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1.
Rev. Col. Bras. Cir ; 48: e20202633, 2021. tab, graf
Article in English | LILACS | ID: biblio-1155374

ABSTRACT

ABSTRACT Objective: to compare the use of 0.5% alcoholic chlorhexidine and 70% alcohol in skin antisepsis for neuraxial blocks. Method: this is a non-inferiority randomized clinical trial, with two parallel arms. Seventy patients who were candidates for neuraxial block were randomly allocated to group A (n = 35), in whom antisepsis was performed with 0.5% alcoholic chlorhexidine, or to group B (n = 35), in whom we used 70% hydrated ethyl alcohol. Swabs were harvested for culture at three times: before antisepsis, two minutes after application of the antiseptic, and immediately after puncture. The samples were sown in three culture media and the number of colony forming units (CFU) per cm² was counted. Results: there was no difference between the groups regarding age, sex, body mass index, time to perform the block or type of block. There were no differences between groups in the CFU/cm² counts before antisepsis. There was less bacterial growth in group B two minutes after application of the antiseptic (p = 0.048), but there was no difference between the groups regarding the number of CFU/cm² at the end of the puncture. Conclusion: 70% alcohol was more effective in reducing the number of CFU/cm² after two minutes, and there was no difference between the two groups regarding skin colonization at the end of the procedure. These results suggest that 70% alcohol may be an option for skin antisepsis before neuraxial blocks. Trial registration: ClinicalTrials.gov, NCT02833376.


RESUMO Objetivo: comparar o uso de solução alcoólica de clorexidina 0,5% e de álcool 70% na antissepsia da pele para bloqueios do neuroeixo. Método: ensaio clínico randomizado de não inferioridade, com dois braços paralelos. Foram selecionados 70 pacientes candidatos à bloqueio do neuroeixo, randomicamente alocados para o grupo A (n=35), em que a antissepsia foi realizada com clorexidina alcoólica 0,5%, ou para o grupo B (n=35), em que se utilizou álcool etílico hidratado 70%. Foram coletadas, com swab, amostras para cultura em três momentos: antes da antissepsia, dois minutos após aplicação do antisséptico, e imediatamente após a punção. As amostras foram semeadas em três meios de cultura e foi contabilizado o número de unidades formadoras de colônias (UFC) por cm². Resultados: não houve diferença entre os grupos quanto à idade, ao sexo, ao índice de massa corporal, ao tempo para realização do bloqueio ou tipo de bloqueio. Também não houve diferenças entre os grupos na contagem de UFC/cm² antes da antissepsia. Constatou-se menor crescimento bacteriano no grupo B dois minutos após aplicação do antisséptico (p=0,048), mas não houve diferença entre os grupos quanto ao número de UFC/cm² ao final da punção. Conclusão: o álcool 70% mostrou-se mais efetivo em reduzir o número de UFC/cm² após dois minutos, e não houve diferença entre os dois grupos quanto à colonização da pele ao final do procedimento. Esses resultados sugerem que o álcool 70% pode ser opção para antissepsia da pele antes de bloqueios do neuroeixo. Registro ensaio clínico: ClinicalTrials.gov, NCT02833376.


Subject(s)
Humans , Skin/microbiology , Surgical Wound Infection/prevention & control , Chlorhexidine/pharmacology , Antisepsis/methods , Ethanol/pharmacology , Anti-Infective Agents, Local/pharmacology , Ethanol/administration & dosage , Anesthesia, Epidural , Anesthesia, Spinal , Anti-Infective Agents, Local/administration & dosage
2.
Rev Assoc Med Bras (1992) ; 66(Suppl 2): 124-129, 2020. tab, graf
Article in English | SES-SP, LILACS, SES-SP | ID: biblio-1136399

ABSTRACT

SUMMARY An alarming fact was revealed by recent publications concerning disinfectants: chlorhexidine digluconate is ineffective for disinfecting surfaces contaminated by the new coronavirus. This is a finding that requires immediate disclosure since this substance is widely used for the disinfection of hands and forearms of surgeons and auxiliaries and in the antisepsis of patients in minimally invasive procedures commonly performed in hospital environments. The objective of this study is to compare the different disinfectants used for disinfection on several surfaces, in a review of worldwide works. Scientific studies were researched in the BVS (Virtual Health Library), PubMed, Medline, and ANVISA (National Health Surveillance Agency) databases. The following agents were studied: alcohol 62-71%, hydrogen peroxide 0.5%, sodium hypochlorite 0.1%, benzalkonium chloride 0.05-0.2%, povidone-iodine 10%, and chlorhexidine digluconate 0.02%, on metal, aluminum, wood, paper, glass, plastic, PVC, silicone, latex (gloves), disposable gowns, ceramic, and Teflon surfaces. Studies have shown that chlorhexidine digluconate is ineffective for inactivating some coronavirus subtypes, suggesting that it is also ineffective to the new coronavirus.


RESUMO Um dado alarmante revelado por publicações a respeito dos agentes desinfetantes: o digluconato de clorexidina é ineficaz para desinfecção de superfícies contaminadas por coronavírus. Trata-se de uma constatação que reclama imediata divulgação, uma vez que essa substância é amplamente usada para degermação de mãos e antebraços dos cirurgiões e auxiliares e na antissepsia dos pacientes, em procedimentos minimamente invasivos, comumente em ambientes hospitalares. O objetivo deste trabalho foi comparar os diferentes desinfetantes usados para desinfecção em diversas superfícies em revisão de trabalhos mundiais. Foram pesquisados trabalhos científicos na BVS (Biblioteca Virtual de Saúde), PubMed, Medline e Anvisa (Agência Nacional de Vigilância Sanitária). Foram estudados os seguintes agentes: álcool 62-71%, peróxido de hidrogênio 0,5%, hipoclorito de sódio 0,1%, cloreto de benzancônio 0,05-0,2%, iodo povidina 10% e digluconato de clorexidina 0,02%, em superfícies de metal, alumínio, madeira, papel, vidro, plástico, PVC, silicone, látex (luvas), avental descartável, cerâmica e teflon. Os estudos demonstraram que o digluconato de clorexidina é ineficaz para a inativação de alguns subtipos de coronavírus, sugerindo que também seja ineficaz contra o novo coronavírus.


Subject(s)
Humans , Povidone-Iodine/pharmacology , Chlorhexidine/pharmacology , Coronavirus/drug effects , Disinfectants/pharmacology , Anti-Infective Agents, Local/pharmacology , Pneumonia, Viral/epidemiology , Disinfection , Coronavirus Infections/epidemiology , Pandemics
3.
J. appl. oral sci ; 28: e20190039, 2020. tab, graf
Article in English | LILACS, BBO | ID: biblio-1090769

ABSTRACT

Abstract This study aimed to evaluate the physical properties and antifungal activities of polymethyl methacrylate (PMMA) acrylic resins after the incorporation of chlorhexidine diacetate salt (CDA). Methodology: First, acrylic resin specimens were fabricated with Vipi Cor® and DuraLay® resins with and without the incorporation of 0.5%, 1.0% or 2.0% CDA. The residual monomer and CDA release were measured at intervals ranging from 2 hours to 28 days using ultraviolet spectrometry combined with high-performance liquid chromatography. The antifungal activity against C. albicans was evaluated with the agar diffusion method. Fourier transform infrared spectroscopy was used to analyze the degree of resin conversion. Finally, the water sorption values of the resins were also measured. Results: The incorporated CDA concentration significantly changed the rate of CDA release (p<0.0001); however, the brand of the material appeared to have no significant influence on drug release. Subsequently, the inhibition zones were compared between the tested groups and within the same brand, and only the comparisons between the CDA 2% and CDA 1% groups and between the CDA 1% and CDA 0.5% groups failed to yield significant differences. Regarding the degrees of conversion, the differences were not significant and were lower only in the CDA 2% groups. Water sorption was significantly increased at the 1.0% and 2.0% concentrations. Conclusions: We concluded that the incorporation of CDA into PMMA-based resins enabled the inhibition of C. albicans growth rate, did not alter the degrees of conversion of the tested resins and did not change the release of residual monomers.


Subject(s)
Chlorhexidine/analogs & derivatives , Polymethyl Methacrylate/chemistry , Antifungal Agents/chemistry , Reference Values , Time Factors , Acrylic Resins/chemistry , Materials Testing , Candida albicans/drug effects , Water/chemistry , Chlorhexidine/pharmacology , Reproducibility of Results , Chromatography, High Pressure Liquid , Spectroscopy, Fourier Transform Infrared , Polymethyl Methacrylate/pharmacology , Antifungal Agents/pharmacology
4.
Braz. arch. biol. technol ; 63: e20190196, 2020. tab, graf
Article in English | LILACS | ID: biblio-1132166

ABSTRACT

Abstract Endodontic infections result from oral pathogenic bacteria which reach and infect dental pulp, as well as surrounding tissues, through cracks, unrepaired caries and failed caries restorations. This study aims to determine the chemical composition of essential oil from Psidium cattleianum leaves (PC-EO) and to assess its antibacterial activity against endodontic bacteria. Antibacterial activity of PC-EO was evaluated in terms of its minimum inhibitory concentration (MIC) values by the broth microdilution method on 96-well microplates. Bacteria Porphyromonas gingivalis (MIC = 20 µg/mL), Prevotella nigrescens (MIC = 62.5 µg/mL), Fusobacterium nucleatum (MIC = 12.5 µg/mL), Actinomyces naeslundii (MIC = 50 µg/mL), Bacteroides fragilis (MIC = 12.5 µg/mL), Aggregatibacter actinomycetemcomitans (MIC = 6.25 µg/mL) and Peptostreptococcus anaerobius (MIC = 62.5 µg/mL) were evaluated and compared to chlorhexidine dihydrochloride (CDH), the positive control. PC-EO was obtained by hydrodistillation with the use of a Clevenger-type apparatus whereas its chemical composition was analyzed by gas chromatography-flame ionization detection (GC-FID) and gas chromatography-mass spectrometry (GC-MS). Viridiflorol (17.9%), β-caryophyllene (11.8%), 1,8-cineole (10.8%) and β-selinene (8.6%) were the major constituents found in PC-EO, which exhibited high antibacterial activity against all endodontic pathogens under investigation. Therefore, PC-EO, a promising source of bioactive compounds, may provide therapeutic solutions for the field of endodontics.


Subject(s)
Oils, Volatile/pharmacology , Chlorhexidine/pharmacology , Psidium/chemistry , Anti-Bacterial Agents/pharmacology , Peptostreptococcus/drug effects , Bacteroides fragilis/drug effects , Actinomyces/drug effects , Microbial Sensitivity Tests , Fusobacterium nucleatum/drug effects , Aggregatibacter actinomycetemcomitans/drug effects , Porphyromonas gingivalis/drug effects , Prevotella nigrescens/drug effects , Gas Chromatography-Mass Spectrometry
5.
Braz. oral res. (Online) ; 33: e035, 2019. tab, graf
Article in English | LILACS | ID: biblio-1001616

ABSTRACT

Abstract: Eugenia dysenterica is a Brazilian tree investigated for its properties and bioactive compounds, which are believed to have both pharmacological and phytochemical therapeutic effects. The leaves of this tree contain tannins, flavonoids, terpenes, and saponins, with reportedly beneficial effects to the human body. Despite these therapeutic applications, its effects have never been tested on oral tissues. Therefore, the aim of the present study was to evaluate the cytotoxic and antioxidant effects and the anti-inflammatory and repair properties of the acetone fraction of E. dysenterica on primary culture of human gingival fibroblasts and on the immortalized murine macrophage cell line (RAW 264.7). For this purpose, a metabolic activity assay, a wound healing assay, a nitric oxide assay, and RT-qPCR were performed. The assays revealed a cytoprotective effect of this plant, suggested by the increase in the expression of SOD1 and NRF2. An antioxidant potential effect was observed in the DPPH• assay. However, the fraction of E. dysenterica did not show anti-inflammatory activity. In conclusion, Eugenia dysenterica may promote cytoprotection when associated with chlorhexidine digluconate because of its antioxidant effect. However, additional studies are necessary on other human dental tissues using other parts of the plant in order to develop a possible mouthwash to assist patients with oral disorders.


Subject(s)
Humans , Animals , Mice , Plant Extracts/pharmacology , Fibroblasts/drug effects , Eugenia/chemistry , Gingiva/chemistry , Anti-Inflammatory Agents/pharmacology , Antioxidants/pharmacology , Reference Values , Time Factors , Wound Healing/drug effects , Brazil , Cells, Cultured , Chlorhexidine/analogs & derivatives , Chlorhexidine/pharmacology , Reproducibility of Results , Plant Leaves/chemistry , Reverse Transcriptase Polymerase Chain Reaction , RAW 264.7 Cells , Nitric Oxide/analysis
6.
Rev. Salusvita (Online) ; 38(4): 1127-1149, 2019.
Article in Portuguese | LILACS | ID: biblio-1117870

ABSTRACT

Introdução: A adesão da resina composta à dentina ocorre pela formação da camada híbrida. Assim, sua degradação ocasiona a perda da resistência de união na interface resina/dentina, influenciando na longevidade da restauração. Após o condicionamento ácido e aplicação do sistema adesivo na dentina desmineralizada, fibras colágenas não envolvidas por sistema adesivo ficam desprotegidas e suscetíveis ao ataque das metaloproteinases (MMPs). Objetivos: Esta revisão buscou esclarecer o efeito das MMPs na degradação da camada híbrida e os efeitos da clorexidina no processo de adesão. Materiais e métodos: Foi realizada uma revisão da literatura por meio de uma busca bibliográfica nas bases de dados Pubmed/ Medline, Scielo e Google Acadêmico, utilizados estudos publicados nos anos de 2005 a 2018. Foi realizada a busca pelos seguintes descritores: Dentistry, MMPs, Chlorhexidine. Resultados: Estas enzimas, presentes na própria dentina, são reativadas pelo ácido fosfórico ou pelos monômeros ácidos dos adesivos autocondicionantes e iniciam a degradação. A aplicação da clorexidina (CHX) na dentina, após o condicionamento ácido, impede ou retarda a degradação das fibras de colágeno da camada híbrida. Conclusão: Concluiu-se que a ligação adesiva à dentina diminui com o passar dos anos devido à ação das MMPs que degradam o colágeno não infiltrado por monômeros adesivos na parte mais profunda da camada híbrida. Além disso, a clorexidina como inibidor terapêutico em sistemas adesivos convencionais é capaz de inibir as MMPs e assim a ligação adesiva à dentina pode ser mantida estável por um período de tempo mais longo.


Introduction: The adhesion of the composite resin to the dentin occurs by the formation of the hybrid layer. Thus, its degradation causes loss of union resistance on interface resin / dentin interface, directly influencing the longevity of the restoration. After the acid etching and the application of the adhesive system into demineralized dentin, collagen fibers not involved by adhesive system get unprotected and susceptibles to attack by metalloproteinases (MMPs). The enzymes, present in the dentin itself, are rehabilitated by phosphoric acid or by the acids monomers of the self-etching adhesives initiating degradation. The application of chlorhexidine (CHX) in the dentin, after acid conditioning, prevents or slows down the degradation of the collagen fibers of the hybrid layer. This literature review sought to clarify the effect of MMPs on the degradation of the hybrid layer and the effects of chlorhexidine on the adhesion process. It was concluded that the adhesive bonding to dentin decreases with the passage of years due in part to the action of MMPs, which degrade collagen not infiltrated by adhesive monomers in the deepest part of the hybrid layer. In addition, the use of chlorhexidine as a therapeutic inhibitor in conventional adhesive systems is capable of inhibiting the MMPs and thus the adhesive bonding to the dentin can be kept stable for a longer period of time.


Subject(s)
Chlorhexidine/pharmacology , Dentin-Bonding Agents/metabolism , Matrix Metalloproteinases/drug effects , Matrix Metalloproteinases/metabolism , Cathepsins/metabolism , Resin Cements/metabolism , Cysteine/metabolism , Fibrillar Collagens/drug effects , Fibrillar Collagens/metabolism
7.
Braz. dent. j ; 29(4): 354-358, July-Aug. 2018. tab, graf
Article in English | LILACS | ID: biblio-974160

ABSTRACT

Abstract This study aimed to evaluate in vitro the antimicrobial effect of a bioadhesive chitosan-based oral membrane with chlorhexidine for local treatment of infections in the oral tissues. Five oral membranes of different compositions were tested: 5% chitosan (G1); 5% chitosan ± 0.2% chlorhexidine (G2), 5% chitosan ± 0.6% chlorhexidine (G3), 5% chitosan ± 1.0% chlorhexidine (G4), and 5% chitosan ± 2.0% chlorhexidine (G5). Also, five gel types were tested according to the following compositions: 5% chitosan gel (G6), 0.2% chlorhexidine gel (G7), 2.0% chlorhexidine gel (G8), 5% chitosan gel ± 0.2% chlorhexidine gel (G9), and 5% chitosan gel ± 2.0% chlorhexidine gel (G10). The antimicrobial action of the samples was tested against Candida albicans and Streptococcus mutans through antibiogram by measuring the inhibition halos. Data were statistically analyzed by Kruskal-Wallis and one-way ANOVA followed by Tukey test (p<0.05). The 2.0% chlorhexidine membrane (G5) and the disks containing 2.0% chlorhexidine gel (G8) showed the greatest inhibition halos for both microorganisms, with statistically significant difference when compared to others tested groups (p=0.008) only for Candida albicans inhibitions results. All the other formulations of membranes and gels showed inhibition halos, but without statistically significant difference. The bioadhesive chitosan-based oral membrane with 2% chlorhexidine and 2% chlorhexidine gel were the most effective in inhibiting the tested microorganisms.


Resumo O objetivo deste estudo foi avaliar in vitro o efeito antimicrobiano de uma bandagem oral bioadesiva de quitosana com clorexidina para o tratamento de infecções dos tecidos orais. Cinco bandagens de diferentes composições foram testadas: Quitosana 5% (G1); Quitosana 5% ± clorexidina a 0,2% (G2), Quitosana 5% ± clorexidina a 0,6% (G3), Quitosana 5% ± clorexidina a 1,0% (G4) e Quitosana 5% ± clorexidina a 2,0% (G5). Foram testados também 5 tipos de géis nas seguintes composições: Gel de Quitosana 5% (G6), Gel de clorexidina a 0,2% (G7), Gel de clorexidina a 2,0% (G8), Gel de Quitosana 5% ± clorexidina a 0,2% (G9) e Gel de Quitosana 5% ± clorexidina a 2,0% (G10). A ação antimicrobiana das amostras foi testada contra Candida albicans e Streptococcus mutans por meio do antibiograma, medindo o halo de inibição. Os dados foram analisados pelo teste de Kruskal-Wallis e ANOVA a um critério seguido pelo teste de Tukey (p<0,05). A membrana com 2,0% de clorexidina (G5) e os discos contendo gel com 2,0% de clorexidina (G8) apresentaram os maiores halos de inibição para os dois microrganismos, com diferença estatisticamente significativa em relação aos demais grupos testados (p=0,008) apenas nos resultados de inibição de C. albicans. Todas as outras formulações de membranas e géis apresentaram halo de inibição, mas sem diferença estatisticamente significativa. A bandagem oral bioadesiva de quitosana com gel de 2% de clorexidina foi a mais efetiva em inibir os microrganismos testados.


Subject(s)
Humans , Bacterial Adhesion/drug effects , Chlorhexidine/pharmacology , Gels , Anti-Infective Agents, Local/pharmacology , Mouth Mucosa/microbiology , Streptococcus mutans/drug effects , In Vitro Techniques , Candida albicans/drug effects , Microbial Sensitivity Tests , Chlorhexidine/administration & dosage , Anti-Infective Agents, Local/administration & dosage
8.
Braz. j. microbiol ; 49(1): 184-188, Jan.-Mar. 2018. tab, graf
Article in English | LILACS | ID: biblio-889206

ABSTRACT

ABSTRACT Removal of bacterial biofilm from the root canal system is essential for the management of endodontic disease. Here we evaluated the antibacterial effect of N-acetylcysteine (NAC), a potent antioxidant and mucolytic agent, against mature multispecies endodontic biofilms consisting of Actinomyces naeslundii, Lactobacillus salivarius, Streptococcus mutans and Enterococcus faecalis on sterile human dentin blocks. The biofilms were exposed to NAC (25, 50 and 100 mg/mL), saturated calcium hydroxide or 2% chlorhexidine solution for 7 days, then examined by scanning electron microscopy. The biofilm viability was measured by viable cell counts and ATP-bioluminescence assay. NAC showed greater efficacy in biofilm cell removal and killing than the other root canal medicaments. Furthermore, 100 mg/mL NAC disrupted the mature multispecies endodontic biofilms completely. These results demonstrate the potential use of NAC in root canal treatment.


Subject(s)
Humans , Acetylcysteine/pharmacology , Streptococcus mutans/drug effects , Actinomyces/drug effects , Enterococcus faecalis/drug effects , Biofilms/drug effects , Dental Pulp Diseases/microbiology , Lactobacillus salivarius/drug effects , Anti-Bacterial Agents/pharmacology , Streptococcus mutans/physiology , Actinomyces/physiology , Calcium Hydroxide/pharmacology , Chlorhexidine/pharmacology , Enterococcus faecalis/physiology , Dental Pulp Cavity/microbiology , Microbial Viability/drug effects , Lactobacillus salivarius/physiology
9.
J. appl. oral sci ; 26: e20170304, 2018. tab, graf
Article in English | LILACS, BBO | ID: biblio-893680

ABSTRACT

Abstract Titanium tetrafluoride (TiF4) is known for interacting with enamel reducing demineralization. However, no information is available about its potential antimicrobial effect. Objectives This study evaluated the antimicrobial and anti-caries potential of TiF4 varnish compared to NaF varnish, chlorhexidine gel (positive control), placebo varnish and untreated (negative controls) using a dental microcosm biofilm model. Material and Methods A microcosm biofilm was produced on bovine enamel previously treated with the varnishes, using inoculum from human saliva mixed with McBain saliva, under 0.2% sucrose exposure, for 14 days. All experiments were performed in biological triplicate (n=4/group in each experiment). Factors evaluated were: bacterial viability (% dead and live bacteria); CFU counting (log10 CFU/mL); and enamel demineralization (transverse microradiography - TMR). Data were analysed using ANOVA/Tukey's test or Kruskal-Wallis/Dunn's test (p<0.05). Results Only chlorhexidine significantly increased the number of dead bacteria (68.8±13.1% dead bacteria) compared to untreated control (48.9±16.1% dead bacteria). No treatment reduced the CFU counting (total microorganism and total streptococci) compared to the negative controls. Only TiF4 was able to reduce enamel demineralization (ΔZ 1110.7±803.2 vol% μm) compared to both negative controls (untreated: ΔZ 4455.3±1176.4 vol% μm). Conclusions TiF4 varnish has no relevant antimicrobial effect. Nevertheless, TiF4 varnish was effective in reducing enamel demineralization under this model.


Subject(s)
Humans , Animals , Cattle , Streptococcus/drug effects , Titanium/pharmacology , Cariostatic Agents/pharmacology , Biofilms/drug effects , Dental Enamel/microbiology , Fluorides/pharmacology , Anti-Bacterial Agents/pharmacology , Saliva/microbiology , Sodium Fluoride/pharmacology , Streptococcus/growth & development , Microradiography , Colony Count, Microbial , Random Allocation , Placebo Effect , Chlorhexidine/pharmacology , Reproducibility of Results , Analysis of Variance , Statistics, Nonparametric , Dental Caries/microbiology , Dental Caries/prevention & control , Dental Enamel/drug effects , Microbial Viability/drug effects
10.
Braz. oral res. (Online) ; 32: e44, 2018. tab, graf
Article in English | LILACS | ID: biblio-889491

ABSTRACT

Abstract The aim of this study was to evaluate the effects of proanthocyanidin (PA) and chlorhexidine (CHX) on the bond strength (BS), failure pattern, and resin-dentin interface morphology of the endodontic sealers EndoREZ and AH Plus after 24 h and 6 months of water storage. A total of 120 prepared bovine roots were divided into six groups: AH Plus, CHX+AH Plus, PA+AH Plus, EndoREZ, CHX+EndoREZ, and PA+EndoREZ. Dentin was treated for 1 or 5 min with 2% CHX or 15% PA, respectively. Roots were filled and stored in water for 24 h or 6 months (n = 10). Root slices were subjected to push-out test and scanning electron microscopy (SEM). Data were compared using two-way ANOVA and student's t-test (α = 5%). BS decreased over time for AH Plus and untreated EndoREZ (p < 0.05). At 24 h, AH Plus had higher BS than EndoREZ (p < 0.001), with no differences among treatments for both sealers (p > 0.05). At 6 months, EndoREZ had higher BS values for CHX and PA than control (p < 0.05). AH Plus had higher BS than EndoREZ (p < 0.001), while with CHX or PA, similar BS was observed in both sealers (p > 0.05). Cohesive and mixed failures were observed in all groups. SEM revealed sealer tags in the root dentin. In conclusion, BS decreased with time and AH Plus had higher BS than EndoREZ in untreated dentin; however, CHX or PA enhanced long-term BS of EndoREZ. Overall, dentin treatment affected failure pattern and resin-dentin interface morphology, particularly for EndoREZ.


Subject(s)
Animals , Cattle , Chlorhexidine/pharmacology , Dental Bonding/methods , Proanthocyanidins/pharmacology , Resins, Synthetic/chemistry , Root Canal Filling Materials/chemistry , Dental Stress Analysis , Microscopy, Electron, Scanning , Tensile Strength
11.
Rio de Janeiro; s.n; s.n; 2018. 62 p. tab, ilus, graf.
Thesis in Portuguese | LILACS, BBO | ID: biblio-964018

ABSTRACT

O objetivo principal do presente estudo, considerando a importância do controle do biofilme, foi avaliar in situ a ação antimicrobiana e análise elementar da incorporação de diacetato de clorexidina(CHX) em resinas acrílicas a base de PMMA. Além disso, avaliar ex vivo o mecanismo de lixiviação da clorexidina por até 14 dias. Primeiramente, foram recrutados 32 indivíduos para utilização de dispositivos acrílicos intraorais palatinos por 24 horas contendo 6 corpos de prova(CPs), sendo subdivididos em 2 grupos: com clorexidina (1%) e sem CHX. A avaliação da atividade antimicrobiana foi realizada por meio de contagem de colônias de microorganismos totais e Estreptococos do grupo mutans. Então, os grupos foram avaliados estatisticamente pelo teste de wilcoxon. A análise estatística aplicada foi o teste de Wilcoxon. No segundo teste, foi feita a análise elementar dos CPs(n=10) por meio das médias das intensidade dos elementos, antes e após o uso do dispositivo, por meio da fluorescência de raio X. Ao final, foi avaliado ex vivo a liberação de clorexidina cumulativa, em meio fechado contendo saliva dos indivíduos(n=5) por até 14 dias, através da ressonância magnética nuclear (RMN). As análises estatísticas da RMN, foram avaliadas pelo programa AMIX e metaboloanalyst. Os resultados mostraram, que para atividade antimicrobiana não houve diferença estatística (p>0,05) entre os grupos. Foi detectado a presença da molécula de clorexidina, antes e após a inserção dos CPs com CHX na cavidade bucal. Já para liberação de clorexidina, foi detectada a droga ao longo de 14 dias em meio fechado para a grupo teste, com liberação maior nas primeiras 24 horas. Conclui-se que, foi comprovada a presença do fármaco na resina acrílica após 24 horas em meio bucal, e seu mecanismo de lixiviação no meio fechado por até 14 dias. Porém, não foram encontrados resultados que confirmem a presença de um potencial antimicrobiano do fármaco, nas concentrações utilizadas nos corpos de prova in situ em 24 horas.


The main objective of the present study, considering the importance of biofilm control, was to evaluate in situ the antimicrobial action and elemental composition of the incorporation of chlorhexidine diacetate (CHX) in acrylic resins based on PMMA. In addition, ex vivo evaluation of the chlorhexidine release mechanism to 14 days. Firstly, 32 individuals were recruited for 24-hour palatal intraoral acrylic devices containing 6 test specimens (SPs), divided into 2 groups: with chlorhexidine (1%) and without CHX. The evaluation of the antimicrobial activity was performed by colonies count of total microorganisms and streptococci mutans group. Then, the groups were statistically evaluated by the wilcoxon test. The statistical analysis applied was the Wilcoxon test. In the second test, elemental analysis of the SPs (n = 10) was done by means of the means intensity of the elements, before and after the use of the device, by X-ray fluorescence. At the end, the release was evaluated ex vivo of cumulative chlorhexidine in a becker containing saliva of the individuals (n = 5) for 14 days, through nuclear magnetic resonance (NMR). The NMR analyzes were evaluated by AMIX and metaboloanalyst. The results showed that for antimicrobial activity there was no statistical difference (p> 0.05) between the groups. The presence of the chlorhexidine molecule was detected before and after the insertion of SPs with CHX in the oral cavity. As for chlorhexidine release, the drug was detected over 14 days in a closed medium for the test group, with a greater release in the first 24 hours. It was concluded that the presence of the drug in the acrylic resin after 24 hours in oral cavity was verified, and its release mechanism in the closed local for 14 days. However, no results were found to confirm the presence of an antimicrobial potential of the drug at the concentrations used in the in situ test specimens in 24 hours


Subject(s)
Humans , Male , Female , Adolescent , Adult , Acrylic Resins , Chlorhexidine/pharmacology , Polymethyl Methacrylate , Dental Plaque/prevention & control , Anti-Infective Agents, Local/pharmacology , Streptococcus mutans/drug effects , Magnetic Resonance Spectroscopy , Statistics, Nonparametric , Fluorescence
12.
Rio de janeiro; s.n; 2018. 75 p. ilus.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1016651

ABSTRACT

O objetivo deste estudo piloto foi comparar a eficácia de um reembasador acrílico macio com ou sem diacetato de clorexidina a 1% no tratamento de pacientes com estomatite protética. As hipóteses testadas foram: (I) o eritema seria melhorado (IIa): a contagem de unidades formadoras de colônias seria reduzida, (IIb): a predominância de um tipo morfológico de Candida seria correlacionada com características clínicas e, (IIc) se uma concentração inibitória mínima do antimicrobiano, poderia ser capaz de atuar sobre o crescimento do fungo. Dezesseis pacientes desdentados totais, portadores de prótese e com estomatite protética foram distribuídos aleatoriamente para os grupos controle (reembasamento com Trusoft) e grupo teste (reembasamento com Trusoft contendo 1% de clorexidina) sendo acompanhados por exames clínicos e laboratoriais por 14 dias. Os parâmetros analisados nas duas consultas de acompanhamento foram: avaliação clínica (exame e fotos) e avaliações microbiológicas (esfregaços e culturas de palato e prótese total). Este estudo foi um ensaio clínico randomizado, duplo-cego,controlado.Os resultados obtidos demonstraram que a superfície do eritema foi significativamente reduzida, mas não diferiu significativamente entre os dois grupos (P> 0,05), assim como a redução da contagem de Candida durante o tratamento entre os grupos (P> 0,05). O tipo de Candida não pôde ser correlacionado ao estágio clínico alcançado. Os resultados dos testes de concentração inibitória mínima, revelaram que uma concentração de 0,05 µg/ml de clorexidina já é capaz de inibir o crescimento de 85% das cepas de testadas.A hipótese principal foi confirmada, o que pode ser interpretado como uma remissão clínica acelerada em ambas as terapias propostas. Embora as hipóteses secundárias não tenham sido confirmadas, a persistência de Candida pode ser apenas a colonização, e a plasticidade morfológica de Candida parece ser fortemente influenciada pela virulência fúngica. Sendo assim, os resultados da análise de concentração inibitória mínima sugerem que uma concentração subinibitória de clorexidina possa estar atuando na virulência da Candida spp. No entanto, não foram encontrados resultados para confirmar a eficácia clínica do diacetato de clorexidina a 1% incorporado ao reembasador macio testado no tratamento da estomatite protética.


The aim of this pilot study was to compare the efficacy of rebase using soft acrylic liner with or without 1% chlorhexidine diacetate in denture stomatitis patients. It was hypothesised that: (I) erythema would be improved (IIa): colony forming unit count would be reduced, (IIb): the predominance of a morphological type of Candida would be correlated with clinical features and, (IIc) a minimum inhibitory concentration of the antimicrobial, could be able to act on the growth of the fungus.Sixteen patients who wearing removable dentures and diagnosed with denture stomatitis were randomly assigned to the control groups (rebase with resilient liner) and test group (rebase with resilient liner containing 1% of chlorhexidine), followed by clinical and laboratory tests for 14 days. The analyzed parameters at two follow-up were: clinical evaluation (examination and photos) and microbiological evaluations (smears and cultures of palates and dentures). This study was a randomized, double-blind, controlled clinical trial. The results obtained showed that the erythema surface was significantly reduced, but did not differ significantly between the two groups (P> 0.05), as did the reduction of colony forming unit during treatment between the groups (P> 0.05) . The Candida type could not be correlated to the achieved clinical stage. The minimum inhibitory concentration test results showed that a concentration of 0,05 µg/ml chlorhexidine is already able to inhibit the growth of 85% of the tested strains. The primary hypothesis was confirmed, which can be interpreted as an accelerated clinical remission in both proposed therapies. Although secondary hypotheses have not been confirmed, Candida's persistence may be just colonization, and the morphological plasticity of Candida seems to be strongly influenced by fungal virulence. Thus, the results of the minimum inhibitory concentration analysis suggest that a subinhibitory concentration of chlorhexidine may be acting on the virulence of Candida spp. However, no results were found to confirm the clinical efficacy of 1% chlorhexidine diacetate incorporated into the soft liner in denture stomatitis.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Stomatitis, Denture/therapy , Chlorhexidine/pharmacology , Treatment Outcome , Denture, Complete/adverse effects , Denture Liners , Double-Blind Method , Randomized Controlled Trial , Statistics, Nonparametric
13.
Braz. oral res. (Online) ; 32: e46, 2018. tab, graf
Article in English | LILACS | ID: biblio-889469

ABSTRACT

Abstract: The aim of this study was to evaluate the antimicrobial action of different endodontic pastes against Enterococcus faecalis ATCC 29212, isolated from the urinary tract, and compare the action with E. faecalis ATCC 4083, isolated from the root canal. For this purpose, dentin blocks were infected for 21 days with both bacteria at different time-intervals to ensure there would be no cross contamination. After this period, blocks were immersed in the test medications for 7 days, according to the following groups: CH/S, CH/P, CH/CMCP, CH/CHX, CH/DAP and TAP. Images of the samples were captured with a confocal microscope and the percentage of live cells was computed by means of the Bioimage program. The ATCC 29212 strain was shown to be more resistant to CH/SS, Calen, CH/DAP, and TAP than the ATCC 4083 strain. The antimicrobial action of the medications against each strain were divergent concerning the order of susceptibility. The authors concluded that the strains behaved in a different manner: in general, those extracted from the urinary tract were more resistant to the tested medications. Therefore, when E. faecalis must be used for in vitro research in endodontics, we suggest the use of ATCC 4083 strain to obtain results that are closer to the clinical reality.


Subject(s)
Animals , Cattle , Calcium Hydroxide/pharmacology , Chlorhexidine/pharmacology , Enterococcus faecalis/drug effects , Biofilms/drug effects , Dental Pulp Cavity/microbiology , Anti-Bacterial Agents/pharmacology , Microscopy, Electron, Scanning , Enterococcus faecalis/classification , Enterococcus faecalis/ultrastructure , Microscopy, Confocal , Biofilms/classification , Dental Pulp Cavity/ultrastructure
14.
J. appl. oral sci ; 25(5): 541-550, Sept.-Oct. 2017. tab, graf
Article in English | LILACS, BBO | ID: biblio-893660

ABSTRACT

Abstract Objectives: Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX. Material and Methods: For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (p<0.05). Results: Incorporation of 1.25% and 2.5% CHX improved the antimicrobial/anti-biofilm activity of GIC, without affecting F release and mechanical characteristics, but 2.5% CHX was cytotoxic. Survival rate of restorations using GIC with 1.25% CHX was similar to GIC. A significant reduction of MS levels was observed for KM+CHX group in children saliva and biofilm 7 days after treatment. Conclusions: The incorporation of 1.25% CHX increased the in vitro antimicrobial activity, without changing chemical-mechanical properties of GIC and odontoblast-like cell viability. This combination improved the in vivo short-term microbiological effect without affecting clinical performance of ART restorations.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Chlorhexidine/pharmacology , Chlorhexidine/chemistry , Dental Atraumatic Restorative Treatment/methods , Glass Ionomer Cements/pharmacology , Glass Ionomer Cements/chemistry , Anti-Infective Agents, Local/pharmacology , Reference Values , Saliva/microbiology , Streptococcus mutans/growth & development , Streptococcus mutans/drug effects , Tensile Strength , Time Factors , In Vitro Techniques , Materials Testing , Candida albicans/growth & development , Candida albicans/drug effects , Colony Count, Microbial , Reproducibility of Results , Analysis of Variance , Treatment Outcome , Statistics, Nonparametric , Biofilms/growth & development , Biofilms/drug effects , Compressive Strength , Fluorides/chemistry , Hardness Tests , Lactobacillus acidophilus/growth & development , Lactobacillus acidophilus/drug effects , Odontoblasts/drug effects
15.
Int. j. morphol ; 35(3): 893-900, Sept. 2017. ilus
Article in English | LILACS | ID: biblio-893070

ABSTRACT

The aim of this study was to evaluate the effect of chlorhexidine (CHX) dentin treatment on microtensile bond strength (µTBS) of adhesive systems in different storage times. Occlusal enamel was removed from ninety third-molars and flat surfaces of middle dentin were exposed. Teeth were randomly divided in 6 groups according to adhesive system (etch-and-rinse : Adper Scotchbond 1XT - ASB ; self-etch: Adper Prompt L-Pop ­ APP; and universal: Single Bond Universal - SBU) and chlorhexidine (CHX) dentin treatment (2 % CHX application for 20 s prior Primer). After resin composite build up, teeth were sectioned to obtain beam specimens and divided in 3 subgroups (n=5): 72h, 3 and 6 months storage times. After the storage times, teeth were tested in tension until failure (0.5 mm/min). SEM was performed to observe hybrid layer of adhesive systems. Data were analyzed using one-way ANOVA and Tukey tests. At 72 h, all equivalent groups (same adhesive system, different dentin treatments) maintained their µTBS when compared CHX-treatment. At 3 and 6 months, non-treated CHX groups showed less µTBS than CHX-treated ones. Six months storage time did not significantly decrease µTBS, except for G2-ASB. The effect of CHX on dentin µTBS depends on storage times and adhesive systems. While immediate µTBS was not affected by CHX treatment, CHX improved dentin µTBS after 3 and 6 months.


El objetivo de este estudio fue evaluar el efecto del tratamiento con clorhexidina (CHX) de la dentina sobre la resistencia de la unión microtensil (mTBS) de los sistemas adhesivos en diferentes tiempos de almacenamiento. Se retiró el esmalte oclusal de noventa terceros molares y se expusieron superficies planas de la dentina media. Los dientes se dividieron al azar en 6 grupos de acuerdo con el sistema adhesivo (con grabado ácido: Adper Scotchbond 1XT-ASB, auto-grabado: Adper Prompt L-Pop-APP y universal: Single Bond Universal- SBU) y el tratamiento de la dentina con clorhexidina (CHX) (aplicación de CHX al 2 % 20 s antes del Primer). Después de la aplicación de la resina compuesta, los dientes fueron seccionados para obtener muestras en forma de barras y divididos en 3 subgrupos (n = 5) con tiempos de almacenamiento de 72 h, 3 y 6 meses. Después de los tiempos de almacenamiento, los dientes se sometieron a tensión hasta la fractura (0,5 mm / min). SEM se realizó para observar la capa híbrida de sistemas adhesivos. Los datos se analizaron mediante ANOVA unidireccional y pruebas de Tukey. A las 72 h, todos los grupos equivalentes (el mismo sistema adhesivo, diferentes tratamientos de dentina) mantuvieron su mTBS cuando se comparó el tratamiento CHX. A los 3 y 6 meses, los grupos CHX no tratados mostraron menos mTBS que los tratados con CHX. Seis meses de tiempo de almacenamiento no disminuyó significativamente el mTBS, excepto para el G2-ASB. El efecto de CHX sobre la dentina mTBS depende del tiempo de almacenamiento y de los sistemas adhesivos. Mientras que el mTBS inmediato no se vio afectado por el tratamiento con CHX, CHX mejoró la mTBS a dentina después de 3 y 6 meses.


Subject(s)
Adhesives/chemistry , Chlorhexidine/pharmacology , Dental Bonding/methods , Dentin-Bonding Agents/chemistry , Dentin , In Vitro Techniques , Materials Testing , Microscopy, Electron , Tensile Strength , Time Factors
16.
Int. j. morphol ; 35(3): 1140-1146, Sept. 2017. ilus
Article in English | LILACS | ID: biblio-893106

ABSTRACT

This study evaluated the effect of chlorhexidine dentin treatment on shear bond strength (SBS) of adhesive systems after different storages. The work included 144 third molars that had their dentin exposed and were divided in 6 groups: G1 (ASB+CHX: Adper Scotchbond 1XT + chlorhexidine 2 % prior Primer); G2(ASB); G3 (APP+CHX: Adper Prompt L-Pop + CHX); G4(APP); G5 (SBU+CHX: Single Bond Universal + CHX); and G6(SBU). Resin build-up was performed and teeth were subdivided regarding storage times (n=8): 72 h, 3 and 6 months. Next, SBS test was performed. At 72 hours, all equivalent groups (same adhesive system, different dentin treatment) showed no significant difference in SBS (P.05). Self-etch adhesive groups (with or without CHX) presented lower SBS compared to other systems (P.05). After 3 and 6 months, all CHX-treated groups presented significantly higher SBS compared to equivalent non-treated groups (P.05). For both storage times, Single Bond Universal presented the highest SBS values within the same dentin treatment (P.05), while Adper Scotchbond and Adper Prompt-L-Pop were not significantly different among them, also within the same dentin treatments [3 months (with CHX: P=.966; without: P=.958) and 6 months (with CHX: P =.887; without: P=.990)]. CHX Dentin disinfection is indicated for all classes of adhesives studied.


Este estudio evaluó el efecto del tratamiento de la dentina con clorhexidina sobre la resistencia al cizallamiento (SBS) de sistemas adhesivos después de diferentes almacenamientos. Se removió el esmalte oclusal a 144 terceros molares y se dejó su dentina media expuesta, posteriormente se dividieron al azar en 6 grupos: G1 (ASB + CHX: Adper Scotchbond 1XT + clorhexidina 2 % antes del Primer); G2 (ASB); G3 (APP + CHX: L-Pop + CHX de Adper); G4 (APP); G5 (SBU + CHX: Single Bond Universal + CHX); y G6 (SBU). Se realizó la aplicación de la resina compuesta y se subdividieron los grupos con respecto a los tiempos de almacenamiento (n = 8): 72h, 3 y 6 meses. A continuación, se realizó la prueba SBS. A las 72 horas, todos los grupos equivalentes (el mismo sistema adhesivo, diferentes tratamientos de dentina) no mostraron diferencias significativas en los valores de SBS (P.05). Los grupos de adhesivo de auto-grabado (con o sin CHX) presentaron valores de SBS más bajos en comparación con otros sistemas (P.05). Después de 3 y 6 meses, todos los grupos tratados con CHX presentaron valores de SBS significativamente mayores en comparación con los grupos no tratados equivalentes (P.05). Para ambos tiempos de almacenamiento, Single Bond Universal presentó los valores de SBS más altos dentro del mismo tratamiento dentinario (P.05), mientras que el Adper Scotchbond y el Adper Prompt-L-Pop no fueron significativamente diferentes entre ellos, también dentro de los mismos tratamientos dentinarios 3 meses (con CHX: P = .966, sin: P = .958) y 6 meses (con CHX: P = .887; sin: P = .990). La desinfección de la dentina con CHX está indicada para todas las clases de adhesivos estudiados.


Subject(s)
Humans , Anti-Infective Agents, Local/pharmacology , Chlorhexidine/pharmacology , Dental Cements/chemistry , Dentin , Dental Materials/chemistry , Materials Testing , Shear Strength , Tensile Strength , Time Factors
17.
Braz. j. infect. dis ; 21(1): 27-34, Jan.-Feb. 2017. tab, graf
Article in English | LILACS | ID: biblio-839179

ABSTRACT

Abstract Objectives: This study aims to investigate the antimicrobial and the anti-biofilm activities of Lactobacillus plantarum extract (LPE) against a panel of oral Staphylococcus aureus (n = 9) and S. aureus ATCC 25923. The in vitro ability of LPE to modulate bacterial resistance to tetracycline, benzalchonium chloride, and chlorhexidine were tested also. Methods: The minimum inhibitory concentrations (MICs) and the minimal bactericidal concentrations of Lactobacillus plantarum extract, tetracycline, benzalchonium chloride and clohrhexidine were determined in absence and in presence of a sub-MIC doses of LPE (1/2 MIC). In addition, the LPE potential to inhibit biofilm formation was assessed by microtiter plate and atomic force microscopy assays. Statistical analysis was performed on SPSS v. 17.0 software using Friedman test and Wilcoxon signed ranks test. These tests were used to assess inter-group difference (p < 0.05). Results: Our results revealed that LPE exhibited a significant antimicrobial and anti-biofilm activities against the tested strains. A synergistic effect of LPEs and drug susceptibility was observed with a 2–8-fold reduction. Conclusion: LPE may be considered to have resistance-modifying activity. A more detailed investigation is necessary to determine the active compound responsible for therapeutic and disinfectant modulation.


Subject(s)
Humans , Child , Staphylococcus aureus/drug effects , Biofilms/growth & development , Drug Resistance, Bacterial/drug effects , Anti-Bacterial Agents/pharmacology , Mouth/microbiology , Reference Values , Tetracycline/pharmacology , Benzalkonium Compounds/pharmacology , Microbial Sensitivity Tests , Chlorhexidine/pharmacology , Polymerase Chain Reaction , Reproducibility of Results , Statistics, Nonparametric , Microscopy, Atomic Force/methods , Biofilms/drug effects , Lactobacillus plantarum/chemistry , Anti-Infective Agents, Local/pharmacology
18.
Rev. Soc. Bras. Med. Trop ; 50(1): 75-79, Jan.-Feb. 2017. tab
Article in English | LILACS | ID: biblio-842827

ABSTRACT

ABSTRACT INTRODUCTION: This study evaluated the susceptibilities of oral candidiasis-derived Candida albicans, fluconazole-resistant (FR) Candida dubliniensis, and fluconazole-susceptible (FS) C. dubliniensis to synthetic antiseptics [chlorhexidine gluconate (CHX), cetylpyridinium chloride (CPC), and triclosan (TRC)] and natural compounds (carvacrol, eugenol and thymol). METHODS: Susceptibility tests were performed based on the M27-A3 reference method. The fluconazole-resistant C. dubliniensis strains were obtained after prolonged in vitro exposure to increasing fluconazole concentrations. The geometric mean values for minimum inhibitory concentrations and minimum fungicidal concentrations were compared among the groups. RESULTS: Fluconazole-susceptible C. dubliniensis was more sensitive to CPC and TRC than FR C. dubliniensis and C. albicans were. However, eugenol and thymol were more active against FR C. dubliniensis. The fungicidal activities of CHX and TRC were similar for the three groups, and FR C. dubliniensis and C. albicans had similar sensitivities to CPC. CONCLUSIONS: The resistance of C. dubliniensis to fluconazole affects its sensitivity the synthetic antiseptics and natural compounds that were tested.


Subject(s)
Humans , Candida/drug effects , Fluconazole/pharmacology , Anti-Infective Agents, Local/pharmacology , Antifungal Agents/pharmacology , Thymol/pharmacology , Triclosan/pharmacology , Candida/isolation & purification , Candida/classification , Candida albicans/drug effects , Eugenol/pharmacology , Microbial Sensitivity Tests , Cetylpyridinium/pharmacology , Chlorhexidine/pharmacology
19.
Braz. oral res. (Online) ; 31: e89, 2017. tab, graf
Article in English | LILACS | ID: biblio-952126

ABSTRACT

Abstract The objective of this study was to evaluate the effects of Cymbopogon citratus essential oil and its main compound (citral) against primary dental colonizers and caries-related species. Chemical characterization of the essential oil was performed by gas chromatography/mass spectroscopy (GC/MS), and the main compound was determined. Antimicrobial activity was tested against Actinomyces naeslundii, Lactobacillus acidophilus, S. gordonii, S. mitis, S. mutans, S. sanguinis and S. sobrinus. Minimum inhibitory and bactericide concentrations were determined by broth microdilution assay for streptococci and lactobacilli reference, and for clinical strains. The effect of the essential oil on bacterial adhesion and biofilm formation/disruption was investigated. Negative (without treatment) and positive controls (chlorhexidine) were used. The effect of citral on preformed biofilm was also tested using the same methodology. Monospecies and microcosm biofilms were tested. ANOVA or Kruskal-Wallis tests were used (α=0.05). Cytotoxicity of the essential oil to human keratinocytes was performed by MTT assay. GC/MS demonstrated one major component (citral). The essential oil showed an inhibitory effect on all tested bacterial species, including S. mutans and L. acidophilus. Essential oil of C. citratus (10X MIC) reduced the number of viable cells of lactobacilli and streptococci biofilms (p < 0.05). The essential oil inhibited adhesion of caries-related polymicrobial biofilm to dental enamel (p < 0.01). Citral significantly reduced the number of viable cells of streptococci biofilm (p < 0.001). The essential oil showed low cytotoxicity to human keratinocytes. Based on these findings, this study can contribute to the development of new formulations for products like mouthwash, against dental biofilms.


Subject(s)
Humans , Oils, Volatile/pharmacology , Biofilms/drug effects , Cymbopogon/chemistry , Dental Caries/microbiology , Dental Caries/prevention & control , Anti-Infective Agents/pharmacology , Reference Values , Streptococcus/growth & development , Streptococcus/drug effects , Time Factors , Bacterial Adhesion/drug effects , Actinomyces/growth & development , Actinomyces/drug effects , Colony Count, Microbial , Microbial Sensitivity Tests , Keratinocytes/drug effects , Cell Survival/drug effects , Chlorhexidine/analogs & derivatives , Chlorhexidine/pharmacology , Reproducibility of Results , Analysis of Variance , Statistics, Nonparametric , Dental Enamel/drug effects , Dental Enamel/microbiology , Lactobacillus acidophilus/growth & development , Lactobacillus acidophilus/drug effects , Gas Chromatography-Mass Spectrometry , Anti-Infective Agents, Local/pharmacology
20.
Bauru; s.n; 2017. 118 p. ilus, tab.
Thesis in English | LILACS, BBO | ID: biblio-879689

ABSTRACT

When endodontic treatment fails, an alternative could be root canal retreatment. During this procedure, all filling material should be removed to allow a new root canal preparation and new obturation of the root canal system. Bacteria are the main cause of endodontic treatment failure, and persistent infection may be related to microorganism ability to penetrate into dentinal tubules. Therefore, this requires the use of irrigating solutions with antimicrobial action and low toxicity. The aim of this study was to evaluate the performance of instruments made of different alloys in root canal re-instrumentation during endodontic retreatment of lateral incisors with apical curvature, using computed microtomography and assessment of these samples by scanning electron microscopy after irrigant activation. Furthermore, the antimicrobial action of a root canal irrigant containing silver nanoparticles, 2% chlorhexidine and 2.5% sodium hypochlorite was evaluated against Enterococcus faecalis biofilm and dentin infected with this microorganism. Thirty extracted maxillary lateral incisors with apical curvature were selected. The teeth were instrumented, filled and divided into three different groups according to the protocol for removal of filling material: Group 1: re-instrumentation with Reciproc R25 instruments, Mtwo 40 and ProDesign Logic 50.01; Group 2: re-instrumentation with ProDesign R, ProDesign Logic 40 and ProDesign Logic 50.01; Group 3: re-instrumentation with Gates-Glidden drills and manual instruments K-file and Hedstroem files. For filling material removal analysis, the samples were scanned in a microtomograph device SkyScan 1174, for comparison of images taken before and after removing the root canal filling, and in each sample the volume was calculated at four levels (apical 1, apical 2, middle and cervical). These samples were split and analyzed by scanning electron microscopy to visualize filling material residues before and after irrigant activation with an ultrasonic device and with the EasyClean system used in continuous rotary motion. Statistical analyses were performed using Kruskal-Wallis, Friedman, Wilcoxon and Dunn tests. Furthermore, the minimum inhibitory concentration of an irrigating solution containing silver nanoparticles was determined against strains of Enterococcus faecalis, by using the microdilution method. Additionally, the antimicrobial activity of silver nanoparticle solution, 2% chlorhexidine and 2.5% sodium hypochlorite was tested against Enterococcus faecalis biofilm in vitro. For biofilm formation, bovine dentin blocks were placed in 24-well culture plates and Enterococcus faecalis biofilm was developed for 21 days. The dentin blocks were divided into 9 experimental groups of 5 blocks each, according to the irrigating solution used and the time in contact with the irrigant (5, 15 and 30 minutes). The samples were stained with Live/Dead reagent for analysis by confocal laser scanning microscopy (CLSM). Finally, the antimicrobial action of these solutions was tested after dentinal tubules were contaminated with Enterococcus faecalis. Dentin tubes were made from bovine incisors, taken to a centrifuge and infected with Enterococcus faecalis. The dentin tubes were treated with silver nanoparticle solution, 2% chlorhexidine and 2.5% sodium hypochlorite, and analyzed by CLSM to assess the antimicrobial activity of these solutions against bacteria in the dentinal tubules. The results showed that residues of filling material were found after root canal reinstrumentation in all groups. No significant difference was observed in removal of filling material between the reciprocating instruments Reciproc and ProDesign R and between rotary instruments Mtwo 40 and ProDesign Logic 40. The ProDesign Logic 50/.01 instrument significantly improved the removal of filling material compared with the use of Reciproc and ProDesign R instruments. The apical levels presented greater amount of remnant filling material compared with middle and cervical levels. After canal reinstrumentation, the passive ultrasonic irrigation and irrigant agitation with EasyClean significantly improved the removal of residual filling material in all root canal thirds. There was no significant difference between the performance of ultrasonics and EasyClean regarding the removal of residual filling material, as well no significant difference was observed in the removal of these residues when comparing apical, middle and cervical thirds. Regarding the action of the irrigating solutions against Enterococcus faecalis, the minimum inhibitory concentration of silver nanoparticle solution capable of eliminating this microorganism in broth and agar plates was 94 ppm. After the irrigation of Enterococcus faecalis biofilm, the silver nanoparticle solution was significantly less effective in killing bacteria compared with chlorhexidine when used for time of contact of 5 minutes. The sodium hypochlorite solution presented antimicrobial activity significantly higher compared with the silver nanoparticle solution and chlorhexidine. This solution also presented higher ability to dissolve biofilm in all times tested, whereas the silver nanoparticle solution presented higher ability to dissolve biofilm compared with chlorhexidine in times of 5 and 15 minutes. In infected intratubular dentin with Enterococcus faecalis, the sodium hypochlorite solution presented significant higher effectiveness than the silver nanoparticle solutions and chlorhexidine, especially in middle third and deep areas of the root canal. When comparing the antimicrobial activity of these solutions in biofilm and infected intratubular dentin, it was shown that when the silver nanoparticle solution was used for shorter periods of time, it was more effective in intratubular dentin compared with biofilm. On the other hand, with longer time of 30 minutes, the number of viable bacteria was higher in intratubular dentin than in biofilm, which was also observed when using the sodium hypochlorite solution in this time of action. It was concluded that to increase the rate of success in endodontic retreatment, the combination of the use of reciprocating and rotary instruments in the removal of filling material, the agitation of irrigants and the use of antimicrobial agents could be used in an attempt to eliminate bacteria that resisted to endodontic treatment. (AU)


Em casos de insucesso do tratamento endodôntico, uma alternativa seria o retratamento do canal radicular. Durante este procedimento deve haver remoção de todo o material obturador para que seja realizada novo preparo biomecânico e nova obturação do sistema de canais radiculares. Bactérias são o principal fator etiológico em casos de fracasso da terapia endodôntica, e esta infecção persistente pode estar relacionada à capacidade dos microganismos em penetrar nos túbulos dentinários. Por este motivo é necessário o uso de soluções na irrigação do canal radicular com ação antimicrobiana e com boa tolerância tecidual. O objetivo deste trabalho foi avaliar o desempenho dos instrumentos de diferentes ligas metálicas na desobturação do canal radicular durante o retratamento endodôntico de incisivos laterais superiores com curvatura apical, por meio da microtomografia computadorizada e análise destas amostras no microscópio eletrônico de varredura após a ativação de irrigantes. Posteriormente foi avaliada a capacidade antimicrobiana de um irrigante do canal radicular contendo nanopartículas de prata, clorexidina a 2% e hipoclorito de sódio a 2,5% frente ao biofilme de Enterococcus faecalis e à dentina contaminada com este mesmo microrganismo. Foram selecionados trinta incisivos laterais superiores humanos extraídos que apresentavam curvatura apical. Os dentes foram instrumentados, obturados e divididos em três diferentes grupos de acordo com o protocolo de remoção do material obturador do canal radicular: no Grupo 1: a desobturação foi realizada com os instrumentos Reciproc R25, Mtwo 40 e ProDesign Logic 50.01; no Grupo 2: foram utilizados os instrumentos ProDesign R, ProDesign Logic 40 e ProDesign Logic 50.01; e no Grupo 3: a desobturação foi realizada com brocas de Gates-Glidden e instrumentos manuais tipo K e Hedstroem. Para a análise da remoção do material obturador, as amostras foram escaneadas em micrótomogafo SkyScan 1174 para que fossem comparadas as imagens antes e após a desobturação do canal radicular, e em cada amostra este volume foi calculado nos quatro níveis (apical 1, 2, médio e cervical). Estas amostras posteriormente foram clivadas e analisadas no microscópio eletrônico de varredura, para a visualização de resíduos de material obturador antes e após a ativação de irrigantes com o ultrassom e com o sistema EasyClean utilizado em rotação contínua. Para a análise estatística dos resultados foram utilizados os testes de Kruskal-Wallis, Friedman, Wilcoxon e Dunn. Posteriormente, foi determinada a concentração inibitória mínima de uma solução irrigadora do canal contendo nanopartículas de prata frente a cepas de Enterococcus faecalis, através do método de diluição em caldo. Em seguida, foi testada a atividade antimicrobiana das soluções de nanopartículas de prata, da clorexidina a 2% e do hipoclorito de sódio a 2,5% sobre o biofilme de Enterococcus faecalis in vitro. Para isso, foram utilizados blocos de dentina bovina colocados em placas de 24 poços e biofilme de Enterococcus faecalis foi formado durante 21 dias. Os blocos de dentina foram divididos em 9 grupos experimentais com 5 blocos cada um, em função dos irrigantes avaliados e do tempo de exposição à solução irrigadora (5, 10 e 15 minutos). As amostras foram coradas com corante Live/Dead para posterior análise no microscópio confocal de varredura a laser (MCVL). Por fim, foi testada a atividade antimicrobiana destas soluções irrigadoras após a contaminação de túbulos dentinários com Enterococcus faecalis. Foram confeccionados tubos de dentina a partir de incisivos bovinos que foram levados à centrífuga e contaminados com Enterococcus faecalis. Os tubos de dentina receberam tratamento com a solução de nanopartículas de prata, com clorexidina a 2% e com hipoclorito de sódio a 2,5%, e foram analisados no MCVL para avaliar a atividade antimicrobiana das soluções sobre bactérias presentes nos túbulos dentinários. Os resultados demonstraram que resíduos de material obturador foram encontrados após a desobturação do canal em todos os grupos. Não houve diferença significante na remoção de material obturador entre os instrumentos reciprocantes Reciproc e ProDesign R e entre os instrumentos rotatórios Mtwo 40 e ProDesign Logic 40. O instrumento ProDesign Logic 50/.01 melhorou significantemente a remoção de material obturador comparado com o uso dos instrumentos Reciproc e ProDesign R. Os níveis apicais apresentaram uma maior quantidade de material obturador remanescente comparados com os níveis médio e cervical. Após a desobturação do canal radicular, a irrigação ultrassônica passiva e agitação dos irrigantes com o EasyClean melhoraram significantemente a remoção de resíduos de material obturador em todos os terços do canal radicular. Não houve diferença significante no desempenho do ultrassom e do EasyClean em relação à remoção de resíduos de material obturador, assim como não foi observada diferença significante na remoção destes resíduos quando comparados terços apical, médio e cervical. No que diz respeito à ação das soluções irrigadoras sobre o Enterococcus faecalis, a concentração inibitória mínima da solução de nanopartículas de prata capaz de eliminar este microrganimo em meio de cultura e ágar foi de 94 ppm. Após a irrigação no biofilme de Enterococcus faecalis, a solução de nanopartículas de prata foi significantemente menos efetiva em matar bactérias comparada com a clorexidina quando utilizadas pelo tempo de 5 minutos. A solução de hipoclorito de sódio apresentou atividade antimicrobiana significantemente maior comparada com as soluções de nanopartículas de prata e clorexidina. Essa solução ainda apresentou maior capacidade de dissolução do biofilme em todos os tempos testados, enquanto que a solução de nanopartículas de prata apresentou maior capacidade de dissolver o biofilme comparada à clorexidina nos tempos de 5 e 15 minutos. Na dentina intratubular infectada com Enterococcus faecalis, a solução de hipoclorito de sódio apresentou efetividade significantemente maior que as soluções de nanopartículas de prata e clorexidina, principalmente no terço médio e na região profunda do canal radicular. Quando comparada a atividade antimicrobiana destas soluções no biofilme e na dentina intratubular infectada, verificou-se que quando a solução de nanopartículas de prata foi utilizada por um tempo mais curto, foi mais efetiva na dentina intratubular comparada com o biofilme. De maneira contrária, com tempo maior de 30 minutos, o número e bactérias viáveis foi maior na dentina intratubular do que no biofilme, o que ocorreu também com a solução de hipoclorito de sódio neste tempo de ação. Conclui-se que para se aumentar a chance de sucesso em tratamentos retratamentos endodônticos, a combinação do uso de instrumentos reciprocantes e rotatórios na desobturação do canal, agitação de irrigantes e uso de agentes com capacidade antimicrobiana podem ser utilizados na tentativa de se eliminar bactérias resistente ao tratamento endodôntico. (AU)


Subject(s)
Humans , Chlorhexidine/pharmacology , Enterococcus faecalis/drug effects , Metal Nanoparticles/chemistry , Root Canal Irrigants/pharmacology , Root Canal Obturation/methods , Sodium Hypochlorite/pharmacology , Anti-Infective Agents/pharmacology , Biofilms/drug effects , Dental Pulp Cavity/microbiology , Materials Testing , Microscopy, Electron, Scanning , Reproducibility of Results , Retreatment/methods , Root Canal Obturation/instrumentation , X-Ray Microtomography
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