Chlorhexidine as a Disinfectant in the Prosthodontic Practice: A Comprehensive Review.

Abstract

Controlling the cross-contamination between the dental clinic and laboratory is of utmost importance to maintain the health of dental healthcare personnel (DHCP) and patients. The aim of this paper was to review the current literature with regard to the use of chlorhexidine as a prosthetic disinfectant in prosthodontic practice. A scoping review of the literature was performed in Medline/PubMed, Ovid Embase, and the Cochrane Library. A search for all literature published from 1980 to 2021 was based on the following keywords: ['Chlorhexidine/gluconate' OR 'chlorhexidine', OR 'gluconate', OR 'denture disinfectants', OR 'antimicrobial', OR 'disinfectant', OR 'impression disinfectants, OR prosthesis' OR 'biofilm, microbiology'] OR [teeth]. We reviewed the disinfectant in terms of its mechanism of action, antimicrobial effectiveness, disinfection techniques, clinical applications, corrosiveness/damage to the structure of prostheses, and reasonable shelf life. Chlorhexidine was tested under different concentrations ranging from 0.2 to 5%. It provided a significant reduction in biofilm viability but had a minimum effect on Candida albicans with a variable effect result that showed no significant differences in the dimensional changes by immersion of alginate dental impressions for no more than 10 minutes and no clinically significant dimensional differences on aluwax, polyether, condensation siloxane, and polyvinyl siloxane were noticed. Nonetheless, chlorhexidine altered the surface of the silicone and acrylic resins and affected the long-term hardness of the relining material. Within the limitations of this review, the use of chlorhexidine disinfectant demonstrates a good measure in the reduction of contamination and cross-infection and has a minimal effect on the dimensional stability of most impression materials. Further studies with in-vitro testing are required to confirm these findings.