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PubMedDate not supplied

Reduced bacteria on transplantable allograft skin after preparation with chlorhexidine gluconate, povidone-iodine, and isopropanol.

A comparison was made of the residual microbiologic contamination on transplantable allograft skin for burn wound coverage taken from cadaver donors prepared by two different protocols. One group was prepared with povidone-iodine, detergent, and 70% isopropanol; the other was prepared with these agents and 4% chlorhexidine gluconate (CG). The skin from each of the donor bodies was removed from independently prepared body areas. Without CG, 13.7% of donor body areas were contaminated; with CG, only 5.6% were contaminated. The number of gram-positive bacterial species isolated from skin after CG preparation was dramatically reduced. The gram-positive bacterial contamination rate dropped from 12.1% to 2.2% of donor body areas, a drop of 82%. With CG, 12 of the 15 contaminant species were eliminated; and we saw a general reduction in the total number of contaminated body areas, a specific and pronounced reduction in gram-positive bacteria, and an increase from 86.3% to 94.4% in the amount of skin obtained from donor cadavers that tested negative for bacterial contamination.

1-Propanol↗
PubMed2000

Antimicrobial substantivity of bovine root dentin exposed to different chlorhexidine delivery vehicles.

Root canal dentin acquires antimicrobial substantivity after exposure to chlorhexidine gluconate (CHX) for 1 wk. Therefore development of a vehicle for delivery of CHX as an intracanal medication is desirable. This in vitro study assessed the efficacy of two CHX delivery vehicles, a controlled-release device and a gel, to affect antimicrobial substantivity of bovine root dentin. Sixty bovine incisor root specimens were prepared with standardized length (10 mm) and canal diameter (3.3 mm), and coated externally with nail polish. Specimens were divided into four equal groups and their canals medicated for 7 days with either: (i) an experimental controlled-release device containing 25% CHX that was immersed in sterile saline; (ii) 2% CHX gel; or (iii) Ca(OH)2 paste. Sterile saline was used as the positive control. After medication, the canals of the specimens were inoculated with Enterococcus faecalis for 21 days. Root canal dentin samples ranging in depth from 0.1 to 0.45 mm were then obtained using sterile round burs of ascending diameter. Each dentin sample was placed in a separate test tube containing Brain Heart Infusion broth and incubated for 24 h. The optical density (OD) of the broth was then measured spectrophotometrically at 540 nm. The positive control showed significantly higher mean OD values (one-way ANOVA and Tukey's Studentized Range Test; p < 0.001) than the three test groups. The CHX controlled-release device group showed significantly lower OD values than the Ca(OH)2 group; however only at dentin depths up to 0.2 mm. In contrast, the CHX gel group consistently showed significantly lower OD values than both the CHX controlled-release device and Ca(OH)2 groups. These results suggest that bovine root canals medicated with 2% CHX gel for 7 days acquire antimicrobial properties for at least 21 days.

Analysis of Variance↗
PubMed2003

Additive antimicrobial activity of calcium hydroxide and chlorhexidine on common endodontic bacterial pathogens.

It is an established procedure to use calcium hydroxide [Ca(OH)2] as a therapeutic component to achieve sterilization of infected root canals. Unfortunately, some bacterial species are relatively resistant to Ca(OH)2 and are therefore associated with treatment failures. The objective of this study was to identify combinations of substances that improve antimicrobial activity. Ca(OH)2 was used as a suspension or as a component of gutta-percha points. Efficacy of killing was compared for (a) Ca(OH)2 suspension alone; (b) zinc oxide (ZnO) points alone; (c) Ca(OH)2 suspension combined with ZnO points; (d) Ca(OH)2 suspension combined with ZnO/chlorhexidine points; and (e) Ca(OH)2 points combined with ZnO/chlorhexidine points. Common endodontopathogenic bacterial species (Enterococcus faecalis, Fusobacterium nucleatum, Peptostreptococcus micros, Porphyromonas gingivalis, Streptococcus intermedius) in pure cultures served as target organisms. In the in vitro assay, the antibacterial substances and approximately 10(7) colony forming units of test bacteria were co-incubated in diluted human serum under growth conditions appropriate for the single bacterial species. Samples were taken on days 0, 1, 2, 4, 7, and 14 of incubation and viable counts determined. Gram-negative bacteria were sufficiently killed by Ca(OH)2 alone. Combinations with other agents did not improve the killing kinetics. For the inactivation of the Gram-positive bacteria P. micros and S. intermedius, a combination of Ca(OH)2 and ZnO/chlorhexidine, killed the bacteria faster than Ca(OH)2 alone. For E. faecalis, combining Ca(OH)2 suspension with ZnO/chlorhexidine points lead to a faster decrease in the overall number of viable bacteria, but no test conditions lead to the complete loss of culture viability. The results of this study support the use of a combination of Ca(OH)2 and chlorhexidine for faster eradication of P. micros and S. intermedius from infected root canals.

Anti-Infective Agents, Local↗
PubMed2004

Antibacterial activity of 2% chlorhexidine gluconate and 5.25% sodium hypochlorite in infected root canal: in vivo study.

In this study, the antibacterial activity of the different antibacterial solutions using as root canal irrigant was compared in the teeth with pulpal necrosis and with periapical pathosis. Thirty root canals of incisors and premolars of 20 patients were used. Before and after the root canal preparation, two canal samples were obtained by a harvesting method using a sterile paper point in the first appointment. During the biomechanical preparation, both irrigant solutions were used for each tooth which were randomly divided into two groups. Last samples were also obtained before the root filling procedure. Samples obtained from the root canals were subjected to microbiologic processing, including anaerobic incubation on trypticase soy agar for 5 to 7 days. After counting of CFU on the plates, we concluded that both chlorhexidine gluconate and sodium hypochlorite were significantly effective to reduce the microorganisms in the teeth with necrotic pulp, periapical pathologies, or both, and could be used successfully as an irrigant solution.

Adult↗
PubMed2004

Physical and chemical properties of chlorhexidine and calcium hydroxide-containing medications.

This study was performed to evaluate the physicochemical properties (pH, contact angle, working time, radio-opacity, and viscosity) of chlorhexidine (CHX) and calcium hydroxide-containing medications in gel form in different concentrations. The pH value was assessed with a pH meter. The contact angle was measured with a goniometer. The radio-opacity and working time measurements were taken in accordance with the standards of the International Organization for Standardization. The viscosity was evaluated using a Brookfield RVDV viscometer. The results showed that CHX did not affect the pH, radio-opacity, and working time of the calcium hydroxide-containing medications (p < 0.05). However, adding CHX lowered the contact angle and increased the viscosity of calcium hydroxide significantly. This research showed that CHX in different concentrations and in combination with calcium hydroxide has satisfactory physicochemical properties to be used as an intracanal medication.

Calcium Hydroxide↗
PubMedDate not supplied

The vaginal microflora of pig-tailed macaques and the effects of chlorhexidine and benzalkonium on this ecosystem.

BACKGROUND AND OBJECTIVES: To characterize normal vaginal microflora of pig-tailed macaques and to evaluate two commonly used intravaginal compounds, chlorhexidine (CHG), a vaginal antiseptic (Surgilube, E. Fougera, Melville, NY), and benzalkonium chloride (BZK) (spermicidal contraceptive) in this monkey model to assess effects on the vaginal microflora. STUDY DESIGN: Vaginal swabs were collected for microbiologic analysis to characterize normal flora. Subsequently, the vagina was exposed to either CHG or BZK twice at 24-hour intervals. RESULTS: The vaginal microflora of 26 pig-tailed macaques was found to be remarkably similar to the vaginal flora of the human with respect to frequency of vaginal colonization by H2O2-producing lactobacilli, Prevotella species, and several other microorganisms. After two vaginal applications at 24-hour intervals, CHG had only small effects on the vaginal microflora of five animals. By contrast, BZK applied by the same protocol had profound adverse effects on the lactobacilli and Peptostreptococcus and more transient effects on vaginal Prevotella and viridans streptococci of six animals. CONCLUSIONS: These observations demonstrate that the vaginal microflora of the pig-tailed macaque is a useful model in which to further evaluate newly developed intravaginal contraceptives that may be microbicidal and/or virucidal before widespread intravaginal use in women.

Animals↗
PubMed2004

Tolerance and safety of different concentrations of chlorhexidine for peripartum vaginal and infant washes: HIVNET 025.

BACKGROUND: There is a continuing need to evaluate sustainable interventions for prevention of mother-to-child transmission (MTCT) of HIV type 1. We evaluated different concentrations (0.25%, 1%, and 2%) of chlorhexidine (CHX) for perinatal maternal and infant washes to identify the maximum tolerable concentration of CHX for such an intervention. METHODS: Women were enrolled during their third trimester at the maternity unit of the Chris Hani Baragwanath Hospital in Soweto, South Africa, and perinatal maternal and infant washes were completed. Subjective maternal symptoms as well as infant examinations were used to assess tolerability of the washes. RESULTS: The 0.25% concentration of CHX was well tolerated by the mothers (n = 29). Ten of 79 women (13%) with 1% CHX washes complained of mild vaginal area burning or itching, and washes were stopped in 5 (6%). Twenty-three of 75 women (31%) in the 2% CHX wash group had subjective complaints, and the washes were stopped in 12 (16%). There were no clinical indications of toxicity of the CHX washes among infants. CONCLUSION: A 1% solution of CHX appears to be a safe and tolerable concentration of CHX for consideration in an MTCT prevention trial.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

A clinical study comparing the skin antisepsis and safety of ChloraPrep, 70% isopropyl alcohol, and 2% aqueous chlorhexidine.

ChloraPrep (2% chlorhexidine gluconate + 70% isopropyl alcohol [CHG + IPA] in a 3.0-mL applicator) is a recently approved antiseptic for preoperative skin preparation. This controlled open-label trial assessed the immediate and persistent antimicrobial efficacy and safety of CHG + IPA compared with 70% IPA or a 2% CHG aqueous solution alone. Each antiseptic significantly reduced abdominal and inguinal microbial counts from baseline at 10 minutes, 6 hours, and 24 hours (P =.0001). CHG + IPA provided significantly more persistent antimicrobial activity on abdominal sites than IPA (P =.003) or CHG (P =.028) at 24 hours. No skin irritations were reported for any of the three antiseptics.

2-Propanol↗
PubMed2004

Antibacterial efficacy of calcium hydroxide and chlorhexidine gluconate irrigants at 37 degrees C and 46 degrees C.

This study investigated the ability of two endodontic irrigants to eliminate Enterococcus faecalis from dentinal tubules, and whether their antimicrobial action was enhanced by heat. The lumens of disks prepared from extracted bovine roots were infected with E. faecalis and incubated for 72 h. Specimens were then filled with saline, 10% calcium hydroxide (Ca(OH)2), or 0.12% chlorhexidine gluconate (CHX) at 24 degrees C or 46 degrees C and incubated at 37 degrees C or 46 degrees C. The samples were then pulverized and plated to quantify residual bacteria. No statistical difference (p > 0.05) in bacterial growth was seen between the two saline groups, or between the two medication groups at a given temperature. CHX and Ca(OH)2 at either temperature produced significantly less growth than either saline group, and CHX or Ca(OH)2 at 46 degrees C produced significantly less growth than either group at 37 degrees C. Heat enhanced the antibacterial action of both experimental irrigants against E. faecalis, but heating saline produced no increase in bactericidal effect.

Animals↗
PubMed2005

Antimicrobial efficacy of chlorhexidine and two calcium hydroxide formulations against Enterococcus faecalis.

The purpose of this study was to investigate the efficacy of chlorhexidine (CHX) and calcium hydroxide (Ca(OH2) against Enterococcus faecalis in vitro. Extracted single-rooted human teeth were instrumented up to size 40. After removal of the smear layer, an inoculum of E. faecalis was inserted into the root canals. After incubation, the inoculum was removed and the root canals were filled with one of three different disinfectants: Ca(OH2 paste, CHX 2%, and a mixture of CHX and Ca(OH2 paste (n = 10 in each group). Control teeth were filled with water of standardized hardness (n = 10). The teeth were then incubated for 3 days. After incubation, each root canal was instrumented, and the removed dentin was examined microbiologically. CHX was significantly more effective against E. faecalis than was Ca(OH2 paste or a mixture of CHX with Ca(OH2 paste (p < 0.05). There was no increase in the efficiency of Ca(OH2 paste when CHX was added (p > 0.05). The results suggest that CHX is effective in the elimination of E. faecalis from dentinal tubules under the conditions of this study.

Calcium Hydroxide↗
PubMed1995

Potentiation of the effects of chlorhexidine diacetate and cetylpyridinium chloride on mycobacteria by ethambutol.

Ethambutol enhanced the effects of chlorhexidine diacetate and cetylpyridinium chloride against Mycobacterium avium, M. bovis BCG, M. fortuitum and M. phlei. The findings show that it is possible to increase the susceptibility of mycobacteria to agents that normally exhibit poor activity against these organisms because of their reduced cellular penetration.

Anti-Infective Agents, Local↗
PubMed2004

A randomized clinical trial on the short-term clinical and microbiological effects of the adjunctive use of a 0.05% chlorhexidine mouth rinse for patients in supportive periodontal care.

OBJECTIVE: To evaluate the clinical and microbiological activity of a new mouth rinse formulation, used as an adjunct to oral hygiene, for patients in supportive periodontal care. PATIENTS AND METHODS: This was a randomized, placebo-controlled clinical trial with two groups: test group, rinsing twice per day with the test product (with 0.05% chlorhexidine and 0.05% cetylpyridinium chloride); and control group, rinsing with a placebo. Treated chronic periodontitis patients were included, and two visits were rendered, baseline, and after 15 days. Clinical outcome variables included plaque and gingival indices, and probing pocket depth. Subgingival samples were processed by culturing. Patient-based variables and adverse effects were also assessed. Outcome variables were compared by t-test, chi2, and Mann-Whitney test. RESULTS: The results belonged to 33 patients. Plaque and gingival indices, and the log of bacterial total counts were reduced in the test group (p < or = 0.01), but differences between groups were only statistically significant (p < 0.05) for plaque and bacterial counts. A significant reduction in the proportions of flora (p < 0.05) and frequency of detection (p = 0.01) of Porphyromonas gingivalis was observed in the test group. CONCLUSIONS: The newly formulated mouth rinse demonstrated short-term plaque-inhibitory activity. This was associated with a reduction in the total load of anaerobic subgingival microflora.

Adult↗
PubMed2004

Influence of a SLS-containing dentifrice on the anti-plaque efficacy of a chlorhexidine mouthrinse.

BACKGROUND: Chlorhexidine (CHX) and sodium lauryl sulphate (SLS), the most widely used detergent in dentifrice, may counteract. Consequently, studies about this interaction suggested that care is required when combining both these compounds, even when they are introduced separately into the oral cavity. The purpose of the present study was to investigate the effect of toothbrushing with a SLS-containing dentifrice in one jaw, on the plaque inhibition of a CHX mouthrinse in the opposite jaw during a 4-day study period. METHODS: The study was an examiner-blind, randomised two-cell, crossover design. It used a 4-day plaque accumulation model to compare two different oral hygiene regimens with a washout period of 17 days. Sixteen healthy volunteers were enrolled in the study and received a thorough dental prophylaxis at the beginning of each 4-day test period. One jaw (upper or lower) was randomly assigned as the "study" jaw. The opposite jaw was assigned as the "dentifrice" jaw and served only to introduce the effect of brushing with a dentifrice in the study model. Two oral hygiene regimens were evaluated. During one randomly assigned test period, the "dentifrice" jaw was treated by toothbrushing with a 1.5% SLS-containing dentifrice and rinsed together with the "study" jaw with 0.2% CHX, thus forming regimen 1. As a control during the other test period, both the "dentifrice" jaw and "study" jaw were only rinsed with 0.2% CHX, forming regimen 2. No other oral hygiene methods were allowed. After 4 days of undisturbed plaque accumulation, the amount of plaque was evaluated (Silness & Löe 1964). The "study" jaw was used to study the effect of the two regimens on the level of plaque accumulation at the end of the 4-day period. RESULTS: The overall plaque index was 0.36 for regimen 1 and 0.34 for regimen 2. There was no significant difference in plaque accumulation between the two regimens. CONCLUSIONS: Within the limitations of the present study design, it can be concluded that ordinary brushing with a 1.5% SLS-containing dentifrice (Colgate Bi-Fluor), followed by rinsing with water does not appear to reduce the level of plaque inhibition offered by a post-brushing CHX rinse.

Adult↗
PubMed1992

Efficacy of a sustained-release device containing chlorhexidine and Ca(OH)2 in preventing secondary infection of dentinal tubules.

This study was conducted to evaluate the efficacy of the antibacterial activity of Ca(OH)2 and a sustained-release device containing chlorhexidine (SRD) in both sterilization and prevention of secondary infection of the root canal system. Bovine root dentine specimens previously incubated with Streptococcus faecalis were used in this experiment. Two different formulations of the SRD (differing in their cross-linkage), Ca(OH)2 and normal saline (control) were evaluated. The degree of bacterial infection of the root canal was tested after incubation periods of 24 h, 72 h and 7 days with these medicaments. Their efficacy in preventing secondary infection after recontamination was tested after 72 h and 7 days. The results demonstrated that both formulations of the SRD significantly reduced the bacterial population in the primary infected groups, as well as preventing secondary infection of the dentinal tubules in the recontaminated group. By contrast, Ca(OH)2 did not show any antibacterial activity, and failed to sterilize the dentinal tubules or prevent secondary infection after recontamination at the time periods examined.

Animals↗
PubMed2003

The influence of organic load on the antimicrobial activity of different concentrations of NaOCl and chlorhexidine in vitro.

AIM: To evaluate bacterial growth after contact with sodium hypochlorite (NaOCl; 1 and 5%) and chlorhexidine (CHX; 0.12, 0.5 and 1%) in vitro with or without the addition of organic material (bovine serum albumin (BSA) 0.5%). METHODOLOGY: Bacterial samples (American Type Culture Collection (ATCC)) of Staphylococcus aureus, Enterococcus faecalis, Escherichia coli, Porphyromonas gingivalis and Fusobacterium nucleatum were kept in contact with each irrigating solution for varying intervals of time: immediately (t0), 5 min (t5), 15 min (t15) and 30 min (t30). Each test was repeated 10 times. In half of the specimens, 0.5% BSA was added as organic material in an attempt to simulate the organic tissue present in the root canal system. Bacterial growth under appropriate condition of incubation was evaluated and compared for each microorganism at all time intervals. RESULTS: A 0.12% CHX solution did not eliminate E. faecalis at any time interval. One percent CHX eliminated all strains, as did both NaOCl concentrations. BSA did not interfere substantially with the antimicrobial activity of any of the irrigating solutions. CONCLUSIONS: Under the condition of this study, a 0.12% CHX solution was ineffective at killing E. faecalis.

Anti-Infective Agents, Local↗
PubMed2005

Effect of ProRoot MTA mixed with chlorhexidine on apoptosis and cell cycle of fibroblasts and macrophages in vitro.

AIM: To compare the percentage of apoptotic cells and the cell cycle profile of fibroblasts and macrophages exposed to either ProRoot mineral trioxide aggregate (MTA) mixed with chlorhexidine (CHX), or exposed to ProRoot MTA mixed with sterile water. METHODOLOGY: Mouse gingival fibroblasts or mouse macrophages were seeded in six-well plates and allowed to attach overnight. Freshly mixed or set (allowed to dry for 24 h) specimens of tooth-coloured (white) ProRoot MTA were prepared with 0.12% CHX gluconate (MTA/CHX) or with sterile water (MTA/H2O). The cells were exposed for 24 h to the MTA specimens, which were placed over permeable membrane inserts to avoid direct contact with the cells. Untreated cells served as controls. Propidium iodide staining followed by flow cytometry was used to evaluate the effects of ProRoot MTA on cell apoptosis and cell cycle. Statistical analyses were performed by one-way anova followed by post-hoc tests with the use of the SigmaStat 2.0 software, and significance was determined at P < or = 0.05. RESULTS: MTA specimens containing CHX induced apoptosis of macrophages and fibroblasts (P < 0.05). In contrast, no change in the proportion of apoptotic cells was observed when sterile water was used to prepare the specimens (P > 0.05). Cell cycle analysis showed that exposure to MTA/CHX decreased the percentage of fibroblasts and macrophages in S phase (DNA synthesis) as compared with exposure to MTA/H2O (P < 0.05). CONCLUSION: This in vitro study demonstrated that the substitution of CHX for sterile water in MTA increases its cytotoxicity. This suggests that the potentially beneficial antimicrobial effect of CHX may be accompanied by an increase in the cytotoxicity of the resulting MTA-based material.

Aluminum Compounds↗
PubMed2005

Effects of 2% chlorhexidine and 5.25% sodium hypochlorite on gutta-percha cones studied by atomic force microscopy.

AIM: To compare the effects of 2% chlorhexidine (CHX) and 5.25% sodium hypochlorite (NaOCl) on gutta-percha (GP) cone structure using atomic force microscopy (AFM). METHODOLOGY: Two standardized GP cones were sectioned 3 mm from the tip, attached to a glass base and immersed in 2% CHX or 5.25% NaOCl for 1, 5, 10, 20 and 30 min. Untreated GP cones were used as control. Topography and elasticity analyses were performed on 12 different regions located between 1 and 2 mm from the tip. Root mean square (RMS) parameters for contact mode imaging and force modulation microscopy variations were measured. The differences between RMS values were tested by anova with Fisher's protected LSD test for multiple comparisons. RESULTS: There was no deterioration in the topography and physical properties studied when 2% CHX was used in comparison with the control (P < 0.05). The RMS parameter for topography increased after 10 min of 5.25% NaOCl exposure in comparison with the control (P < 0.05). In addition, 5.25% NaOCl increased the elasticity of the GP cone after an immersion time of 1 min in comparison with the control (P < 0.05). CONCLUSIONS: Two per cent CHX did not change GP cone structure following up to 30 min exposure. Conversely, 5.25% NaOCl caused elastic changes after 1 min exposure.

Chlorhexidine↗
PubMed1986

Reversal of the surface effects of chlorhexidine diacetate on cells of Providencia stuartii.

Chlorhexidine diacetate (CHA) increased the hydrophobicity of the cell surface of cells of three strains of Providencia stuartii. Removal of at least some of the CHA from the cells by washing them with an appropriate antidote partially reversed the hydrophobicity-increasing action of the biguanide. The effects of other treatments on cell surface hydrophobicity were examined with these strains and, for comparison, with two strains each of Escherichia coli and Pseudomonas aeruginosa: ethylenediamine tetraacetic acid affected all strains, although not to the same extent, whereas thermal injury (55 degrees C) produced marked changes only with the two E. coli strains.

Cell Membrane↗