A randomized clinical trial compared the effect of intra-alveolar 0.2 % Chlorohexidine bio-adhesive gel versus 0.12% Chlorohexidine rinse in reducing alveolar osteitis following molar teeth extractions

OBJECTIVES: To evaluate socket healing, incidence of acute alveolar ostieitis (AO) and associated pain following single molar tooth extraction in patients who receive intra-alveolar 0.2% chlorhexidine (CHX) gel, and those who rinsed with 0.12 % CHX rinse. Study DESIGN: A prospective randomized clinical trial was conducted on two parallel groups of patients. Group1(141 patients): Rinsed with 0.12 % CHX rinse from the second postoperative day, two times daily for a week.Group2 (160 patients): Who had direct intra-alveolar application of 0.2% CHX gel and day 3 post-operatively. The socket was evaluated 3 and 7 day postoperatively for the presence of AO by checking probing tenderness in the socket, empty socket, food debris, halitosis and pain assessment by VAS. RESULTS: Forty-eight AO cases were diagnosed out of 301 extractions (15.9%). In Group1, 25 cases were found(17.7%) while 23 cases were found in Group2 (14.4%). The difference was not statistically significant (p = 0.428).Presence of empty socket and food debris in Group1 were higher than in Group2 but the difference was not statistically significant (p= 0.390 & p = 0.415). Occurrence of halitosis in Group2 was more than Group1, but the difference was not significant (p= 0.440). Statistical significance was found between AO in extraction done by root separation (29%) and those routinely extracted (12.3 %) (p = 0.001).CONCLUSIONS: Postoperative evaluation of molar extraction sockets that received direct intra-alveolar application of0.2% CHX gel showed insignificant less occurrence of AO when compared with 0.12 % CHX rinse

In Vivo Antiplaque Effect of Three Edible Toothpastes

OBJECTIVES: The objective of this study was to analyse the antibacterial and antiplaque activity of three edible toothpastes with the widest worldwide distribution: KidScents(TM), which contains essential oils; Browning B&B(TM), with medicinal plants; and Wysong Probiodent(TM), which contains probiotics. Study DESIGN: The study group was formed of twenty healthy volunteers (dental students) with a good oral health status. Using a balanced randomisation system, all volunteers performed toothbrushing with four products (the three edible toothpastes and water) at intervals of one week. Bacterial vitality in the saliva was analysed by epifluorescence microscopy and plaque regrowth was evaluated using the Turesky-Quigley-Hein plaque index.RESULTS: Bacterial vitality in the saliva was significantly higher after toothbrushing with water (positive control) than with the three toothpastes (P=0.002, P=0.003 and P<0.001, respectively). The plaque index was significantly higher after using these three toothpastes than after toothbrushing with water (P=0.047, P=0.032 and P<0.001, respectively).CONCLUSIONS: The three edible toothpastes analysed have some antimicrobial activity but favour plaque regrowth

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Antimicrobial activity and enterococcus faecalis biofilm formation on chlorhexidine varnishes

Objective: To evaluate, in vitro, the antimicrobial activity and biofilm formation of three chlorhexidine varnishes in four Enterococcus faecalis strains: E. faecalis ATCC 29212, E. faecalis EF-D1 (from failed endodontic treatment), E. faecalis 072 (cheese) and E. faecalis U-1765 (nosocomial infection), and one Enterococcus durans strain (failed endodontic treatment). Study Design: The direct contact test was used to study the antimicrobial activity. Bacterial suspensions were exposed for one hour to EC40, Cervitec (CE) and Cervitec Plus (CEP) varnishes. "Eradication" was defined as 100% bacterial kill. The formation of enterococci biofilms was tested on the surface of the varnishes after 24 hours of incubation and expressed as percentage of biofilm reduction. Results: EC40 eradicated all strains except E. faecalis ATCC 29212, where 98.78% kill was achieved. CE and CEP showed antimicrobial activity against all the strains, but most clearly against E. durans and E. faecalis 072. EC40 completely inhibited the formation of biofilm of E. faecalis ATCC 29212, E. faecalis 072 and E. durans. CE and CEP led to over 92% of biofilm reduction, except in the case of E. faecalis U-1765 on CEP (76.42%). Conclusion: The three varnishes studied were seen to be effective in killing the tested strains of enterococci and in inhibiting the formation of biofilm, the best results being observed with EC40 (AU)

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Eradication of enterococci biofilms by lactic acid aloneand combined with chlorhexidine and cetrimide

Objective: The antimicrobial activity of lactic acid (LA) alone or in combination with chlorhexidine (CHX) and cetrimide (CTR) against three Enterococcus faecalis strains, E. faecalis ATCC 29212, E. faecalis EF�D1 and E. faecalis U�1765, one Enterococcus durans strain and one dual�species biofilm was investigated.Study Design: The irrigating solutions tested were 20%, 15%, 10%, 5% and 2.5% LA, alone and in combination with 2% CHX and with 0.2% CTR. The biofilms were grown in the MBECTM high�throughput device for 24 hours and exposed to the solutions for 30 seconds and 1 minute. "Eradication" was defined as 100% bacterial kill.Results: Twenty percent LA eradicated all enterococci biofilms after 30 seconds contact time. The association of LA + 0.2% CTR achieved better results than LA alone, in contrast with the results obtained using LA + 2% CHX. E. durans was eradicated by all the tested solutions at 1 minute. The dual�species biofilm, E. faecalis ATCC 29212 + E. durans, gave intermediate values of the pure cultures. Conclusions: LA is capable of eradicating enterococci biofilm at a concentration of 20%. The combination of lower concentrations with 0.2% CTR achieved eradication after 1 minute (AU)

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Reaction rate of NaOCl in contact with bovine dentine: effect of activation, exposure time, concentration and pH.

AIM: To determine the influence of activation method (ultrasound or laser), concentration, pH and exposure time on the reaction rate (RR) of NaOCl when in contact with dentinal walls. METHODOLOGY: The walls from standardized root canals in bovine incisors were exposed to a standardized volume of sodium hypochlorite (NaOCl) with different concentrations (2% and 10%), pH (5 and 12) and exposure times (1 and 4min). Two irrigation protocols were tested: passive ultrasonic irrigation or laser activated irrigation with no activation as the control. The activation interval lasted 1min followed by a rest interval of 3 min with no activation. The RR was determined by measuring the iodine concentration using an iodine/thiosulfate titration method. RESULTS: Exposure time, concentration and activation method influenced the reaction rate of NaOCl whereas pH did not. CONCLUSIONS: Activation is a strong modulator of the reaction rate of NaOCl. During the rest interval of 3min, the consumption of available chlorine increased significantly. This effect seems to be more pronounced after irrigant activation by laser. pH did not affect the reaction rate of 2% NaOCl.

Efecto de soluciones de irrigación y sus combinaciones sobre la microdureza de la dentina radicular / Effects of irrigation solutions and their combinations on the microhardness of root canal dentin

Objetivo: en este trabajo se comparó la microdureza de la dentina radicular antes y después de la irrigación con soluciones empleadas solas y combinadas. Material y métodos: 35 dientes humanos anterosuperiores fueron instrumentados, sus raíces fueron cortadas en tercios, incluidas individualmente en resina acrílica y pulidas. Las piezas fueron divididas al azar en grupos de 5 raíces cada uno. Se pusieron en contacto durante 15 minutos con las siguientes soluciones: grupo1: EDTA 17%, grupo 2: hipoclorito de sodio (NaOCI) 1%, grupo 2: gluconato de clorhexidina (CHX) 05%, grupo 4: solución fisiológica, grupo 5: NaOCl 1% + EDTA 17%, grupo 6: NaOCl 1% + CHX 0,5%, Grupo 7: EDTA 17% + CHX 0,5%. La microdureza Vickers fue medida inicialmente y post irrigación a 0,5mm y 1mm, del conducto radicular, empleando 300 g, durante 15 segundos. Resultados: Mediante Variancia de tres vías con medidas repetidas en dos factores y comparaciones múltiples con ajuste de Bonferroni, se observaron diferencias significtativas (p<0,05) en la reducción de la microdureza al emplear EDTA 17% + NaOCl 1%, EDTA 17% + CHX 0,5% en los tercios apical, medio y cervical y con NAOCl 1% en los tercios medio y cervical. Conclusiones: EDTA 17% y sus combinaciones fueron más efectivas en reducir la microdureza dentinaria (AU)

Objective: The purpose of this study was to compare the root dentin microhardness before and after irrigation with alone and combined solutions. Material and Methods: Thirty-five human maxillary anterior teeth were used in this study. The crowns were removed at the cement-enamel junction, the root canals were enlarged. Each root was transversally sectioned into cervical, middle and apical segments and were mounted in an individual silicon device with acrylic resin. The dentin surface was polished. Prior to application of thest solutions, the Vicker´s hardness values of the specimens were measures. The roots were irrigated: group 1 (n=5) EDTA 17% Ç(n=5), group 2: sodium hypochlorite (NaOCl) 1% (n=5), group 3: chlorhexidine gluconate (CHX) 0,5% (n=5) group 4: saline solution (n=5) group 5: NaOCl 1% + EDTA 17% (n=5), group 6: NaOCl 1% + CHX 0,5% (n=5), group 7; EDTA 17% + CHX 0,5% (n=5). Microhardness measurements were performed on each section at 0,5 mm, and 1mm, from the pulp-dentin interface using 300 g. load perpendicular to the surface for 15 seconds. Results: With three-way Variance with repeated measures on two factors and multiple comparisons Bonferroni, significant differences (p<0,05) in the reduction of microhardness when using 17% EDTA, 17% EDTA + 1% NAOCl, EDTA 17% + CHX 0,5% in the apical, middle and cervical thirds and 1% NaOCl in the cervical and middle thirds. Conclusions: EDTA 17% and theis combinations were more effective than other solutions in microhardness reduction (AU)

Glutaraldehyde in dentistry--a review.

The disinfective and fixative properties of glutaraldehyde are now widely investigated. Glutaraldehyde is effective against micro-organisms and their spores. Recently, studies have shown the effectiveness of glutaraldehyde against the HIV virus. 2% glutaraldehyde is now recommended for the sterilisation of surgical instruments, operating areas, dental impressions and root canals during endodontic therapy. Studies have also shown that glutaraldehyde is an effective fixative with minimum side effects, limited penetration and quick acting. Pulpotomy studies using glutaraldehyde as the fixative agent produce high success rates. The important feature is the vital pulpal tissue at the apical third suggesting its limited penetration. The small amounts that get distributed systemically are quickly metabolised and excreted in the urine or exhaled as carbon dioxide.