Chlorhexidine Gel Research Articles

Inhibition of cocoa peel (theobroma cacao l.) extract gel on growth of staphylococcus aureus

Objective: The aim of this study was examined the inhibition of cocoa peel (Theobroma cacao L.) ethanol extract gel against the growth of Staphylococcus aureus. One of antimicrobial agents that is frequently used for treatment of S.aureus infection is chlorhexidine. Prolonged use of chlorhexidine can cause side effects, such as discoloration of teeth, restorations and tongue, and also desquamative lesions of oral mucosa. Therefore, to minimize the side effects of synthetic antimicrobial agents, an alternative antimicrobial therapy is needed, such as topical antimicrobials derived from natural ingredients like cocoa peel. Material and Methods: This study was an in vitro laboratory experimental study with a post test only control groupdesign. Identified cocoa peel were extracted using ultrasonic method with ethanol 70% then formulated into gel with dosage of 20 mg/ml, 40 mg/ml, 80 mg/ml, 160 mg/ml, and 320 mg/ml, then tested using disk diffusion method and compared with positive control, chlorhexidine gel and negative control, gelling base. Result: Inhibition zone was formed in group of cocoa peel ethanol extract gel with dosage of 80 mg/ml, 160 mg/ml, and 320 mg/ml, which indicated that there was inhibition activity against Staphylococcus aureus. The results of statistical tests showed that there were significant differences between sample groups. Conclusion: ethanol extract gel of cocoa peel (Theobroma cacao L.) can inhibit the growth of Staphylococcus aureus with dosage of 80 mg/ml, 160 mg/ml, and 320 mg/ml.

Microbiological profile of root canals indicated for endodontic retreatment due to secondary endodontic infections or for prosthetic reasons.

The objective of this study was to evaluate the microbiological profile of root canals indicated for endodontic retreatment due to secondary endodontic infections evidenced by the presence of chronic apical periodontitis (G1) or for prosthetic reasons, without clinical and radiographic signs of endodontic reinfection (G2). Microbiological samples were collected from thirty teeth (N=30) out of which 15 were indicated for retreatment due to the presence of chronic apical periodontitis (G1) and 15 were indicated exclusively for prosthetic reasons (G2). Samples were collected from root canals before (S1), after chemomechanical preparation (S2), and after 30 days of intracanal medication composed of calcium hydroxide and 2% chlorhexidine gel (S3). The molecular analysis was performed using Nested-PCR for the detection of 17 bacterial species. The efficacy of each stage of the retreatment in reducing the microbial load was verified by counting colony-forming units (CFU). The statistical analysis considered a significance level of 5%. The results showed that bacteria were detected in 100% of the cases in S1, in both groups, by Nested PCR. The most frequently found species in S1 in both groups were Enterococcus faecalis, Fusobacterium nucleatum, Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, and Parvimonas micra. The microbial load of G1 was higher than G2 in the initial samples (S1). Endodontic retreatment was effective in reducing the microbial load in G1 and G2. Statistically significant associations were found between specific bacteria and clinical signs and symptoms. It was concluded that the microbial community present in the root canal of teeth indicated for endodontic retreatment is mixed and heterogeneous. G1 and G2 differ in the number of species per case and microbial load. Endodontic retreatment was effective in reducing the microbial load. Statistically significant associations were found between specific bacteria and clinical signs and symptoms.

Sociocultural practices, beliefs, and myths surrounding newborn cord care in Bayelsa State, Nigeria: A qualitative study.

Persisting sociocultural beliefs have continued to significantly influence the adoption of recommended newborn care practices by women in Sub-Saharan Africa. This study aimed at identifying the sociocultural practices, beliefs, and myths surrounding newborn cord care by women residing in Bayelsa State, Nigeria. This was a qualitative study that involved 24 women and 3 traditional birth attendants (TBAs) in three focus group discussions and three in-depth interviews respectively. Interview guides were used to lead the discussions and the interviews which were audiotaped, translated and then transcribed. Thematic analysis was done using NVivo QSR version 12.2 Pro. Several themes describing various sociocultural practices, beliefs, and myths surrounding cord care were uncovered. Most women preferred to be delivered by a TBA who usually cuts the infant's cord with a razor blade and ties the stump with hair or sewing thread. Substances used for cord care included methylated spirirt, "African never-die" leaf, and "Close-Up" toothpaste. All the participants agreed that methylated spirit was a potent antiseptic for cord care but none of them had heard about nor used chlorhexidine gel. It was a common belief that abdominal massage and the application of substances to the cord were solutions to common cord-related problems. Mothers, TBAs and relatives were influential regarding choices of cord care practices. Sociocultural practices, beliefs, and myths are still major barriers to the adoption of recommended cord care practices by women in Bayelsa State. Interventions should be targeted at improving delivery in health facilities and educating women in the community on good cord care practices.

Comparison of Cytotoxicity between Mineral Trioxide Aggregate Mixed with Chlorhexidine and Common Endodontic Regeneration Medicaments on Periodontal Ligament Stem Cells: an in Vitro Study.

Objectives: The combination of mineral trioxide aggregate (MTA) and 2% chlorhexidine (CHX) has been recently introduced as an intracanal medicament. The aim of this study was to evaluate the potential cytotoxic effects of MTA mixed with 2% chlorhexidine gel on human periodontal ligament stem cells (PDLSCs) and compare it with other common endodontic regeneration medicaments. Materials and Methods: Minimum inhibitory concentration and minimum bactericidal concentration of six experimental groups against Enterococcus faecalis was determined. The study groups consisted of RetoMTA mixed with 2% chlorhexidine gel (MTA+CHX), calcium hydroxide (CH), CH mixed with CHX gel, two concentrations of double antibiotic paste, and 2% CHX. The direct cytotoxic effect of minimum bactericidal concentration was evaluated by MTT on PDLSCs on days 1, 3, and 7. One-way ANOVA and post hoc tests were used for data analysis (P<0.05). Results: The viability of cells treated with MTA+CHX decreased significantly over time (P<0.05) making this group the most cytotoxic intracanal medicament on the 3rd and 7th days of treatment. On day one, the highest viability percentage was detected in the CH+CHX group followed by the CHX group. On day 3, CH+CHX and CHX groups displayed the highest viability percentage. On day 7, the highest viability was observed in the CHX group, which showed no significant difference with the control group (P=0.12). Conclusion: Regarding the antimicrobial potency of intracanal medicaments at minimum bactericidal concentration levels, CHX gel appears to be the least cytotoxic drug, while MTA+CHX shows the highest reduction in viability percentage.

Chlorhexidine gel topical application ameliorates inflammatory bone loss in experimental periodontitis

This study aimed to evaluate the impact of chlorhexidine (CHX) gel on inflammation-induced periodontal tissue destruction, osteoclastogenesis, subgingival microbiota, and on the modulation of the RANKL/OPG as well as inflammatory mediators during bone remodeling invivo. Ligation- and LPS injection-induced experimental periodontitis were created to investigate the effect of topical application of CHX gel invivo. Alveolar bone loss, osteoclast number and gingival inflammation was evaluated by micro-CT, histological, immunohistochemistry and biochemical analysis. The composition of the subgingival microbiota was characterized by 16S rRNA gene sequencing. Data shows significant decreases in the alveolar bone destruction in rats from ligation-plus-CHX gel group compared to ligation group. In addition, significant decreases in the number of osteoclasts on bone surface and the protein level of receptor activator of nuclear factor κB ligand (RANKL) in gingival tissue were observed in rats from ligation-plus-CHX gel group. Moreover, data shows significantly decreased inflammatory cell infiltration and decreased expression of cyclooxygenase (COX-2) and inducible NO synthase (iNOS) in gingival tissue from ligation-plus-CHX gel group versus ligation group. Assessment of the subgingival microbiota revealed changes in rats with CHX gel application treatment. HX gel presents protective effect on gingival tissue inflammation, osteoclastogenesis, RANKL/OPG expression, inflammatory mediators, and alveolar bone loss invivo, which may have a translational impact on the adjunctive use in the management of inflammation-induced alveolar bone loss.

Ozonized Hydrogels vs. 1% Chlorhexidine Gel for the Clinical and Domiciliary Management of Peri-Implant Mucositis: A Randomized Clinical Trial

Peri-implant mucositis consists of a reversible inflammation of peri-implant tissues characterized by bleeding on gentle probing in the absence of bone loss. Ozone therapy is being extensively studied for its efficacy in treating different dental conditions. To date, few studies have evaluated ozone as an adjunct to the oral hygiene measures of peri-implant mucositis patients. The aim of the present study is to assess the efficacy of an ozonized gel (Trial group) compared to chlorhexidine (Control group) after a domiciliary protocol of oral hygiene in a 6-month study. According to a split-mouth study design, patients were divided into Group 1 for the application of chlorhexidine gel in peri-implant mucositis sites of quadrants Q1 and Q3, whereas in quadrants Q2 and Q4, the ozonized gel was in-office administered. For Group 2, the quadrants were inverted. At baseline (T0), and after 1 (T1), 2 (T2), and 3 (T3) months, Probing Depth (PD), Plaque Index (PI), SI Suppuration Index (SI), Bleeding Score (BS) and Marginal Mucosa Condition (MMC) were measured. A statistically significant decrease was found for all the variables assessed in each group (p < 0.05), whereas significant intergroup differences were found only for PI, BoP, and BS. Accordingly, both agents tested in this study showed an efficacy in treating peri-implant mucositis. The ozonized gel deserves particular attention, considering the better outcome than chlorhexidine on specific clinical periodontal parameters, as well as its lesser shortcomings.

Aesthetic Restorations: The Role of The Dental Hygienist in Professional Maintenance: In Vitro Microbiological Study

The aim of this in vitro study is to try to identify a treatment in the field of professional oral hygiene techniques that is ideal and less invasive with regard to prosthetic restorations, chosen in lithium disilicate and feldspar ceramics. Seventeen veneers were prepared (eight in lithium disilicate and nine in feldspar ceramic) and each of them was attached to an extracted tooth. The treatment groups were initially contaminated in the Microbiology Laboratory of Università Vita-Salute San Raffaele. After 24 h they were treated with four different methods of professional oral hygiene and were then sent to the Microscopy Laboratory, in which they were analysed by SEM, with 180X, 250X, and 500X magnification, to assess any damage caused to the treated surfaces. The SEM analysis produced 64 images that were evaluated by an experienced dentist, and the use of the prophetic cup seemed to be the most suitable among the evaluated treatments. However, from a microbiological point of view, this method was the least effective in terms of reducing bacterial growth. In this regard, the use of a prophylactic rubber cup combined with a 0.20% chlorhexidine gel is recommended during professional oral hygiene sessions for the maintenance of aesthetic prosthetic restorations.

Difference of Two Antiseptic Gels for the Treatment of Peri-Implant Mucositis on Plaque Index and Bleeding Score: A Randomized Controlled Clinical Study

Aim: To analyze and compare the effectiveness of two antibacterial gels in the treatment of mucositis. Methods: After signing the informed consent, in accordance with the Helsinki Declaration of 1975, revised in 2000, 21 patients were included in the study and divided by randomization into two groups. At the baseline, the modified bleeding index (mBI) and plaque index (PI) values were measured, and an oral hygiene and implant disinfection session was carried out. The session was repeated at 7, 15, and 30 days and after 2 and 3 months from the baseline. Two products were used—a bioadhesive gel in the test group and a 1% chlorhexidine gel in the control group. Results: Due to three dropouts, the final sample was composed of 18 patients. An improvement in periodontal indices was observed, similar to mBI and PI values, in both groups. There were no complications except for the appearance of pigmentations in the control group. Conclusions: The antibacterial power and effectiveness of the two gels are comparable. Considering the small sample size of the study cohort, further studies are needed to validate the results obtained from this pilot study.

Regenerative therapy in young permanent tooth: Case report

Pulp necrosis in immature permanent teeth represents a challenge for clinical management. The dentin wall in immature teeth is thin and the root is short, leading to an unfavorable long-term prognosis due to the risk of root fracture. Regenerative endodontic procedures have been shown to be effective and improve the prognosis of the compromised immature tooth by re-establishing functional pulp tissue that promotes continued root development and immune competence. The objective of the study was to report a case of a young permanent molar, diagnosed with necrosis and incomplete rhizogenesis. A female patient, 08 years old, attended the clinic of the specialization course in Endodontics, Faculty of Dentistry São Leopoldo Mandic, Belo Horizonte Unit. Regenerative therapy was proposed, which involved the following steps: anesthesia, opening, odontometry, minimal instrumentation, disinfection with 2% chlorhexidine gel, irrigation with saline solution, intracanal medication with calcium hydroxide paste, induction of bleeding to form a blood clot, cervical sealing with mineral trioxide aggregate and composite resin. The patient remained symptom-free up to 5 months after treatment. However, radiographically, an increase in the periapical radiolucent area was noted, so it was decided to carry out the conventional endodontic treatment. Regenerative therapy can be an alternative to apexification in immature teeth in cases of irreversible pulpitis and pulp necrosis associated or not with a periapicalesionson. It is a simple treatment with advantageous results as it promotes an increase in the length and thickness of the dentin wall and apical closure as seen in the case described in this work.

Curcumin Gel Versus Chlorhexidine Gel for Treatment of Chronic Gingivitis Associated with Fixed Orthodontic Appliance

Background and aims: Gingivitis in orthodontic treatment remains a challenging and undesirable consequence of orthodontic treatment. Hence, a variety of chemical or herbal agents, methods, and techniques have been investigated to prevent or reduce gingivitis that occurs in orthodontic treatment. In this study, we will evaluate and compare the effect of curcumin (CMN) gel with chlorhexidine (CHX) gel on clinical parameters (plaque and gingival index) and oral bacterial number (total bacterial count test) in fixed orthodontic patients that have gingivitis. We are the first to use curcumin gel for patients that have gingivitis with fixed orthodontic appliances. Samples and Methods: Forty-five patients with fixed orthodontic appliances with metallic brackets that have generalized chronic dental plaque-induced gingivitis were selected randomly and divided into three groups - Group I (control), Group II (CMN), and Group III (CHX), respectively. Clinical parameters which are plaque index (PI) and gingival index (GI) were recorded at the baseline, 14 days, and 21 days of treatment, and a total bacterial count test (TBCT) was done for all the participants before and after treatment. Results: Both Curcumin and Chlorhexidine gel groups showed a significant reduction (P&lt;0.05) in PI, GI, and TBCT compared to the control group at the end of treatment (after 21 days). However, there was no significant difference between Curcumin and Chlorhexidine gel groups (P&gt;0.05). Conclusion: The results of this study show that curcumin and chlorhexidine gel have comparable anti-plaque, anti-gingivitis, and antibacterial activities and that both can be used to effectively treat plaque-induced gingivitis.

Comparative Evaluation of 4% Cranberry Gel And 1% Chlorhexidine Gel as an Adjunct to SRP in Gingivitis Patients.

Introduction - Cranberry, a native North American fruit, has lately come into spotlight owing to its multiple beneficial effects on periodontal health. Aim - To evaluate the anti-inflammatory and anti-plaque efficacy of 4% Cranberry gel as an adjunct to SRP in generalized moderate to severe gingivitis patients. Methodology - 30 subjects with age range of 17 to 60 years, with moderate to severe gingivitis were chosen for study, After Phase-I therapy, the subjects were randomly allocated to 2 groups: Group 1(Test)(n=15)–4% cranberry gel and Group 2(Control)(n=15)–1% chlorhexidine gel (Hexigel®). Subjects were instructed to apply the pea sized amount of gel topically on the gingival surface, two times a day after brushing and to keep it for 5 minutes during 14-day period. The clinical outcomes plaque index gingival index and modified sulcular bleeding index were recorded at baseline, 7 th day and 21st day. Using ttest, statical analysis was performed. Results – Both the group that received Cranberry gel and Hexi gel showed significant improvement in clinical parameters after 7 th and 21st days. However, on inter group comparison, there was no significant difference between two groups. Conclusion – The 4% Cranberry gel as well as 1% Hexi gel were seen to be similarly efficient in generalized moderate to severe gingivitis patients

An in vitro comparative evaluation of the effect of three intracanal medicaments – chlorhexidine gel, triple antibiotic paste, and calcium hydroxide paste on the push-out bond strength of MTA Plus, Biodentine, and calcium-enriched mixture

ABSTRACT Aim: Caries or traumatic injuries affecting young permanent teeth during root development usually result in an open apex which is highly challenging to treat. The aim of this study was to evaluate the push-out bond strength of apical plugs of Mineral Trioxide Aggregate (MTA) Plus, Biodentine, and calcium-enriched mixture (CEM) after premedication with chlorhexidine, triple antibiotic paste (TAP), and calcium hydroxide. Methods: Fifty-four extracted intact anterior teeth were decoronated and 3 mm was sectioned from the apex. The canals were rendered parallel using #80 K-files and #3, #4 Peeso reamers to mimic an open apex situation. The samples were divided into 3 groups containing 18 samples each for the three intracanal medicaments. After premedication, the samples were stored for 2 weeks at 37°C, following which the canals were cleaned using #80 K-file along with ethylenediaminetetraacetic acid and sodium hypochlorite irrigation. The samples were further divided into three subgroups, each containing six samples for the three calcium silicate cement used in this study. They were later subjected to push-out bond strength testing. Results: Regardless of the type of intracanal medicament used, Biodentine had significantly higher bond strength than MTA Plus and CEM. The highest push-out bond strength results were obtained in samples premedicated with chlorhexidine. Compared to TAP and calcium hydroxide (Ca(OH) 2), this value was statistically significant (P &lt; 0.001). Conclusion: Within the limitations of this study, Biodentine showed the highest push-out bond strength as compared to MTA Plus and CEM. Chlorhexidine may be superior to calcium hydroxide and TAP medicaments when used for apexification procedures with calcium silicate cement.

Corneal Blindness Caused by Accidental Ocular Use of Chlorhexidine (Hexz) Gel in Two Newborn Born in the Health District of Kati in Mali

Introduction: Corneal opacities in children are relatively common. In children, it is urgent because of the risk of irreversible amblyopia. The causes of these blindnesses vary considerably according to the regions of the world. Chlorhexidine digluconate is a broad-spectrum antiseptic directed against gram-positive and gram-negative bacteria. It has been used as an antiseptic for more than 50 years, both in humans and in animals. However, despite these benefits, it can cause serious damage if applied to the eyes. Incidents of eye damage with 7.1% chlorhexidine have been reported to WHO across Africa. Observation: We report and write two cases of bilateral corneal blindness caused by accidental ocular use of chlorhexidine (HEXZ) GEL 7.1% in two newborns in the health district of Kati in MALI. The ophthalmological examination had revealed corneal opacity, conjunctival hyperaemia and limbic ischemia greater than 50% in 1 eye out of 4, corresponding to stage IV of the ROPPER HALL classification; 2 eyes out of 4 were at stage III and 1 eye out of 4 was at stage I of the same classification. Conclusion: It is essential to ensure correct use of chlorhexidine digluconate gel 7%. It is an antiseptic which should not be used on the ocular and auditory mucous membranes, at the risk of most often permanent burns.

Disinfectant effectiveness of chlorhexidine gel compared to sodium hypochlorite: a systematic review with meta-analysis.

This study aimed to compare the disinfectant ability of chlorhexidine (CHX) gel and sodium hypochlorite (NaOCl). Systematic searches were conducted from inception until December 8th, 2022 (MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, Embase, and Grey Literature databases). Only randomized clinical trials were included. The revised Cochrane risk of bias tools for randomized trials were used to assess the quality of studies. Meta-analyses were performed. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool. Six studies were included. Five had a low risk of bias and 1 had some concerns. Three studies assessed bacterial reduction. Two were included in the meta-analysis for bacterial reduction (mean difference, 75.03 [confidence interval, CI, -271.15, 421.22], p = 0.67; I2 = 74%); and 3 in the meta-analysis for cultivable bacteria after chemomechanical preparation (odds ratio, 1.03 [CI, 0.20, 5.31], P = 0.98; I2 = 49%). Five studies assessed endotoxin reduction. Three were included in a meta-analysis (mean difference, 20.59 [CI, -36.41, 77.59], p = 0.48; I2 = 74%). There seems to be no difference in the disinfectant ability of CHX gel and NaOCl, but further research is necessary.

Implant abutment disinfection using plasma of argon and 0.2% and chlorhexidine gel applications immediately before prosthesis delivery: clinical and radiographic status at 5-years of follow-up.

The purpose of this five-year follow-up study was to investigate the clinical and radiologic status of implants that had undergone abutment disinfection immediately prior to prosthetic loading (PL) using plasma of argon (PA) or 0.2% chlorhexidine (CHX) gel. Sixty patients who had had an implant-supported prosthesis fitted at least five years previously were recruited for this study. In groups 1, 2, and 3, implant abutment disinfection was performed using PA, 0.2% CHX, and a vapor protocol, respectively. Modified plaque index (mPI), modified bleeding index (mBI), probing depth (PD), and mesial and distal crestal bone loss (CBL) were measured. A questionnaire on routine oral hygiene, smoking habits, and systemic health status was also administered. Sample size estimation was performed, and group comparisons were made. Probability values less than 0.05 were considered statistically significant. Group 1, 2, and 3 included 20 (20 implants) patients each. At five-year's follow-up, there was no difference in mBI, mPI, and PD in all groups. There was no significant difference in peri-implant CBL in all patients. None of the patients were immunosuppressed or had periodontal disease, and or had used nicotinic products within the past five years. Toothbrushing twice daily was reported by at least 90% of individuals in all groups. Flossing of interproximal spaces once daily was reported by at minimum 60% of individuals in all groups. Disinfection of implant abutments directly before PL can be performed using AP, or 0.2% CHX gel.

Quantitative assessment of umbilical cord care practices amongst mothers in Jos, Plateau State, Nigeria.

A newly cut neonatal umbilical stump is a potential portal of pathogen entry leading to omphalitis. Neonatal sepsis can complicate omphalitis, but good cord care practices can reduce this risk. The objective of this study was to assess umbilical cord care practices in tertiary-, secondary- and primary-level healthcare facilities in Jos, Nigeria. A multi-centre, cross-sectional study of 284 mothers of infants aged 3-6 weeks old attending immunisation clinics in the three-level healthcare facilities using multistage sampling technique between April and September 2019. Data were analysed using SPSS version 23.0. Pearson's Chi-squared test was used to compare categorical variables. Adjusted odds ratios (AORs) and 95% confidence interval (CI) were used as point and interval estimates, respectively. P < 0.05 was adjudged to be statistically significant. The mean age of the mothers and infants was 25 ± 6 years and 5 ± 1 week, respectively. Only 2.2% of mothers used chlorhexidine (CHX) gel for cord care. Mothers showed good knowledge but poor practice of cord care. A significant positive relationship was observed between quality of cord care practices and level of healthcare facility (χ2 = 15.213; df = 2; P < 0.001). Good cord care practices were predicted by mothers' age 30-46 (AOR = 3.6; CI: 1.4-9.1) and good knowledge of cord care (AOR = 4.7; 95% CI: 2.2-9.9). The study has highlighted the good knowledge but poor practices of cord care by mothers and the need to scale up the uptake of CHX gel in Jos. Mother's age and good knowledge of cord care are predictors of good cord care practices.

Evaluation and comparison of antibacterial effects of a licorice gel and chlorhexidine gel on Porphyromonas gingivalis, Aggregatibacter actinomycetamcomitans, and Tannerella forsythia – An in vitro study

INTRODUCTION: Periodontitis is known to cause inflammation and progressive breakdown of tooth-supporting structures. The treatment for periodontitis includes scaling and root planing that effectively removes the disease causing plaque and antimicrobial agents such as chlorhexidine (CHX) used as an adjunct to maintain the healthy state of tissues. However, these antimicrobial agents have unpleasant side effects that have led researchers toward discovering, isolating, and developing natural herbal plant extracts as effective antimicrobial agents. Hence, the purpose of the study was to assess and compare the antimicrobial activity of the one such herbal plant extract Glycyrrhiza glabra (licorice) gel and CHX gel on periopathogens.MATERIALS AND METHODS: The hydroalcoholic root extract of G. glabra (licorice) was prepared through maceration, evaporation, and lyophilization to obtain dried crude extract. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the G. glabra extract against Porphyromonas gingivalis, Aggregatibacter Actinomycetemcomitans, and Tannerella forsythia were determined using broth dilution method and streaking on blood agar plates. The gel was then prepared accordingly using Carbopol 940. The antibacterial activity of the prepared G. glabra gel was tested and compared to CHX gel using the agar well diffusion assay.RESULTS: The MIC of G. glabra extract was found to be 15 mg against A. actinomycetamcomitans and T. forsythia and 7.5 mg against P. gingivalis. The MBC of the G. glabra extract was 30 mg for all three organisms. The antibacterial effects of the prepared licorice gel were assessed using agar well diffusion assay, and it showed that 100 μl of prepared licorice gel had a greater effect on A. actinomycetamcomitans and T. forsythia but not P. gingivalis.CONCLUSION: Licorice extract showed inhibitory activity against P. gingivalis, A. actinomycetamcomitans, and T. forsythia.

The microbial community of persistent endodontic infection and the use of root canal disinfectants against E. faecalis: In vitro and in vivo review

In cases of unsuccessful endodontic treatment, E. faecalis is commonly detected and remains popular among the scientific community for in vitro and in vivo research. The nature of the bacteria's predominance is dependent on the difficulty in cleaning the apical portion of the tooth and E. faecalis' capacity to grow deep into the dentinal tubules. The purpose of this review is to gather current research on root canal disinfection against E. faecalis. In this literature review, four databases were searched: PubMed, EBSCOhost, ScienceDirect, and Google Scholar, with explicit inclusion and exclusion criteria. The compiled review shows that a predominant multi-microbial community within a persistent root canal infection include Porphyromonas gingivalis, Fusobacterium nucleatum, and Enterococcus faecalis. E. faecalis produces moderate biofilms and causes infection through its virulence factors such as esp, cylA, ace, gelE, asa, and efaA. Several disinfecting agents and approaches have been explored for their capacity to eradicate E. faecalis and penetrate the dentinal tubules. Sodium hypochlorite (NaOCl) and chlorhexidine (CHX) gel eliminate E. faecalis and other resistant microbes such as Staphylococcus aureus, and Escherichia coli. Combing NaOCl irrigation with the following: Photon-induced photoacoustic streaming, passive ultrasonic irrigation, and diode laser irradiation, eradicates E. faecalis. The current research has shifted towards nanoparticles against E. faecalis because of its dissolution capacity, size, and antimicrobial efficacy. E. faecalis resists calcium hydroxide through its proton pump mechanism, but it is susceptible to Ca(OH)2 when applying a proton pump inhibitor or chlorhexidine.

Comparative Evaluation of Metformin Gel and Chlorhexidine Gel as Adjunct to Scaling and Root Planning in the Treatment of Chronic Periodontitis: A Clinical Study

Introduction: Pyorrhoea is an inflammatory gum disease in which destruction of tooth supporting tissues that results ultimate tooth mobility and exfoliation. In local drug delivery (LDD), which includes the delivery of therapeutic agents like Irrigating systems, fibers, gels, strips, films, microparticles, nanoparticles and low dose antimicrobial agents via systemic and local route as an adjunct to mechanical therapy which has beneficial for periodontal therapy. Aim: To evaluate and compare the efficacy of subgingivally delivered 1% Metformin gel and Chlorhexidine gel as an adjunct to scaling and root planing in the management of patients with chronic periodontitis. Materials and Method: Twenty systemically healthy patients with the age group of 20-60 years irrespective of gender suffering from generalized chronic periodontitis were selected, in which fourty sites were randomized at split mouth level and divided into two groups: (Group A -SRP+1% Metformin gel and Group B - SRP+ 0.2% Chlorhexidine gel). Parameters such as, Plaque index (PI), Modified gingival index (MGI), Probing pocket depth (PPD), and Relative clinical attachment level (R-CAL) were measured at baseline and after 1 month and 3 months. The significance of difference within and between the groups was evaluated with paired and unpaired t-tests. Result: In our study, the mean Plaque index (PI), Modified gingival index (MGI), Probing pocket depth (PPD), and Relative clinical attachment level (R-CAL) showed a statistically significant difference from baseline to 1 month and 3 months (p≤0.05) in both Group A and Group B. But, Mean PPD reduction and mean R-CAL gain was found to be greater in Group-A than Group B at 1 month and 3 months. Conclusion: Both Metformin and 0.2% Chlorhexidine gel can be considered as effective as a LDD agent adjunct to scaling and root planning (SRP) in the management of chronic periodontitis. But, 1% Metformin gel was more effective as a LDD adjunct to SRP in curative of chronic periodontitis patient than Chlorhexidine gel (Cevitec gel).

Comparison of reverse torque values of abutment screws with the application of oil-based and water-based antibacterial agents.

Using antibacterial agents to remove the foul odor of the implant cavity and prevent peri-implantitis can affect the detorque values and lead to the loosening of the abutment screw. This study investigated the effects of tetracycline and chlorhexidine gel on detorque values. This in vitro study was carried out on three groups of five implants. Group G1 was the control group, and no material was applied to the implant cavity. In group G2, the implant cavity was first filled with artificial saliva and then with chlorhexidine gel. In group G3, the implant cavity was first filled with artificial saliva and then with tetracycline. The abutments were tightened with 25 N/cm2 and then loosened. Finally, the detorque values were calculated. The highest detorque values were recorded in group G1. Group G3 showed the lowest detorque values. ANOVA showed significant differences in mean detorque values (P<0.05) between the three groups. According to this study, applying antibacterial agents decreased the detorque values and increased the risk of screw loosening. The reduction of detorque values was more pronounced with the oil-based antibacterial agent (tetracycline).