Short-term anti-plaque effect of two chlorhexidine varnishes.

BACKGROUND: Chlorhexidine (CHX) varnishes have been mainly used for the prevention of caries in high-risk populations. Reports regarding their anti-plaque effect on a clinical level are limited to non-existing as opposed to their microbiological impact on plaque formation. AIM: The aim of this preliminary investigation was to evaluate the anti-plaque effect of two CHX varnishes applied on sound enamel in relation to a positive control, a negative control and to one another. METHODS: Sixteen healthy subjects volunteered for this randomized-controlled, single-blind, four-treatment-four-period crossover-designed clinical trial. A 3-day plaque re-growth model was used to determine de novo plaque accumulation following CHX rinsing, Cervitec application, EC40 application and no therapy. The amount of plaque was measured using the Quigley and Hein plaque index and "automatic image analysis" (AIA). RESULTS AND CONCLUSIONS: Varnish treatment resulted in significantly higher plaque levels than CHX rinsing irrespective of the varnish that was used (p< or =0.002), implying that the latter is likely to remain the gold standard as an anti-plaque agent. However, highly significant differences were also found in favour of both varnish systems when compared with no therapy (p<0.001), which indicates that varnish treatment is an effective means of inhibiting plaque formation in a short time span. Cervitec exhibited slightly, yet significantly, higher plaque levels in comparison with EC40 as determined by AIA (p=0.006). Large-scale trials with a longer observation period are necessary to substantiate these results.

[Chlorhexidine varnishes in dentistry]. / Les vernis à la chlorhexidine en Médecine Dentaire.

Since the discovery of chlorhexidine as a potential surface antiseptic in the fifties, it has been abundantly used in different kinds of dental pharmaceutics. During the past decade chlorhexidine containing varnishes have been added to this list. These products present several advantages in comparison to the existing chlorhexidine formulations. Varnishes should be considered as further options for prevention of fissure and approximal caries, possibly in combination with already established methods. For patients at high risk for root surface caries, varnish application might be a meaningful preventive and therapeutic approach. In this paper, the existing literature on the use of two different chlorhexidine varnishes (Cervitec and EC40) in different fields in dentistry will be reviewed.