Oral antibacterial effect of chlorhexidine treatments and professional prophylaxis in children

Aim: The primary aim of this longitudinal study was to evaluate additional effects of 4-weekchlorhexidine digluconate (CHX) gel treatments to control Aggregatibacter actinomycetemcomitanscounts in children after professional dental prophylaxis. Porphyromonas gingivalis and Streptococcusmutans counts were also determined to evaluate the secondary effects of anti-plaque treatments onmicrobial shifts. Methods: Twenty-six children with A. actinomycetemcomitans counts >4 log10/mL of saliva and/or Quigley-Hein plaque index >3.0 were enrolled in this study. Patients wererandomly assigned to groups GI (placebo gel), GII (0.5% CHX gel), GIII (1% CHX gel), and GIV(2% CHX gel). Four sessions of treatment were performed during 4 weeks after a session ofprofessional dental prophylaxis. Real-Time polymerase chain reaction (PCR) was used todetermine viable microorganism counts in non-stimulated whole saliva samples collected atbaseline, one week, one month and three months after interruption of treatments. Results: Areduction of all bacterial counts was detected after the 3-month follow-up in all groups. Lowercounts of P. gingivalis were achieved from 1 week on after treatments. The 2% CHX concentrationseemed to contribute to lower A. actinomycetemcomitans levels and increase S. mutans levels.Conclusions: Professional dental prophylaxis was effective to control salivary levels of A.actinomycetemcomitans, P. gingivalis and S. mutans. Additional antimicrobial effects, however,were not observed by the combination of professional dental prophylaxis and 4-week chlorhexidinegel treatments.

Efeito do gel de clorexidina em diferentes concentrações no controle do biofilme bacteriano e da inflamação gengival em crianças / Effect of clorexidina in different concentrations in the control on dental plaque and inflammation gingival in children

O presente estudo teve como objetivo avaliar a efetividade da utilização de géis de clorexidina nas concentrações de 0,5%, 1% e 2% para o controle do biofilme dentário e da inflamação gengival em crianças na faixa etária de 7 a 11 anos de idade. A amostra foi composta por 40 crianças, aleatoriamente divididas em quatro grupos: G1 (grupo controle - não utilização de agente químico), G2 (utilização de gel de clorexidina a 0,5%), G3 (utilização de gel de clorexidina a 1%) e G4 (utilização de gel de clorexidina a 2%) para determinação dos índices de placa e gengival. O gel de clorexidina foi aplicado com a utilização de moldeiras descartáveis pré-fabricadas (5 mL), por 1 minuto, uma vez por semana, durante 4 semanas. As avaliações clínicas foram feitas após 1 semana, 1 mês, 3 e 6 meses da última aplicação do gel. Os resultados obtidos foram analisados pela análise de variância a dois critérios, sendo adotado nível de significância igual a 5%. Os índices de placa e gengival reduziram durante o período experimental em todos os grupos. Não houve diferença significante (p <0.05) entre os grupos tratados com gel de clorexidina quando comparado com o grupo placebo na redução de placa e índice gengival. Os resultados mostraram que formulações diferentes de gel de clorexidina não produzem efeito inibidor da placa bacteriana e da inflamação gengival. Sendo assim, estudos adicionais são necessários para esclarecer o papel da clorexidina na prevenção de cárie e doença periodontal em crianças.

The purpose of the present study was to assess the effect of three different formulations of chlorhexidine gel in the concentrations of 0.2%, 1% and 2% for the control of plaque accumulation and gingivitis. This was a double-blind, longitudinal, non-crossover study in 48 children between 7 to 11 years of age. Subjects were randomly assigned to 4 different groups: G 1 (placebo), G 2 (0.2% chlorhexidine gel), G 3 (1% chlorhexidine gel) and G 4 (2% chlorhexidine gel). The chlorhexidine gel was administered once a week during 4 weeks. The clinical evaluations were made after 1 week, 1, 3 and 6 months of the last application of the chlorhexidine gel. Mean plaque and gingival scores were reduced over the four-week trial period for experimental and control groups. There was no significant difference (p<0.05) between the groups treated with chlorhexidine gel when compared with the placebo group in the reduction of plaque and gingival scores. The results indicated that different formulations of chlorhexidine gel did not produce an effective inhibitor of plaque growth. Within the limitations of the present study design, further studies are required to clarify the role of chlorhexidine to prevent caries and periodontal disease.