Articles de revues sur le sujet « Chlorhexidine »

SubstantivityThe effectiveness of Chlorhexidine stems from its capacity to absorb to negatively charged surfaces in the mouth (e.g. tooth, mucosa, pellicle, restorative materials), being slowly released from these retention sites and therefore maintaining prolonged antimicrobial activity for several hours. This process is known as substantivity, and only chlorhexidine and tetracycline have this property so far.    Regarding its substantivity, it has been found that the use of chlorhexidine as root canal irrigating substance prevented microbial activity from 48 hrs, 7 days (in the liquid and gel formulation).    It seems that the antimicrobial substantivity is related to the chlorhexidine molecules available to interact with the dentin. Furthermore, the outstanding substantivity of chlorhexidineto dentin (evaluated at an interval from 0.5 h to 8 weeks) and its reported effect on the inhibition of dentinal proteases may explain why chlorhexidine can prolong the durability of resin-dentin bonds, particularly in the presence of collagen.Chlorhexidine & Biofilms    A biofilm can be defined as communities of microorganisms attached to a surface, embedded in an extracellular matrix of polysaccharides. Within these microcolonies, bacteria have developed into organized communities with functional heterogeneity. It constitutes a protected mode of growth that allows survival in a hostile environment. Bacteria in such an environment differ greatly in phenotype when compared with their planktonic counterparts, and are far less susceptible to antimicrobial killing. It has been reported that microorganisms grown in biofilms could be 2-fold to 1000- fold more resistant than the corresponding planktonic form of the same organisms.    Several studies using a single-species biofilm model and apical dentin biofilm have reported that higher concentration of NaOCl (varying from 2.25% to 6%) and chlorhexidine solution (2%) were effective against the tested microorganisms. The mechanical agitation improved the antimicrobial properties of the chemical substances, favouring the agents in liquid presentation, especially 5.25% NaOCl and 2% Chlorhexidine. Although chlorhexidine is effective against bacterial biofilms, NaOCl is the only irrigation solution with the capacity of disrupting biofilms.Chlorhexidine & Coronal Microleakage    Canals medicated with chlorhexidine alone or in combination with calcium hydroxide retard the entrance of microorganisms through the coronal portion of the tooth into the root canal system, due to its wide antimicrobial activity and substantivity. Such a finding is interesting, especially if the coronal restoration becomes defective or if it is lost. Regarding coronal microleakage during the intracoronal bleaching, it was found that chlorhexidine used as a vehicle for sodium perborate enhanced its antimicrobial activity and did not affect adversely dentin microhardness.Tissue Dissolution Capacity    As far as the use of an auxiliary chemical substance in Endodontics is concerned, several studies have been performed in the search for a substance with major desirable properties for root canal irrigation, which includes the capacity to dissolve organic tissues. The tissue dissolution capacity of a substance depends mainly on three factors:the frequency of shaking,the amount of organic matter in relation to the amount of irrigant in the canal systemand the surface area of tissue that is available for contact with the irrigant.    Chlorhexidine gluconate has been recommended as a root canal irrigant because of its broad spectrum antimicrobial action, substantivity and low toxicity. However, chlorhexidine's incapacity of tissue dissolution has been pointed out as its major disadvantage. Some attempts have been made to evaluate the activity of chlorhexidine to dissolve organic matter, demonstrating that both preparations of this substance, aqueous solution or gel, were not able to dissolve pulp tissues. Bleeding in case of vital pulp will stop only with the complete removal of the pulp tissue by a full instrumentation of the root canal within its whole extension. Therefore, when chlorhexidineis used as an irrigant, emphasis should be given to full canal instrumentation in order to remove all pulp tissue, as chlorhexidine does not promote a superficial necrosis.    Due to its viscosity and rheological action, which keeps the debris in suspension, the gel seems to compensate for chlorhexidine's inability to dissolve pulp tissue, by promoting a better mechanical cleansing of the root canal and removing dentin debris and remaining tissues. The mechanical properties of the gel seem to be the main factor for this difference because the same chemical agent in the liquid form showed lower cleaning efficiency, although presenting similar antimicrobial activity.    Another important fact to be pointed out is that due to the complexity of the root canal system, even irrigation with 5.25% NaOCl does not remove all debris and organic tissues. On the other hand, dentin and organic tissues that get in contact with chlorhexidine during irrigation maintain a prolonged antimicrobial activity, as chlorhexidine is slowly released from these retention sites. Furthermore, if chlorhexidineis extruded through the apex, it does not induce pain to the patients.Interaction with Endodontic Irrigants    Due to its wide spectrum antimicrobial activity and its inability of dissolving organic tissues, an irrigation regimen has been proposed, in which NaOCl would be used throughout instrumentation, followed by EDTA, and chlorhexidine would be used as a final irrigant.    The combination of NaOCl and chlorhexidine has been advocated to enhance their antimicrobial properties, and the advantage of using a final rinse with chlorhexidine would be the prolonged antimicrobial activity due to the chlorhexidine substantivity. It has been reported that the antimicrobial effect of 2.5% NaOCl and 0.2% chlorhexidine used in combination was better than that of either component.    Apart from the antimicrobial aspect, the association of NaOCl with chlorhexidine leads to the formation of an orange-brown precipitate, resulting in a chemical smear layer that covers the dentinal tubules and may interfere with the seal of the root filling. In addition, this precipitate changes the colour of the tooth and is cytotoxic.    On investigationNaOCl and chlorhexidine, with and without EDTA, when used in combination as endodontic irrigants against Enterococcus faecalis, and verified that combining EDTA with NaOCl or chlorhexidinewas more effective than using EDTA alone. However, chlorhexidine combined with EDTA also leads to the formation of precipitates, resulting in a chemical smear layer that covers the dentinal tubules. Regarding the orange-brown precipitate, it occurs due the presence of NaOCl, an oxidizing agent causing chlorination of the guanidino nitrogens of the chlorhexidine. Thus, after chemo-mechanical preparation with NaOCl, the use of chlorhexidine as a final irrigant or as an intracanal medicament would require the removal of NaOCl from the canal.    It has been found that with regard to the use of NaOCl with chlorhexidine, 10 ml of distilled water in association or not with 17% EDTA and 10% citric acid was not enough to inhibit the formation of the chemical smear layer. In the cases where one wants to associate these substances, the protocol using phosphoric acid did not induce formation of chemical smear layer.    In summary, it is important to remove all traces of the substances used inside the root canals in order to avoid interactions between them. To be continued…………………….(It's a review of literature and not an original article)

ABSTRACT Aim To compare the antimicrobial effect of 2% chlorhexidine, 2.5% sodium hypochlorite and MUMS containing 2% chlorhexidine. Materials and methods All of the above irrigants were examined on Enterococcus faecalis, Streptococcus mutans, Candida albicans, Lactobacillus casei and E.coli. A total of 0.5 CC of each solution and 0.5 CC of McFarland solution bacterium were added to each examination tube. After 15, 30 and 45 minutes, colony count was performed for each tube. The difference in the number of bacteria indicated the effect taken by disinfectant material. Results MUMS containing chlorhexidine showed the antimicrobial properties just like chlorhexidine's effect against E.coli, Streptococcus mutans, Candida albicans, Enterococcus faecalis and Lactobacillus casei in preventing these entire microorganisms to incubate. Sodium hypochlorite was not effective against Enterococcus faecalis and Candida albicans incubated in 15, 30 and 45 minutes and Enterococcus faecalis in 15 minutes. Conclusion MUMS has antimicrobial properties similar to chlorhexidine. Clinical significance As MUMS containing chlorhexidine can transfer chlorhexidine through its own surfactant around apical area and it can open the dentinal tubules by its own chelator for more penetration of chlorhexidine, it may be a choice for canal irrigation. How to cite this article Bidar M, Hooshiar S, Naderinasab M, Moazzami M, Orafaee H, Naghavi N, Jafarzadeh H. Comparative Study of the Antimicrobial Effect of Three Irrigant Solutions (Chlorhexidine, Sodium Hypochlorite and Chlorhexidinated MUMS). J Contemp Dent Pract 2012;13(4): 436-439.

Background: Lactobacillus acidophilus is gram-positive bacteria that produces acids from carbohydrates and causing dental caries. Caries treatment is done by the cavitation of teeth which is preceded by cavity disinfection. The purpose of cavity disinfection is to kill microorganisms and reduce the risk of new carious lesions. Bacterial elimination can be done using chlorhexidine and laser. Chlorhexidine is widely used for cleaning cavities but cannot remove biofilms, tissue debris and has limited elimination of bacteria in the dentinal tubules. Another way to eliminate bacteria is using Photodynamic Therapy (PDT) which consists of photosensitizer and laser. Until now there has not been a single ingredient that is considered to cleanse the cavity thoroughly. There has been no research yet that examine the number of Lactobacillus acidophilus after using chlorhexidine 2%, laser diode (405 nm), and combination of 2% chlorhexidine with laser diode (405 nm). Objective: To compare the decreasing number of living Lactobacillus acidophilus after using chlorhexidine 2%, laser diode (405 nm), and combination of chlorhexidine 2% with laser diode (405 nm). Methods: A total of 24 samples of Lactobacillus acidophilus were divided into 4 groups: (I) chlorhexidine 2%, (II) chlorophyll photosensitizer and 75 seconds irradiation, (III) combination of chlorhexidine2%, chlorophyll photosensitizer, and 75 seconds irradiation. After treatment, the sample was incubated 48 hours and the colony count was calculated for each group. Results of the analysis were carried out by ANOVA and Tukey HSD tests with p <0.05. Results: The average number of group colonies (I) was 35.33 CFU/ml, (II) 16.83 CFU/ml, (III) 9.5 CFU/ml, (IV) 123.33 CFU/ml. Conclusion: The combination of 2% chlorhexidine with diode laser (405 nm) gives the least amount of living Lactobacillus acidophilus bacteria compared with the administration of 2% chlorhexidine and laser diode (405 nm).

Plaque control is the main method for preventing periodontal diseases. Chlorhexidineia a gold standard mouthrinse but it has a side effect which limits its use. Triclosanwhich does not have side effects was used to evaluate its efficacy againstchlorhexidine. This experiment aimed to evaluate the effect of chlorhexidine andtriclosan on undisturbed plaque formation for 72 hours. Two groups, chlorhexidineand triclosan, respectively consists of 14 volunteers refrained from all mechanicaloral hygiene measures for the following 72 hours and rinsed instead twice daily for 1minute with 15 mL of either chlorhexidine or triclosan. The plaque accumulation wasassessed after 24, 48 and 72 hours using Modified Quigley-Hein Score. The medianplaque score between both groups on day 1 was not significantly different (p= 0.625),but the score on day 2 and day 3 were significantly different (p= 0.007 and 0.017respectively). The score between day 1 and day 3 on subjects using chlorhexidine wasnot significantly different (p= 0.109) unlike on subjects using triclosan (p= 0.003).The conclusion was chlorhexidine is more effective in controlling plaque formationcompared to triclosan.

Background: Streptococcus mutans is a major contributor to the formation of dental plaque and the initiation of caries. Orthodontic appliances, particularly removable ones, can create favorable conditions for S. mutans colonization, increasing the risk of caries and other oral health issues. Chlorhexidine is a commonly used antimicrobial agent in dentistry, but it can have side effects like tooth staining and altered taste. Guava leaf extract has shown promising antibacterial properties due to its rich content of flavonoids, tannins, and other bioactive compounds. This study aimed to compare the effectiveness of guava leaf extract and chlorhexidine in reducing S. mutans colonization on acrylic-based removable orthodontic appliances. Methods: This in vitro study used 25 acrylic plates, which were divided into five groups: guava leaf extract at concentrations of 75%, 80%, and 90%, chlorhexidine gluconate 0.2% (positive control), and aquades (negative control). The acrylic plates were first contaminated with S. mutans and then immersed in the respective solutions for 10 minutes. The number of S. mutans colonies was then counted using a colony counter. Results: The mean number of S. mutans colonies was significantly lower in the chlorhexidine group (27.8 ± 6.6 CFU/ml) and the guava leaf extract groups (9.4 ± 3.3 CFU/ml for 90%, 42 ± 7.8 CFU/ml for 80%, and 381 ± 81.1 CFU/ml for 75%) compared to the aquades group (1461.2 ± 274.5 CFU/ml). There was no significant difference between the chlorhexidine group and the 90% and 80% guava leaf extract groups. Conclusion: Guava leaf extract, particularly at concentrations of 90% and 80%, is as effective as chlorhexidine in reducing S. mutans colonization on orthodontic appliances. Guava leaf extract may be a promising natural alternative to chlorhexidine for maintaining oral hygiene in orthodontic patients, especially those with concerns about chlorhexidine's side effects.

The aim of this paper is to evaluate the antibacterial property of royal jelly and chlorhexidine 0.2%. As a methodology, in our study, we used piastres in blood agar, where the holes in the agar field were made through a glass pipette, sterile "Paster", in a diameter of 7 mm. Used a bacterial culture of Streptococcus gr. D (Enterococcus faecalis) in a concentration of 105, which was distributed in sterile condition, using a sterile tampon, according to the method of diffusion in agar. As a result, we used a ruler for the measurement of inhibition areas: -in the royal jelly’s hole, the radius of inhibition resulted 14 mm, -in the chlorhexidine’s hole, the radius of inhibition resulted 20 mm. Based on the results obtained from our study, presented facts to use the royal jelly and chlorhexidine 0.2% in the dental practice. As a conclusion, we can say that the royal jelly contains important elements with antibacterial action compared to the chlorhexidine one.

The aim of this paper is to evaluate the antibacterial property of royal jelly and chlorhexidine 0.2%. As a methodology, in our study, we used piastres in blood agar, where the holes in the agar field were made through a glass pipette, sterile "Paster", in a diameter of 7 mm. Used a bacterial culture of Streptococcus gr. D (Enterococcus faecalis) in a concentration of 105, which was distributed in sterile condition, using a sterile tampon, according to the method of diffusion in agar. As a result, we used a ruler for the measurement of inhibition areas: -in the royal jelly’s hole, the radius of inhibition resulted 14 mm, -in the chlorhexidine’s hole, the radius of inhibition resulted 20 mm. Based on the results obtained from our study, presented facts to use the royal jelly and chlorhexidine 0.2% in the dental practice. As a conclusion, we can say that the royal jelly contains important elements with antibacterial action compared to the chlorhexidine one.

Background: Preparation of a new product with the goal of reducing chlorhexidine’s side effects without decreasing (and even increasing) its effectiveness is a desirable goal for researchers in the field of oral hygiene. The aim of this study was to evaluate the efficacy of Chlorhexidine 0.2% and Cetylpyridinium 0.05% combination in reducing oral bacteria in comparison with Chlorhexidine 0.2%, Cetylpyridinium 0.05% and Persica mouthwashes.
 Methods: 100 healthy volunteers aged between 18 and 30 years were randomly assigned to 5 groups. The first group received Chlorhexidine 0.2%, the second group received Cetylpyridinium 0.05%, the third received Persica, the fourth received Chlorhexidine 0.2% plus Cetylpyridinium 0.05%, and the fifth group received Chlorhexidine 0.05% plus Cetylpyridinium 0.05%. Samples were obtained at baseline and thirty minutes after oral rinsing with the mouthwashes. The number of colony-forming units (CFU/mL) before and after mouthwash administration was compared for each sample. 
 Results: The preparation with the most bacterial count reduction was found to be Chlorhexidine 0.2% and Cetylpyridinium 0.05% combination. However, the difference between efficacy of Chlorhexidine 0.2% plus Cetylpyridinium 0.05% and Chlorhexidine 0.05% plus Cetylpyridinium 0.05% was found not to be statistically significant. 
 Conclusions: A new mouthwash preparation including chlorhexidine 0.05% and cetylpyridinium 0.05 % combination is the most desirable due to the increased efficacy and fewer side effects.