Clinical evaluation of low-level laser therapy and fluoride varnish for treating cervical dentinal hypersensitivity

The aim of this study was to evaluate in vivo the use of low-level galium-aluminium-arsenide (GaAlAs) (BDP 600) laser and sodium fluoride varnish (Duraphat((R))) in the treatment of cervical dentine hypersensitivity. Twelve patients, with at least two sensitive teeth were selected. A total of 60 teeth were included in the trial. Prior to desensitizing treatment, dentine hypersensitivity was assessed by a thermal stimulus and patients' response to the examination was considered to be a control. The GaAlAs laser (15 mW, 4 J/cm(2)) was irradiated on contact mode and fluoride varnish was applied at cervical region. The efficiency of the treatments was assessed at three examination periods: immediately after first application, 15 and 30 days after the first application. The degree of sensitivity was determined following predefined criteria. Data were submitted to analysis and no statistically significant difference was observed between fluoride varnish and laser. Considering the treatments separately, there was no significant difference for the fluoride varnish at the three examination periods, and for laser therapy, significant difference (P < 0.05) was found solely between the values obtained before the treatment and 30 days after the first application. It may be concluded that both treatments may be effective in decreasing cervical dentinal hypersensitivity. Moreover, the low-level GaAlAs laser showed improved results for treating teeth with higher degree of sensitivity.

Maximum inhibitory dilution of mouthwashes containing chlorhexidine and polyhexamethylene biguanide against salivary Staphylococcus aureus

Objective: The aim of the present study was to determine the in vitro maximum inhibitory dilution (MID) of two chlorhexidine-based oral mouthwashes (CHX): Noplak (R), Periogard (R), and one polyhexamethylene biguanide-based mouthwash (PHMB): Sanifill Premium (R) against 28 field Staphylococcus aureus strains using the agar dilution method. Materials and Methods: For each product, decimal dilutions ranging from 1/10 to 1/655,360 were prepared in distilled water and added to Mueller Hinton Agar culture medium. After homogenization, the culture medium was poured onto Petri dishes. Strains were inoculated using a Steers multipoint inoculator and dishes were incubated at 37 degrees C for 24hours. For reading, MID was considered as the maximum dilution of the mouthwash still capable of inhibiting microbial growth. Results: Sanifill Premium (R) inhibited the growth of all strains at 1/40 dilution and of 1 strain at 1/80 dilution. Noplak (R) inhibited the growth of 23 strains at 1/640 dilution and of all 28 strains at 1/320 dilution. Periogard (R) showed inhibited growth of 7 strains at 1/640 dilution and of all 28 strains at 1/320 dilution. Data were submitted to Kruskal-Wallis statistical test, showing significant differences between the mouthwashes evaluated (p<0.05). No significant difference was found between Noplak (R) and Periogard (R) (p>0.05). Sanifill Premium (R) was the least effective (p<0.05). Conclusion: It was concluded that CHX-based mouthwashes present better antimicrobial activity against S. Aureus than the PHMB-based mouthwash.

Response of mice connective tissue to intracanal dressings containing chlorhexidine

Substances containing chlorhexidine (CHX) have been studied as intracanal medicaments. The aim of the present study was to characterize the response of mouse subcutaneous connective tissue to CHX-containing medications by conventional optical microscopy. The tissue response was evaluated by implanting polyethylene tubes containing one of the substances evaluated: Calen paste + 0.5% CHX, Calen + 2% CHX, 2% CHX gel, and Calen paste (control). After experimental periods of 7, 21, and 63 days, the implants (n = 10) were removed along with the subcutaneous connective tissue. Tissue samples were subjected to histological processing, and sections were stained with hematoxylin and eosin. Qualitative and quantitative analyses of the number of inflammatory cells, blood vessels, and vascularized areas were performed. Results were analyzed by ANOVA and Tukey tests with the significance level set at 5%. We concluded that Calen + 0.5% CHX led to reparative tissue response in contrast with Calen + 2% CHX and 2% CHX gel, which induced persistent inflammatory response, pointing to the aggressive nature of this mixture. When Calen + 2% CHX and 2% CHX gel were compared, the latter induced more intense inflammatory response. Microsc. Res. Tech., 2012. (C) 2012 Wiley Periodicals, Inc.

Effects of chlorhexidine and sodium hypochlorite on the microhardness of root canal dentin

Objective. The purpose of this study was to evaluate the effects of endodontic irrigants on the microhardness of root canal dentin.Study design. Thirty extracted single-rooted human teeth were used. The crowns were sectioned at the cementoenamel junction. Each root was transversely sectioned into cervical, middle, and apical segments, resulting in 90 specimens. The 3 sections of each root were separately mounted in an individual silicon device with acrylic resin. The specimens were randomly divided into the following 3 groups (n = 30), according to the irrigant solution used: (1) group 1, control (saline solution); (2) group 2, 2% chlorhexidine gluconate solution; and (3) group 3, 1% sodium hypochlorite (NaOCl). After 15 minutes of irrigation, dentin microhardness was measured on each section at 500 mu m and 1000 mu m from the pulp-dentin interface with a Vickers diamond microhardness tester in Vickers hardness number (VHN).Results. Data obtained were analyzed using analysis of variance and the Tukey test (5%). Specimens irrigated with 2% chlorhexidine (group 2) or 1% NaOCl (group 3) presented lower values of dentin microhardness, with significant difference in relation to the control group (P < .05).Conclusion. It could be concluded that chlorhexidine and NaOCl solutions significantly reduced the microhardness of root canal dentin at 500 mu m and 1000 mu m from the pulp-dentin interface.

Antimicrobial activity of Calendula officinalis, Camellia sinensis and chlorhexidine against the adherence of microorganisms to sutures after extraction of unerupted third molars

Objective: The objective of this study was to compare the antimicrobial effect of mouthwashes containing Calendula officinalis L., Camellia sinensis (L.) Kuntze and 0.12% chlorhexidine digluconate on the adherence of microorganisms to suture materials after extraction of unerupted third molars. Material and Methods: Eighteen patients with unerupted maxillary third molars indicated for extraction were selected (n=6 per mouthwash). First, the patients were subjected to extraction of the left tooth and instructed not to use any type of antiseptic solution at the site of surgery (control group). After 15 days, the right tooth was extracted and the patients were instructed to use the Calendula officinalis, Camellia sinensis or chlorhexidine mouthwash during 1 week (experimental group). For each surgery, the sutures were removed on postoperative day 7 and placed in sterile phosphate-buffered saline. Next, serial dilutions were prepared and seeded onto different culture media for the growth of the following microorganisms: blood agar for total microorganism growth; Mitis Salivarius bacitracin sucrose agar for mutans group streptococci; mannitol agar for Staphylococcus spp.; MacConkey agar for enterobacteria and Pseudomonas spp., and Sabouraud dextrose agar containing chloramphenicol for Candida spp. The plates were incubated during 24-48 h at 37 degrees C for microorganism count (CFU/nnL). Results: The three mouthwashes tested reduced the number of microorganisms adhered to the sutures compared to the control group. However, significant differences between the control and experimental groups were only observed for the mouthwash containing 0.12% chlorhexidine digluconate. Conclusions: Calendula officinalis L. and Camellia sinensis (L.) Kuntze presented antimicrobial activity against the adherence of microorganisms to sutures but were not as efficient as chlorhexidine digluconate.

Biocompatibility of a chlorhexidine local delivery system in a subcutaneous mouse model

Objective: This study aimed evaluating histologically and histomorphometrically the response of the conjunctive tissue face to the implant of chlorhexidine chips in the subcutaneous tissues of rats. Study Design: In this research 35 male rats Wistar were used to analyze the biocompatibility and the degradation process of chlorhexidine chip. In each animal, it was made 2 incisions for subcutaneous implantation of chlorhexidine chip (test group) and a polytetrafluorethylene membrane (control group). The morphological changes in subcutaneous implantations were assessed after 1, 3, 5, 7, 10, 14, 21 days. The data were submitted to Friedman nonparametric test to analyze the comparisons among observation periods and to allow the comparison among groups. Results: Differences were found in the analysis of the inflammatory response when comparing the tested materials (p values <= 0.05). In test group was observed hemorrhage, edema and intense inflammatory infiltrate predominantly neutrophilic around material. From 3-day and subsequent periods was verified granulation tissue externally at this infiltrate. From 10-day on was observed crescent area of degradation of chlorhexidine chip, associated with neutrophilic and macrophagic infiltrate, that maintained until 21-day. In the control group, moderate inflammatory infiltrate was observed initially, predominantly polymorphonuclear, edema and granulation tissue 3-day period. The inflammatory infiltrate was gradually replaced for granulation tissue, culminating in a fibrous capsule. Giant multinucleate cells situated at contact interface with the coating was examined since 3-day and persisted until 21-day. Conclusion: The chlorhexidine chip induces an intense acute inflammatory response at subcutaneous tissue of rats. Therefore, at conditions of this study was not biocompatible.

Scanning electron microscope evaluation of chlorhexidine gel and liquid associated with sodium hypochlorite cleaning on the root canal walls

Objective. The aim of this study was to evaluate, by scanning electronic microscopy (SEM), the cleaning of the root canal walls after instrumentation and irrigation with 2.5% sodium hypochlorite (NaOCl) associated with 2% chlorhexidine (CHX) gel or liquid, combined or not with 17% ethylenediamine tetra-acetic acid (EDTA).Study design. Sixty single-root human teeth were subjected to standardized root canal instrumentation with different irrigants (n = 10): G1) NaOCl + CHX liquid; G2) NaOCl + CHX liquid + EDTA + saline solution; G3) NaOCl + CHX gel; G4) NaOCl + CHX gel + EDTA + saline solution; G5) saline solution; G6) saline solution + EDTA. After instrumentation, the teeth were prepared for SEM analysis (x500 and x2,000) to evaluate the cleaning of the cervical, middle, and apical thirds. The area analyzed was quantified according to the percentage of open and closed tubules, and data were statistically analyzed by analysis of variance and Tukey tests (P = .05).Results. The number of open tubules was highest in G4 in all root thirds, showing statistically significant difference from G1, G2, and G5 (P < .05). G1 presented higher quantity of closed tubules significant than G2.Conclusion. Irrigation with NaOCl and CHX gel followed by EDTA and saline solution produced greater cleaning of the root canal walls. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:e82-e87)

Application of Nonisothermal Cure Kinetics to the Interaction of Poly(ethylene terephthalate) with Alkyd Resin Varnish

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Non-isothermal decomposition kinetics of the interaction of poly(ethylene terephthalate) with alkyd varnish

The recycling of soft drink bottles poly(ethylene terephthalate) (PET) has been used as an additive in varnish containing alkyd resin. The PET, called to recycled PET (PET-R), was added to the varnish in increasing amounts. Samples of varnish containing PET-R (VPET-R) were used as a film onto slides and its thermal properties were evaluated using thermogravimetry (TG). Throughout the visual analysis and thermal behavior of VPET-R it is possible to identify that the maximum amount of PET-R added to the varnish without changing in the film properties was 2%.The kinetic parameters, such as activation energy (E) and the pre-exponential factor (A) were calculated by the isoconversional Flynn-Wall-Ozawa method for the samples containing 0.5 to 2.0% PET-R. A decrease in the values of E was verified for lower amounts of PET-R for the thermal decomposition reaction. A kinetic compensation effect (KCE) represented by the lnA=-13.42+0.23E equation was observed for all samples. The most suitable kinetic model to describe this decomposition process is the autocatalytic Sestak-Berggren, being the model applied to heterogeneous systems.

Antimicrobial activity of 2% chlorhexidine gluconate, 1% sodium hypochlorite and paramonochlorophenol combined with furacin against S. aureus, C. albicans, E. faecalise and P. aureginosa

OBJETIVO: Analisar a ação antimicrobiana da clorexidina a 2%, do hipoclorito de sódio a 1% e do paramonoclorofenol associado ao furacin sobre S aureus, C albicans, E faecalise e P aureginosa. METODOLOGIA: Foram utilizadas 40 placas Petri. Quatro placas foram separadas como controle negativo e em 4 outras, além do meio de cultura, semearam-se os microrganismos, com o círculo de papel, para se obter o controle positivo. em 32 placas seguiu-se a colocação de 4 círculos de filtro de papel esterilizados e impregnados das substâncias testes e controle, depositados em cada quadrante das mesmas. Os grupos foram analisados por 7 dias. Para a verificação dos resultados, usaram-se os halos de inibição de crescimento bacteriano. RESULTADOS: A clorexidina 2% foi significantemente (P<0,05) mais efetiva para todas as cepas microbianas que as demais substâncias. O hipoclorito de sódio a 1% apresentou resultados intermediários. O paramonoclorofenol associado ao furacin (PMC+F) obteve os piores resultados. CONCLUSÃO: A clorexidina obteve os melhores resultados. O PMC+F apresentou os menores halos de inibição.

Effect of an experimental 4% titanium tetrafluoride varnish on dental erosion by a soft drink

Objectives: This in vitro study assessed the effect of an experimental 4%TiF4 varnish on enamel erosion.Methods: Sixty bovine enamel blocks were randomly allocated to each type of varnish:Duraphat((R)) -D (NaF, 2.26%F), Duofluorid((R))-F(NaF, 2.71% F), TiF4-T(2.45%F) and no-fluoride-P. After application of the varnishes, the blocks were subjected to six sequential pH cycles (cola drink for 10 min and artificial saliva for 50 min, each) per day, during 4 days. After the pH cycles, the blocks were maintained in artificial saliva for 18 h. Enamel alterations were determined in the 2nd and 4th days, using profilometry (wear) and microhardness (%SMHC) tests. Data were tested using ANOVA and Tukey's tests (p < 0.05).Results: the mean %SMHC (+/- S.D.) at the 2nd and 4th day was, respectively, D (-77.26 +/- 5.04(a) and -88.59 +/- 5.11(A)), F (-76.79 +/- 7.82(a) and -88.78 +/- 6.10(A)), T(-88.28 +/- 3.19(b) and -92.04 +/- 2.54(A,B)) and P (-87.96 +/- 2.23(b) and -94.15 +/- 1.14(B)). The mean wear (mu m +/- S.D.) at the 2nd and 4th day was, respectively, D (3.16 +/- 0.32(a) and 7.56 +/- 0.90(A)), F(3.35 +/- 0.78(a,b) and 7.92 +/- 0.98(A)), T (3.81 +/- 0.43(b) and 7.69 +/- 0.76(A)) and P (3.43 +/- 1.13(a,b) and 7.31 +/- 0.53(A)).Conclusions: the NaF varnishes reduced the softening, but had no effect on the reduction of the wear. The TiF4 varnish was not able to reduce the softening and wear. (C) 2007 Elsevier Ltd. All rights reserved.

Effect of rotary or manual instrumentation, with or without a calcium hydroxide/1% chlorhexidine intracanal dressing, on the healing of experimentally induced chronic periapical lesions

Objective. To evaluate the healing of experimentally induced chronic periapical lesions in dogs at 30, 75, and 120 days after root canal instrumentation with rotary NiTi files or manual K-files, with or without a calcium hydroxide/1% chlorhexidine paste intracanal dressing.Study design. The second, third, and fourth mandibular premolars and the second and third maxillary premolars of 5 dogs (12 to 18 months of age, weighing 8 to 15 kg) were selected for treatment (a total of 82 root canals). After pulp removal, the root canals were left exposed to the oral cavity for 7 days to allow microbial contamination, after which the root canals were sealed with ZOE cement until periapical lesions were confirmed with radiography. Group I and II teeth were instrumented with manual K-files using the crown-down technique. In group III and IV teeth, NiTi rotary files were used. The apical delta was perforated by using #20 to #30 K-files at the length of the tooth, thus creating a standardized apical opening. The apical stop was enlarged to size 70, with 2.5% sodium hypochlorite irrigation at each file change. Teeth in groups II and IV were dressed with calcium hydroxide (Ca(OH)(2))/1% chlorhexidine (CHX) paste for 15 days before root filling. Group I and III teeth did not receive an intracanal dressing. The access openings of the teeth were permanently restored with silver amalgam condensed on a glass ionomer cement base. Pairs of standardized periapical radiographs were taken at the beginning of the treatment (0 days) and at 30, 75, and 120 days after filling.Results. There was no significant difference in the rate of radiographic healing of the periapical lesions between manual and rotary instrumentation. Radiographs taken at 120 days showed that the treatment with Ca(OH)(2)/1% CHX paste resulted in a significant reduction in mean size of the periapical lesions in comparison to single-session treatment. These findings were also true for histologic observations.Conclusion. The findings support the hypothesis that, regardless of the instrumentation technique (manual or rotary), the use of an intracanal dressing is important in the endodontic treatment of dog's teeth with experimentally induced chronic periapical lesions.

Scanning electron microscopic study of the cleaning ability of chlorhexidine as a root-canal irrigant

Aim To evaluate in vitro the cleaning of root-canal walls after irrigation with different irrigants.Methodology A total of 36 recently extracted human teeth were divided into four experimental groups according to the irrigating solution used: saline; 2% chlorhexidine; 2.5% sodium hypochlorite; and 2.5% sodium hypochlorite + EDTA. The cleaning of the apical, middle and coronal thirds of the root canals was evaluated by scanning electron microscope examination using a 4-point scoring system.Results the best cleaning was obtained using 2.5% sodium hypochlorite and EDTA, followed by 2.5% sodium hypochlorite only (P < 0.05), whose cleaning was similar to chlorhexidine only in the cervical third. Cleaning by saline and 2% chlorhexidine was worse than the other two groups and was similar in all thirds. Better cleaning was found in the cervical and middle thirds for all groups with the worst results in the apical third.Conclusions the apical third of the root canals was not cleaned as well as the middle and coronal thirds. Cleaning by chlorhexidine and saline was inferior compared to the cleaning by sodium hypochlorite with and without EDTA.

Effect of Cervitec (R) on mutans streptococci in plaque and on caries formation on occlusal fissures of erupting permanent molars

The aim of this study was to evaluate the effect of Cervitec(R) on the abundance of mutans streptococci (MS) in occlusal dental plaque and on 2-year caries increment of partly erupting first permanent molars. Sixteen healthy schoolchildren aged 6-8 years, with at least 2 sound contralateral partly erupted permanent molars, received diet counselling and daily parental supervised toothbrushing with a fluoride dentifrice. Stimulated saliva samples were collected at baseline and after 1 year to evaluate MS levels. In a split-mouth design, Cervitec varnish was applied to one of the teeth at baseline and after 3 and 6 months, while the other tooth in the same jaw was a control. At the 9-month follow-up the teeth were in occlusal contact. At this time, varnish was not applied. At 3 and 6 months after the first application of varnish a significant suppression of MS was observed in plaque. Caries investigations, performed at baseline and every 3 months during the 2 years after the start of the study, showed that all the teeth treated with the varnish were free of caries after 2 years, whereas 8/16 control teeth developed incipient caries. In conclusion, our results suggest that treatment with Cervitec reduces MS in plaque on erupting permanent molars and can lead to a significant decrease in caries incidence. Copyright (C) 2002 S. Karger AG, Basel.