Influência da clorexidina na capacidade de umectabilidade da dentina hígida e afetada por cárie por um sistema adesivo

To evaluate the effect of chlorhexidine (CHX) on the wettability of sound and caries affected dentin by a simplified adhesive system. Material and Methods: Flat coronal dentin surfaces were produced on 60 sound molars, 30 of which were artificially decayed. The teeth were divided randomly into 3 groups (n = 10) with smear layer (SL), without SL impregnated with water and without SL impregnated with chlorhexidine. The SL removal was performed by phosphoric acid etching for 15 s. 20 uL of distilled water or 2% chlorhexidine digluconate were applied on the demineralized dentin for 60 s. Then, a drop of Single Bond 2 was deposited on each surface. Contact angles between dentin surface and adhesive was measured by means of a goniometer and data were submitted to ANOVA and Tukey tests (α = 0.05). Results: Higher contact angles were obtained on sound versus caries affected dentin (p <0.05), regardeless of the surface treatment. For both substrates, contact angles statistically higher were obtained for dentin covered with SL (P <0.05). The SL removal resulted in significant reduction of the angles (P <0.05) and no difference was found among angles produced on demineralized dentin impregnated with water or chlorhexidine (p> 0.05). Conclusion: Caries affected dentin wettability was higher than sound dentin and that characteristic was not influenced by chlorhexidine application.

Efeito antimicrobiano e citotóxico do óleo essencial de Cymbopogon citratus sobre células odontoblastóides

The aim of this study was to evaluate the antimicrobial and cytotoxic effect of essential oil (EO) of lemon grass (Cymbopogon citratus). From the agar diffusion method, different concentrations of EO (0.135%, 0.2% and 1%), and control solutions (chlorhexidine (Chx), distilled water (Ad) and cereal alcohol (Ac)) were applied on cultures of Candida albicans (C.a), Streptococcus mutans (S.m), Streptococcus sobrinus (S.sob) and Lactobacillus acidophilus (L.a). For C.a, S.m and S.sob, the largest inhibition zones in descending order were: Chx, Ac and EO 1%, while the latter two were statistically similar (Mann-Whitney, p> 0.05). For L.a, the largest inhibition halo was observed for the Chx, followed by EO at 1%, 0.2%, 0.135% and Ac. For evaluation of cytotoxicity, the following groups were set: G1: 0,1% EO; G2: pure EO; G3 (positive control): H2 O2 ; G4: cereal alcohol; and G5 (negative control): culture medium – DMEM. The solutions were applied on the cultured MDPC-23 cells, which were plated (30,000 cells/cm2 ) in wells of 24 well-dishes. Cell metabolism was evaluated by MTT assay. Considering G5 (negative control) as 100% of cell metabolism, it was observed for G1, G2, G3 and G4 a percentage reduction in cell metabolism of 29.6%, 82%, 81.2% and 33.4%, respectively. It was concluded that the low concentration of 0,1% OE (C. citratus) was able to inhibit the growth of the strains tested as well as caused mild cytotoxicity to the cultured MDPC-23 cells.

Avaliação comparativa in vivo da eficácia do óleo de melaleuca, clorexidina e listerine sobre streptococcus mutans e microrganismos totais na saliva

Objective: To compare the efficacy of the mouthwashes 0.12% chlorhexidine, Listerine, and 0.5% and 2% Melaleuca Alternifolia oil against the salivary levels of Streptococcus mutans and total microorganisms. Methods: This study was double-blind controlled and paired clinical assay. Twenty-six volunteers aged 21 to 35 years old were enrolled. At baseline, 1 mL of unstimulated saliva was collected from each subject, 1 and 15 min after mouthrinsing with the following solutions: sterile distilled water, 0.12% chlorhexidine digluconate, Listerine (©Johnson & Johnson do Brasil), 0.5% and 2% concentrations of Melaleuca Alternifolia (Sigma-Aldrich). The volunteers used all the evaluated mouthrinses with a 15-day interval between the solutions. Immediately after rinsing, saliva was collected and serial dilutions were performed, followed by plating in blood agar culture medium for growth of total microorganisms and SB-20 (Sucrose-Bacitracin agar) for growth of S. mutans, and incubation at 37 °C for 48 h in microaerophilia. After incubation, the number of colonies was counted and expressed as colony forming units (UFC/mL). Results: Chlorhexidine showed antimicrobial action by reducing total microorganisms and S. mutans, while the action of 0.5% Melaleuca Alternifolia was similar to that of distilled water. Listerine and 2% Melaleuca Alternifolia oil reduced total microbial counts by 11% and 9% respectively, and S. mutans by 20% and 11%. Conclusion: A single rinse with 0.12% chlorhexidine is effective in reducing the levels of total microorganisms and S. mutans present in saliva. Under the same testing conditions, Listerine and 0.5% and 2% Melaleuca Alternifolia oil presented lower efficacy than chlorhexidine.

Estudo microbiológico comparativo entre sabão de clorexidina 2% e um novo sabão antisséptico para lavagem pré-operatória das mãos

Objective: To evaluate, by means of a microbiologic study, two kinds of soaps suggested by surgeons for presurgical handwashing, comparing a well-known antibacterial soap with a new soap formulated from vegetable oils. Materials and methods: Ten volunteers performed handwashing according to previously established protocols for routine antisepsis in operating rooms using 3 different soaps: a common, commercially marketed soap, serving as the control group (Group 1), with no antibacterial characteristics; a soap with 2% chlorhexidine (Group II); and a new soap formulated from vegetable oils at a concentration of 20%, known as surfactant, which was designed by the Chemistry Institute (Unesp/Araraquara – Grupo de Materiais Fotônicos) (Group III). The microbiological samples were collected immediately before and after handwashing and one hour later with the volunteer wearing surgical gloves. Results: ANOVA revealed that the following significant differences are found in the number of bacterial colonies: between soap types (a smaller number of colonies in the Group II soap), between periods (reduction in the number of colonies in the Group II soap), and the significant effect of the soap versus time interaction. Conclusion: The 2% chlorhexidine soap performed better in reducing the number of bacterial colonies on the hands immediately after handwashing and after one hour with the use of surgical gloves, when compared to the 20% surfactant soap.

Comparação entre soluções irrigadoras na endodontia: clorexidina x hipoclorito de sodio

The objective of this review was reporting an overview about the properties of two irrigating solutions, solution of sodium hypochlorite and chlorhexidine, used in the treatment of root canals. A solution must submit irrigating antimicrobial action, dissolve waste tissue, promote wetting to facilitate the instrumentation, and present biocompatibility with the adjacent tissues. The sodium hypochlorite used in different concentrations has been the solution of choice among professionals by presenting antimicrobial action and act as a solvent tissue. However, today, chlorhexidine has been widely used as an irrigating solution due to specific properties that enable its use, such as substantivity, antimicrobial effectiveness, and low toxicity. Thus the solution of chlorhexidine with different concentrations is presented as an alternative to irrigating solution for the treatment of root canals.

Avaliação da alteração dimensional de modelos obtidos a partir de moldagens com alginato tradicional e outro com desinfetante

The present study aims at evaluating dimensional alteration of stone casts made from impressions with a standard irreversible hydrocolloid and an antimicrobial one. For this, an alginate without disinfectant (Type II Jeltrate) and other containing chlorhexidine (Type II Avagel) were used, which rose by the same regime of treatment: without disinfection; immersion; and spraying. A 1% sodium hypochlorite solution was used for 10 minutes. To obtain the impressions, a perforated impression tray was made from a standard metal model. After molding, the molds were washed in running water for 30 seconds to simulate removal of saliva. Then, with the exception of the control group, these molds were subjected to disinfection treatment. After 10 minutes they were washed again. 60 samples poured with type V special gypsum (Durone) were obtained, that were measured 3 times in a stereomicroscope (SZX12, Olympus) to record the average of dimensional alterations. The disinfection treatment did not bring significant changes in the models obtained from both alginate tested (standard p = 0.7102; with chlorhexidine p = 0.5832). The results showed a statistically significant and additional advantage of the traditional alginate on alginate with chlorhexidine, with respect to dimensional alteration (p < 0.05).

Effects of coronal leakage on concentration of hydrogen ions and calcium hydroxide release of several calcium hydroxide pastes over different periods of time

Purpose: To evaluate the effects of coronal leakage on concentration of hydrogen ions (pH) and calcium release of several calcium hydroxide pastes, over different periods of time. Material and Methods: Fifty extracted human mandibular central incisors (n=10) were instrumented up to the F2 instrument and assigned to the following intracanal dressing: G1- Calen, G2- Calen with 0.4% chlorhexidine (CHX), G3- Calcium hydroxide with camphorated paramonochlorophenol (CPMC) and glycerin, G4- Calen, but temporary filling material maintained during all test (positive control) and G5- Root canal without intracanal dressing (negative control). All groups were immersed in distilled water for 7 days. In sequence, the temporary filling materials were removed, except in controls groups. All specimens were individually mounted on a specific device and only its root again immersed in distilled water. Concentration of hydrogen ions and calcium release by calcium hydroxide pastes in distilled water were evaluated in 24h, 7, 14 and 28 days. The results were submitted to ANOVA test (p = 0.05). After 28 days, root canals from experimental groups were examined in SEM. Results: G1, G2, G3 and G4 presented similar pH values and calcium release and did not differ from each other (p>0.05), up to 7 days. After this time G1, G2 and G3 presented values lower values than G4 (p<0.05). In SEM analysis, calcium hydroxide residues were observed in all experimental groups. Conclusions: After 7 days, coronal leakage decreased the concentration of hydrogen ions and calcium ion release provided by all calcium hydroxide pastes.

Avaliação in vitro do pH do hidróxido de cálcio usado como medicação intracanal em associação com clorexidina e racealfatocoferol

Objective: The aim of this study was to evaluate the pH of calcium hydroxide (CalenTM) when associated or not with chlorhexidine 0.4%, and when associated with chlorhexidine with the addition of 20% or 10% of alphatocopherol (AchéTM), assessed in several periods of time. Methods: Fourty dentine tubes 20 mm, properly standardized, were made from bovine anterior teeth roots. Following, a perforation was achieved in the roots distal face at 7 mm from the cervical radicular line by using a #1/2 carbide bur. After complete root sealing is made, except in the perforation local, the radicular canals were filled with one of the following associations: Group I – Calen®; Group II – Calen™ with chlorehxidine at 0.4%; Group III – Calen™ with chlorhexidine at 0.4% with the addition of 20% (weight) of alhatocopherol compound and Group IV – Calen™ with chlorhexidine at 0.4% with the addition of 10% (weight) alphatocopherol. After cervical sealing is accomplished, the roots were immersed in water MiliQ and the pH, assessed in 24h, 7, 14, 21, 28 and 45 days. Results and Conclusion: In all periods tested, the pH of the calcium hydroxide (Calen™) was similar to the pH of the calcium hydroxide (Calen™) associated with chlorhexidine 0.4% and 10% alphatocopherol (p > 0.05). The association of 20% alphatocopherol obtained the pH lower than the association with 10% (p < 0.05). The pH of the association with chlorhexidine was similar to the pure calcium hydrocide (Calen™) after the 14th day (p > 0.05) only. Therefore, on the 45th day, this difference was significant again (p < 0.05).

Influência do cimento obturador e agente de irrigação final na infiltração marginal em situações de sobreobturações endodônticas

Objective: The objective of this paper was to verify if the final irrigation at 17% EDTA, separately or followed by chlorhexidine digluconate at 2% interferes on the apical marginal leakage in root canal overfilling, due to the use of two root canal filling materials (Sealer 26TM or SealapexTM). Methods: Forty lower incisors extracted, with a single root canal, were biomechanically prepared, at 2.0mm beyond the radicular apex, with ProTaper SystemTM, finishing it with the F3 instrument. Irrigation was accomplished with 1.0 mL NaOCl at 2.5% at each change of equipment caliper and, in the end, with 5.0 mL normal saline solution. After achieving this procedure, the foraminal channels was standardized with a file K 25 until its DO appears in the foraminal opening. From this moment, the teeth were subdivided into two groups of 20 specimens each, because of the final irrigation method used: I – irrigation with EDTA at 17% for 3min and II – identical protocol, thus, after EDTA aspiration at17%, it was again irrigated with chlorhexidine digluconate at 2%, also kept intra-canal for 3min. Each group was again sub-divided into two sub-groups (ten teeth each), according to the cement used (Sealer 26TM or SealapexTM), and filled by using a single gutta-percha F1 (ProTaperTM, Universal Filling), in such a manner that it goes 2.0 mm beyond the radicular apex. Soon after that, the teeth were immersed in Rhodamine BTM for 72h, vacuum and after the roots have been bucolingually grooved, the leakages marked were measured with program Image ToolTM. Results and Conclusions: The leakage magnitude was similar among themselves (p > 0.05), except for group Sealapex®, thus the final use with chlorhexidine reduced apical leakage (p < 0.05).

Antimicrobial activity of root canal irrigants associated with cetrimide against biofilm and planktonic Enterococcus Faecalis

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Marginal adaptation of Class V restorations with current generation dentin-bonding agents: effect of different dentin surface treatments.

This study sought to assess the use of chlorhexidine with several excipients as a dentin surface treatment and its effect on marginal adaptation of class V restorations with current-generation dentin bonding agents. A total of 120 human third molars were selected and allocated into 12 groups, with standardized buccal class V restorations randomly divided into preconditioned dentin rinsed with: water; water + chlorhexidine; ethanol; or ethanol + chlorhexidine. After rinsing of dentin (previously conditioned with 35% phosphoric acid) with the test solutions, the Adper single bond 2, prime and bond 2.1, and Excite bonding systems were applied randomly. Restorations were performed with FiltekTM Z350 XT composite resin. The resulting specimens were subjected to thermal and mechanical load cycling. Quantitative analysis of marginal adaptation was performed on epoxy replicas by means of scanning electron microscopy. Results were assessed by means of the Kruskal-Wallis test (percentages of continuous margins) and Wilcoxon test (differences between percentages of continuous margins before and after thermal cycling and mechanical loading), at a significance level of p < 0.05. Outcomes in the chlorhexidine-treated groups were not superior to those obtained with other treatments.

Effects of Er, Cr:YSGG laser irradiation on external adaptation of restorations in caries-affected cavities

This study evaluated the effect of Er,Cr:YSGG laser irradiation on the external adaptation of composite resin restorations in caries-affected cavities. Mixed class V cavity preparations were performed in 36 intact human third molars, in half of which caries was artificially induced. Both healthy and carious dentin were etched with 35% phosphoric acid (Ultradent Products Inc., South Jordan, Utah, USA), and the teeth were divided into three groups, i.e., (a) untreated etched dentin, (b) application of the Er, Cr:YSGG laser and (c) use of chlorhexidine as an adjunct in the bonding process. Restorations were fabricated with Z350 XT FiltekTM composite resin (3M ESPE) and subsequently the specimens were subjected to thermocycling to simulate artificial ageing. Quantitative analysis of external adaptation was performed by scanning electron microscopy in both healthy and affected dentin using epoxy resin replicas. It was concluded that the application of laser and chlorhexidine did not affect the percentages of marginal adaptation of class V restorations. Furthermore, thermocycling may influence adaptation values.

Residues of different gel formulations on dentinal walls: a SEM/EDS analysis

The aim of this study was to evaluate the presence of residues of sodium hypo-chlorite gel, chlorhexidine gel, and EDTA gel on dentina l walls after canal preparat ion throughchemical SEM- elemental chemical microanal ys is (EDS) analysis. Forty-eight single-rootedteeth were selected. They had their crowns sectioned and were instrumented with a reciprocat-ing system. The canals were irrigated with 5 mL of saline solution during root canal preparation.After instrumentation, the root canals were irrigated with 3 mL 17% EDTA followed by 1 min ofultrasonic passive activation (33 20 sec) to remove the smear layer, and then irrigated with3 mL of saline solution. The specimens were randomized into three groups (n 5 12) accord ing tothe chemical substance that filled the root canal for 30 min: GI: 5.5% sodium hypochlorite gel;GII: 2% chlorhexidine gel; GIII: 24% EDTA gel; Negative c ontrol group: no substance was used.Then, the root canals were irrigated with 6 mL of saline solution followed by 1 min of ultrasonicpassive activation (33 20 sec). After ultrasonic activation , the canals were irrigated with 2 mLsaline. The roots were sect ioned, and the perce ntage of each chemical element present in thesamples was analyzed through chemi cal SEM-EDS microanalysis. All expe rimental groupsshowed a significantly higher percentage of chemical elements (Na and/or Cl) than the controlgroup (P < 0.03). This in vitro study has shown that, regardless of chemical solutions used evenafter the final irrigation protocol, chemical residues of d ifferent substances remained attached tothe r oot c anal wa lls. Microsc. Res. Tech. 78:495–49 9, 2015.

In vitro study of staining agents effects on optical properties of esthetic restorative materials

The authors have studied the effect of four staining agents on the optical properties of esthetic restorative materials through translucency tests. Two commercial brands of composite resins were used: Point 4 (Kerr) and Charisma (Heraeus-Kulzer). The liquids tested were: wine, cola, chlorhexidine solution and nicotine solution. The translucency was measured at different periods of time: P0 – before immersion (baseline), P1 - 1 h after immersion, P2 - 2 h after immersion and successively, P3 – 24 h after immersion up to a period of 7 weeks. ANOVA statistical analysis was applied to the data (p < 0.05). The results lead to the following conclusions: (1) Composite resins submitted to the tested immersion mediums were stained, (2) the lower percentage of translucency was observed for nicotine containing solution, (3) The percentage of translucency decreased with the period of immersion.

Efficiency of cares over toothbrush storage to prevent contamination

This study evaluated the efficiency of a toothbrush holder to prevent contamination of toothbrushes used by preschool children. For that, the sample was composed by children 6 years old, enrolled in an educational and recreational center in Araraquara/SP, and divided into 3 groups: G1: same continuing routine storage toothbrushes, G2: children received only a new toothbrush holder for storage; G3: they received new toothbrushes holder for storage and solution of chlorhexidine digluconate to 0.12% to dabble in the toothbrush after use. After brushing their teeth, toothbrushes were collected for microbiological analysis. The data were analyzed using the distribution of frequencies. It was observed that, in general, higher prevalence of the microorganism in the toothbrushes was Streptococcus viridans (58.97%), followed by Estafilococcus (35.90%), the bacillus of air (28.21%) and Neisseria mucosa (5.13%). Evaluating frequency, it was noted that the contamination presented by Streptococcus is higher in G1 when compared to G2 and G3, while for Estafilococcus, the presence was more significant in G3. Thus, it was concluded that the use of new toothbrushes holder able to avoid direct contact between brushes and allow drying without smothering could be an excellent alternative to educational institutions that require the storage group.