Abstract
BackgroundChlorhexidine gluconate (CHG) has been proven to be effective in preventing and controlling biofilm formation. At the same time, an increase in calculus formation is known as one of considerable side effects. The purpose of this study was to investigate whether mineral deposition preceding a calculus formation would occur at an early stage after the use of CHG using an in vitro saliva-related biofilm model.MethodsBiofilms were developed on the MBEC™ device in brain heart infusion (BHI) broth containing 0.5% sucrose at 37 °C for 3 days under anaerobic conditions. Biofilms were periodically exposed to 1 min applications of 0.12% CHG every 12 h and incubated for up to 2 days in BHI containing a calcifying solution. Calcium and phosphate in the biofilm were measured using atomic absorption spectrophotometry and a phosphate assay kit, respectively. Morphological structure was observed using a scanning electron microscope (SEM), and chemical composition was analyzed with an electron probe microanalyzer (EPMA).ResultsThe concentrations of Ca and Pi following a single exposure to CHG increased significantly compared with the control. Repeatedly exposing biofilms to CHG dose-dependently increased Ca deposition, and the amount of Ca was five times as much as that of the control. Pi levels in CHG-treated biofilms were significantly higher than those from the control group (p < 0.05); however, the influence of the number of exposures was limited. Analyses using an SEM and EPMA showed many clusters containing calcium and phosphate complexes in CHG-treated biofilms. Upon composition analysis of the clusters, calcium was detected at a greater concentration than phosphate.ConclusionsFindings suggested that CHG may promote mineral uptake into the biofilm soon after its use. It is necessary to disrupt the biofilm prior to the start of a CHG mouthwash in order to reduce the side effects associated with this procedure. The management of patients is also important.
Highlights
Chlorhexidine gluconate (CHG) has been proven to be effective in preventing and controlling biofilm formation
Periodontal diseases are initiated by bacterial biofilms that induce a host inflammatory immune response, which could lead to tooth loss and contribute to systemic inflammation [1]
Since the oral biofilm can be removed without surgical intervention, mechanical elimination such as brushing and flossing is fundamental for its control [2,3,4]
Summary
Chlorhexidine gluconate (CHG) has been proven to be effective in preventing and controlling biofilm formation. The purpose of this study was to investigate whether mineral deposition preceding a calculus formation would occur at an early stage after the use of CHG using an in vitro saliva-related biofilm model. One of the most widely used and thoroughly investigated antiseptics is chlorhexidine gluconate (CHG), which is used in CHG oral rinse. This has been proven to be safe, stable, and effective in preventing plaque formation and inhibiting the development of gingivitis [7, 8]
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