 1981 were reviewed. 11 of them had a history of intra-articular injection. They underwent synovectomy, debridement, and continuous irrigation using a Salem double-lumen tube after confirmation that one side of the femorotibial joint cartilage was basically healthy. RESULTS: The infection was successfully treated in 9 of the 11 patients. Of these 9 patients, one died after 3 years and 2 underwent total knee arthroplasty after 3 and 8 years. The remaining 6 patients were followed up for 5 to 15 years. Five of them had deteriorating arthropathy, and the condition was unchanged in the others. Two of these 6 patients had pain while walking, and their Japanese Orthopaedic Association scores were 70. The remaining 4 had good knee function and reduction of pain, with a mean Japanese Orthopaedic Association score of 91 and a mean range of motion of 131 degrees. CONCLUSION: Arthrodesis is frequently considered the treatment for osteoarthritis if the joint destruction has affected the weight-bearing surface. However, in our experience, even when inflammatory granulation develops in the cartilage surface of one side of the femorotibial joint, good results can still be obtained by synovectomy, debridement, and continuous irrigation. After the pyogenic arthritis has subsided, if osteoarthritis has advanced and bowleg has exacerbated, further treatment options are available, such as tibial resection and even joint replacement. Continuous irrigation should be considered a feasible treatment option for pyogenic arthritis.

Adrenal Cortex Hormones↗
PubMed1977

Air caloric test: irrigation technique.

The technique of using air to perform the caloric test is discussed. Greater temperature differences and larger volumes of air are needed to achieve stimulations equal to those caused by water irrigations. Special consideration must be given to the design and operation of air irrigation equipment. The effects of irrigating a wet canal and of misdirecting the air jet are discussed. A new air irrigation apparatus is described.

Air↗
PubMedDate not supplied

Colostomy irrigation: are we offering it enough?

This article discusses the use of irrigation for suitable colostomists and reasons why it can have a very positive effect on lifestyle. While it is evidence-based it also includes anecdotal tips from patients who irrigate. The suitability of patients to irrigate and ways to 'get started' with irrigation are discussed.

Colostomy↗
PubMed1982

Arthroscopy under local anaesthesia using controlled pressure-irrigation with prilocaine.

One hundred and seventy-four consecutive patients with symptoms of derangement of the knee were examined with an arthroscope under local anaesthesia using a continuous pressure-irrigation system. A 0.2 per cent prilocaine-saline solution was used as irrigation fluid. In the first 19 patients the serum level of prilocaine was monitored for six hours after the start of irrigation. Eighteen of the 174 patients had a transcutaneous partial meniscectomy at the same time as the examination. All the patients tolerated the examination well. The distension of the knee produced by the pressure-irrigation system provided a high degree of diagnostic accuracy. The serum levels of prilocaine were low throughout the monitoring period reaching a mean peak value of 0.28 micrograms per millilitre after one hour. There were no adverse side-effects. This technique provides a safe and efficient method to meet the increasing demands of arthroscopic procedures of the knee.

Adolescent↗
PubMed1982

Effect of nonsterile versus sterile water irrigation with ultrasonic scaling on postoperative bacteremias.

The contribution of nonsterile water irrigation during ultrasonic scaling to postoperative blood stream contamination was evaluated. Thirty human volunteers were subjected to a random split-mouth technique comparing sterile and municipal tap water irrigation with ultrasonic root preparation on contralateral mandibular quadrants. Scaling was performed by a single operator using a premeasured quantity of irrigant. Postoperative blood samples were obtained immediately and cultured aerobically and anaerobically in tryptic soy broth and on BHI agar plates for enumeration of colony forming units. Positive blood cultures were inoculated onto selective media for presumptive identification. The difference in the bacteremia incidence after scaling with sterile water (50%) versus scaling with tap water (53.3%) was not significant. The degree of the bacteremias (less than 1 colony forming unit/ml) was similar between groups. Therefore tap water irrigation used in ultrasonic scaling did not appear to be a significant causative agent in postoperative bacteremias.

Adult↗
PubMed1989

The effect of 2% chlorhexidine digluconate irrigation on clinical parameters and the level of Bacteroides gingivalis in periodontal pockets.

Eight patients with moderate periodontitis volunteered to participate in a study to assess the effect of subgingival 2% chlorhexidine irrigation, with and without scaling and root planing, on clinical parameters and the level of Bacteroides gingivalis in periodontal pockets. Each quadrant was required to have at least one site with a probing depth of 6 mm or greater and bleeding on probing. The patients were treated following a randomized four quadrant design: one quadrant received no treatment; a second quadrant received scaling and root planing only; a third quadrant received chlorhexidine irrigation only; the fourth quadrant received scaling and root planing, plus chlorhexidine irrigation. Sites to receive chlorhexidine were irrigated at 0, 1, 2, and 3 weeks. Clinical and microbiological indices were measured and recorded at 0, 5, 7, 11, and 15 weeks. The clinical parameters measured included; Plaque Index (PI), Gingival Index (GI), probing depth (PD), Bleeding Tendency (BT), and attachment level (AL). The attachment level was measured using an occlusal stint as a fixed reference point. The level of Bacteroides gingivalis was measured by labeling the plaque sample with a polyclonal fluorescent antibody. The plaque smear was then read using a fluorescent microscope at 1000 magnification. The Spearman Rank-Order Correlation was used to determine the relationship between parameters at baseline. The effects of the treatment groups were compared using the Neuman-Keuls Multiple Comparison Technique. The results showed that a positive correlation existed between B. gingivalis (rs = 0.68) and Bleeding Tendency and between P1I (rs = 0.77) and GI.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Retention of antimicrobial activity by human root surfaces after in situ subgingival irrigation with tetracycline HCl or chlorhexidine.

Substantivity of tetracycline HCl and chlorhexidine digluconate was assessed in extracted teeth. Fifty periodontally compromised teeth scheduled for extraction with probing depths ranging between 6 and 12 mm were root planed and then irrigated in situ with 1 of 4 solutions: tetracycline HCl at concentrations of 10 or 50 mg/ml, 0.12% chlorhexidine digluconate, or 0.9% sterile saline. Each tooth was exposed to 150 ml of the respective irrigation solution. Following extractions, the teeth were transferred to tris buffered saline and incubated at room temperature for 22 days. Incubation solutions were replaced at 24-hour intervals. Removed solutions were examined for desorbed antimicrobial activity using a microtiter assay in which bacterial growth was evaluated by optical density readings. Tetracycline HCl 50 mg/ml exhibited significantly greater antimicrobial activity than chlorhexidine digluconate for 12 days and greater than saline for 16 days. Tetracycline HCl 10 mg/ml exhibited significantly greater antimicrobial activity than chlorhexidine digluconate and saline for 4 days. Chlorhexidine digluconate did not exhibit any significant antimicrobial activity at any time point. Our findings demonstrate long-lasting substantivity of tetracycline HCl, but not chlorhexidine digluconate, by teeth exposed to a single episode of pocket irrigation of their periodontally-exposed roots. The amount of antimicrobial activity retained is proportional to the concentration of tetracycline HCl used for irrigation.

Adsorption↗
PubMed1997

Clinical and microbiological effects of subgingival antimicrobial irrigation with citric acid as evaluated by an enzyme immunoassay and culture analysis.

The purpose of the present study was to compare an enzyme immunoassay with culture samples from untreated and non-surgically treated periodontal pockets and to assess the clinical and microbiological effects of citric acid irrigation as a supplement to scaling and root planing. The enzyme immunoassay used in this study is a chairside diagnostic tool aimed at identifying the presence of P. gingivalis, P. intermedia, and A. actinomycetemcomitans. Six sites with pocket depths > or = 6 mm in each of 16 patients were monitored for 24 weeks using clinical and microbiological parameters. In two out of the six sites, scaling and root planing was supplemented with subgingival citric acid irrigation of the pocket after completion of the mechanical treatment. The sensitivity of the immunoassay in relation to culture was calculated to 85.5% and the specificity to 90.2%. The immunoassay corresponded to a detection level of 10(4) as estimated by culture. Sites treated with a combination of scaling and irrigation with citric acid demonstrated a similar healing pattern as sites treated with scaling and root planing alone. The profile of the marker bacteria was almost parallel for the two groups. The results of this investigation thus indicated that the immunoassay can be used as a screening tool for selected periodontal pathogens and that adjunctive irrigation with citric acid has no measurable clinical or microbiological effects.

Adult↗
PubMed2005

Position paper: The role of supra- and subgingival irrigation in the treatment of periodontal diseases.

This position paper addresses the role of supra- and subgingival irrigation in the treatment of periodontal diseases. It was prepared by the Committee on Research, Science and Therapy of the American Academy of Periodontology. The document is divided into two portions, consisting of supragingival irrigation and subgingival irrigation. In their respective segments, these treatment techniques are assessed as monotherapies and as adjuncts to conventional treatment. The conclusions drawn in this paper represent the position of the American Academy of Periodontology regarding irrigation therapy in the treatment of periodontal diseases.

Anti-Infective Agents, Local↗
PubMed2005

Reamed femoral nailing in sheep: does irrigation and aspiration of intramedullary contents alter the systemic response?

BACKGROUND: Reaming of the femoral canal has been demonstrated to introduce intramedullary contents into the circulation with subsequent pulmonary embolization. The aim of this study was to investigate whether this effect can be minimized by use of a reamer system that provides simultaneous irrigation and aspiration of intramedullary contents. METHODS: A unilateral lung contusion was created and intramedullary femoral nailing was subsequently performed in eighteen female skeletally mature Merino sheep. The animals were divided into three groups, of six animals each, to receive one of three types of treatment: reamed femoral nailing; reaming, irrigation, and aspiration; and unreamed femoral nailing. Blood samples were obtained and a bronchoalveolar lavage was performed at baseline, immediately after creation of the lung contusion, immediately after intramedullary nailing, and at four hours after surgery. Pulmonary permeability, polymorphonuclear leukocyte activity, and systemic hemostatic response were measured. Lung specimens were obtained for histological evaluation. RESULTS: At baseline and immediately after creation of the lung contusion, endothelial permeability was comparable among the three groups. At four hours postoperatively, pulmonary permeability was significantly higher in the group treated with reamed femoral nailing (urea/protein ratio; 256.7) than in the group treated with reaming, irrigation, and aspiration (urea/protein ratio, 91.5) and the group treated with unreamed femoral nailing (urea/protein, 110.64) (p < 0.05). The stimulatory capacity of the polymorphonuclear leukocytes was significantly decreased (p < 0.05) only in the group treated with reamed femoral nailing; the other two groups had no significant decrease postoperatively (p > 0.05). The D-dimer level at four hours postoperatively was significantly higher in the group treated with reamed femoral nailing than it was in the other two groups (p < 0.05). Histological examination showed that the grades of edema and polymorphonuclear leukocyte diapedesis were also highest in the group treated with reamed femoral nailing. CONCLUSIONS: It appears that, in the presence of a unilateral pulmonary injury, the systemic effects of intramedullary reaming of an intact femur can be minimized with use of a modified reamer design that simultaneously irrigates the canal and removes debris. Additional clinical validation of this reaming system is necessary.

Animals↗