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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↗
PubMed1985

Effect of self-administered daily irrigation with 0.02% SnF2 on periodontal disease activity.

To determine the effect on periodontal health of a daily self-administered irrigation with 0.02% stannous fluoride (SnF2) solution, 28 subjects who had moderate to advanced periodontitis were randomly divided into 3 groups: a control group (n = 9) which used no irrigation, a group (n = 8) which used a self-administered water irrigation device (Water Pik) daily with water (H2O group) and a group (n = 11) which used the Water Pik in a similar manner but with SnF2 solution (SnF2 group). All subjects were instructed in routine tooth brushing and flossing but received no other periodontal treatment. 4 study sites were selected from each patient which had pocket depths greater than 4 mm and bleeding upon probing. Plaque index, gingival index, bleeding tendency, pocket depth, loss of attachment, and microbiologic samples of subgingival plaque for morphologic determinations were collected from all study sites at baseline, 2, 6, and 10 weeks. A cross-over was then initiated for 2 additional monthly checks in which the H2O group changed to SnF2 and the SnF2 group was divided into 2 subgroups which either continued to use SnF2 or changed to H2O. The control group completed the study at the beginning of the crossover. The clinical data showed significantly more improvement in periodontal health during the first 10 weeks for the SnF2 group (p less than 0.01). After cross-over, the clinical data indicated the group that changed from H2O to SnF2 significantly improved their periodontal health, while the group that changed from SnF2 to H2O became worse. The microbiologic data showed trends which agreed with the clinical data during the first 10 weeks but were less significant. After cross-over, the %s of motile rods and spirochetes were too small (0-7%) to establish statistically significant changes considering the accuracy of the technique used.

Bacteria↗
PubMed1986

Depth of penetration in periodontal pockets with oral irrigation.

The purpose of this study was to determine the effectiveness of the Water Pik oral irrigator as a vehicle for delivering an aqueous solution into periodontal pockets. Plaque-disclosing dye diluted with sterile saline solution was applied with the irrigator toward the gingival margins of teeth at 90 degrees and at 45 degrees prior to their extraction. The mean % penetration measured between a reference notch at the gingival crest and the periodontal ligament at the bottom of the pocket showed no statistical difference between the two angles of application. Penetration ranged from 44% to 71%, the lowest being into pockets 4-7 mm; higher mean penetration was noted in both subgroups 0-3 and greater than 7 mm. No statistical difference was found between proximal and facial or lingual surfaces, maxilla and mandible, existence of tooth contact, and proximal tissue contour or consistency. The mean % penetration was independent of pocket depth (chi 2 analysis). Correlation between pocket depth and mean penetration was low for all but one subgroup (90 degrees application and pockets greater than 7 mm). The results suggest that the oral irrigator will deliver an aqueous solution into periodontal pockets and will penetrate on average to approximately half the depth of the pockets.

Dental Devices, Home Care↗
PubMed1991

The effects of subgingival irrigation with low dosage metronidazole on periodontal inflammation.

The effects on chronic periodontitis of a simplified oral hygiene regimen combined with subgingival irrigation with 0.5% metronidazole were investigated. 19 patients, with 548 pockets greater than or equal to 4 mm, completed a 3-month randomised double-blind placebo-controlled trial. At day 0, prior to treatment, and at days 7, 28, 56 and 84, plaque index, sulcus bleeding index and probable pocket depth were recorded. The simplified oral hygiene regimen consisted of (1) one episode of root debridement, removal of subgingival approximal overhangs on restorations and subcontact area debridement with abrasive strips and polishing, and (2) instruction in Bass brushing (twice daily) with no stress on interdental cleaning. After baseline debridement, patients were allocated 0.5% metronidazole or a placebo. They were instructed to irrigate subgingivally once daily for 28 days. Treatment resulted in marked improvement in both groups and proportionately more sites improved in the metronidazole group at 28, 56 and 84 days. There were no significant differences between the procedures at any time. It was concluded that a simplified oral hygiene regimen combined with daily subgingival irrigation with 0.5% metronidazole or a placebo was effective in reducing periodontitis for at least a further 8 weeks, and that proportionately more sites improved in the metronidazole group.

Administration, Topical↗
PubMed1994

Repeated subgingival oxygen irrigations in untreated periodontal patients.

The aim of this study was to assess the effect of repeated subgingival oxygen irrigations in previously untreated deep periodontal pockets. 112 pockets > or = 4 mm were selected in 14 subjects. Probing attachment level and bleeding on probing were recorded, as well as the presence of disease-associated micro-organisms within the pocket. Subsequently, the pockets were irrigated with gaseous oxygen 1 x a week during a continuous 8-week period. Irrigations with nitrogen served as control. The re-evaluation of all clinical and microbiological parameters at the end of study revealed that repeated oxygen insufflations resulted in a significant clinical improvement of the periodontal baseline conditions superior to the one found in the control.

Adult↗
PubMed1993

Antibacterial effects of various endodontic irrigants on selected anaerobic bacteria.

This study was undertaken to determine the antibacterial effects of various endodontic irrigants against six selected anaerobic bacteria. The organisms were mixed separately with dilutions of each of the irrigants in tubes containing fluid thioglycollate broth and allowed to remain in contact for specific time periods before being evaluated for growth. Of the six irrigants tested, chlorhexidine appeared to be the most effective antibacterial substance. Hydrogen peroxide, sodium hypochlorite and REDTA were less effective while the calcium hydroxide and saline solutions proved to be totally ineffective.

Bacteria, Anaerobic↗
PubMed2005

Intracavernosal irrigation by cold saline as a simple method of treating iatrogenic prolonged erection.

AIMS AND METHODS: The aim of this study was to evaluate the efficacy of aspiration and irrigation of the corpora cavernosa with cold saline as a simple outpatient method for treating prolonged penile erection after intracavernous injection of vasoactive agents. RESULTS: Aspiration and irrigation was needed in 70 out of 122 cases with iatrogenic priapism in whom cooling of the penis and perineum failed to achieve detumescence. According to the temperature of the saline used, patients were randomized into four different groups: A, B, C, and D with a saline temperature 10, 15, 20, and 37 degrees C, respectively. MAIN OUTCOME: We used a significantly larger volume of saline in groups C and D compared to group A. On the other hand there was no significant difference in the volume of saline used between groups A and B. Complete detumescence was achieved in 24/25 (96%) of cases in group A compared to 9/15 (60%) of cases in group D. CONCLUSION: We recommend corporal aspiration and irrigation with 10 degrees C saline for patients with prolonged penile erection who failed to respond to the noninvasive measures using ice-cold compresses and physical exercise.

Adolescent↗
PubMed1984

Management of chemical eye injuries with prolonged irrigation.

To study the effect of prolonged irrigation in the treatment of chemical eye injuries we reviewed the case records of 172 patients. Most of the patients were men in working age. The injury was caused by acid in 57 patients (33%). Of the acid burns, 28 were due to AIV solution commonly used in agriculture in Finland, and 27 were due to inorganic acids. Alkaline burns occurred in 64 (37%) patients including 33 cases with natrium hydroxide and 20 cases with mortar and cement burns. Other chemicals including organic solvents and surfactants caused the eye burn in 51 (30%) cases. Fifty three patients mostly with alkaline and acid burns were treated with prolonged irrigation with one liter of physiological saline using intravenous delivery system during 1-2 hours. The extent of damage was smaller, the visual outcome better, and the duration of treatment at the hospital and absence from work were shorter in patients treated with prolonged irrigation than without such treatment.

Accidents, Occupational↗
PubMedDate not supplied

A mathematical model for irrigated epicardial radiofrequency ablation.

A mathematical model for epicardial radiofrequency ablation using an electrode irrigated by saline is proposed. Saline flow profiles are derived using thin film theory, and heat convection due to blood flow is also included in the model. Results from a computer implementation of the model using a finite element method suggest that transmural ablation lesions can be made in 4-mm-thick tissue. Effects of parameters such as tissue and saline layer thickness, irrigation rate, blood flow rate, and applied power are investigated. Saline is found to irrigate as well as ablate. Rise in saline temperature and consequent ablation by saline is more pronounced as saline layer becomes thicker. Electrode tip temperatures as much as 40 degrees C lower than maximum tissue temperature were found in simulations.

Blood Flow Velocity↗
PubMed1989

The use of a new design irrigator for the emergency treatment of chemical eye injuries in an accident and emergency department.

The introduction of a hand-held drench hose into a district general hospital accident and emergency department, for the emergency irrigation of chemically injured eyes is reported. The hose is described, together with the technique of irrigation. The advantages that a high-flow, low pressure system affords over conventional irrigation methods are discussed. The system appears to offer a simple, immediately available, effective tool for emergency eye care, which is suitable for use by a variety of personnel.

Burns, Chemical↗
PubMed1999

Effect of cautery with irrigation forceps on the remnant liver after hepatectomy in rats.

Monopolar cautery with irrigation forceps (CIF) was devised for use in liver resection that does not require occlusion of inflow to the remnant liver. However, a high power output is required to divide the hepatic parenchyma which boils the irrigation water. This study was performed to investigate the effects of using CIF on the hepatic parenchyma. Histologic and biochemical examination was performed in rats which had undergone hepatectomy using the CIF, irrigating bipolar (IB), Pringle's maneuver with blunt dissection (group P), or a sham operation. A greater cautery distance was obtained with the CIF than the IB. There was no significant difference in the remnant liver function after the 1st postoperative day in any of the groups. CIF is an effective instrument for anatomic or nonanatomic hepatic resection.

Animals↗
PubMed1998

Successful irrigated-tip catheter ablation of atrial flutter resistant to conventional radiofrequency ablation.

BACKGROUND: Catheter ablation of typical right atrial flutter is now widely performed. The best end point has been demonstrated to be bidirectional isthmus block. We investigated the use of irrigated-tip catheters in a small subset of patients who failed isthmus ablation with conventional radiofrequency (RF) ablation. METHODS AND RESULTS: Of 170 patients referred for ablation of common atrial flutter, conventional ablation of the cavotricuspid isthmus with >21 applications failed to create a bidirectional block in 13 (7.6%). An irrigated-tip catheter ablation was performed on identified gaps in the ablation line according to a protocol found to be safe in animals: a moderate flow rate of 17 mL/min and temperature-controlled (target, 50 degrees C) RF delivery with a power limit of 50 W. Bidirectional isthmus block was achieved in 12 patients by use of a mean delivered power of 40+/-6 W with a single application in 6 patients and 2 to 6 applications in the other 6. No side effects occurred during or after the procedure. CONCLUSIONS: Irrigated-tip catheter ablation is safe and effective for achieving cavotricuspid isthmus block when conventional RF energy has failed.

Adult↗
PubMedDate not supplied

Amiodarone-induced torsade de pointes during bladder irrigation: an unusual presentation--a case report.

The authors present a case of early (within 4 days) development of torsade de pointes (TdP) associated with oral amiodarone therapy. Consistent with other reports this case of TdP occurred in the context of multiple exacerbating factors including hypokalemia and digoxin excess. Transient prolongation of the QT during bladder irrigation prompted the episode of TdP. It is well known that bradycardia exacerbates acquired TdP. The authors speculate that the increased vagal tone during bladder irrigation, a vagal maneuver, in the context of amiodarone therapy resulted in amiodarone-induced proarrhythmia. In the absence of amiodarone therapy, a second bladder irrigation did not induce TdP despite hypokalemia and hypomagnesemia.

Aged↗
PubMedDate not supplied

The effect of intraoperative antibiotics in irrigating solutions on aqueous humor contamination and endophthalmitis after phacoemulsification surgery.

PURPOSE: To determine the efficacy of intraoperative antibiotic use in irrigating solutions on aqueous humor contamination during phacoemulsification surgery and to evaluate the corresponding risk of postoperative endophthalmitis. METHODS: 644 eyes of 640 patients who underwent phacoemulsification surgery with foldable intraocular lens (IOL) implantation were included in this study. Preoperative conjunctival smears were taken and eyes were allocated to receive irrigating infusion fluid containing either balanced salt solution (BSS)-only (group 1; 322 eyes) or BSS with antibiotics (vancomycin and gentamycin) during surgery (group 2; 322 eyes). Bacterial contamination rates of aqueous humor samples taken in the beginning and at the end of operation were compared. Predictive factors for the development of postoperative endophthalmitis were determined by clinical and microbiologic analyses. RESULTS: The rates of culture-positivity were similar between group 1 and group 2 for both preoperative conjunctival smears and aqueous samples (p > 0.05). Aqueous samples taken at the end of operation were found to be contaminated in 68 (21.1%) eyes in group 1 and 22 (6.8%) eyes in group 2, and the difference was significant (p = 0.0001; OR = 3.65 (2.1-6.0)). Capsular rupture was associated with higher rate of contamination in both groups (p = 0.0001; OR = 7.7 and p = 0.0001; OR = 8.1). Two eyes in the BSS-only group developed postoperative endophthalmitis and these cases had posterior capsular rupture during the surgery and culture-positivity for staphylococcus epidermidis throughout the study. CONCLUSIONS: Intraoperative antibiotic irrigation decreases aqueous humor contamination during phacoemulsification. Further studies are warranted to determine the interrelationship between aqueous humor contamination and endophthalmitis in eyes with posterior capsular rupture.

Acetates↗
PubMed2005

Does irrigation of the ear to remove impacted wax improve hearing?

Irrigation of the ear to remove impacted wax is a commonly performed nursing procedure in primary and community care. The main presenting symptom is hearing loss. This review sought to determine whether there is any evidence that irrigation of the ear to remove impacted wax improves hearing. The strategy used was that of a mini-review. Four databases were searched. Randomized controlled trials (RCTs), quasi-randomized studies and non-randomized comparative studies were considered if they demonstrated an objective measure of hearing before and after ear irrigation. Four studies were selected for critical appraisal. Only one study, a single-blind RCT, measured outcome by number of individuals that had their hearing improved by a clinically significant amount (33%). The results of this RCT may be over-estimated and so more evidence may be required before the question can be fully answered.

Cerumen↗
PubMed1997

Rigid thorascopic debridement and continuous pleural irrigation in the management of empyema.

STUDY OBJECTIVE: To determine the role of rigid thoracoscopy and continuous pleural irrigation as an alternative to thoracotomy in critically ill patients. DESIGN/SETTING/PATIENTS/INTERVENTIONS: Thirteen patients with empyema (one bilateral) underwent thorascopic decortication and continuous postoperative irrigation with normal saline solution. Seven patients required preoperative ventilator support. MEASUREMENTS AND RESULTS: Double-lumen intubation was utilized in only two cases. Empyemas were drained effectively in all patients, including nine patients in whom dense adhesions were encountered. Mean duration of irrigation was 3.5 +/- 0.5 days. There were no deaths. One patient developed a recurrent empyema 1 week after resolution of symptoms and underwent thoracotomy. CONCLUSIONS: Rigid thorascopic decortication is an effective method for treating empyemas and can be considered before thoracotomy. It can be performed in patients who might not be candidates for video-assisted thorascopic approaches owing to inability to tolerate one-lung anesthesia or who have dense adhesions preventing lung collapse.

Adult↗
PubMed1996

Assessing pre-procedural subgingival irrigation and rinsing with an antiseptic mouthrinse to reduce bacteremia.

In this controlled clinical study, the authors examined the effect of subgingival irrigation and rinsing with an antiseptic mouthrinse before ultrasonic scaling of a quadrant containing inflamed gingivae. The results showed that pre-procedural subgingival irrigation and rinsing can significantly reduce the level of bacteremia associated with ultrasonic scaling. These results support the American Heart Association's recommendation of adjunctive subgingival irrigation prior to invasive procedures in patients at risk of developing bacterial endocarditis.

Adult↗