Chlorhexidine Gluconate Gel Research Articles

Comparative clinical efficacy of Murraya koenigii gel and chlorhexidine gluconate gel for improvement of oral health

Comparative clinical efficacy of Murraya koenigii gel and Chlorhexidine gluconate gel for improvement of oral health Introduction: Gingivitis is a non-destructive, plaque induced disease that causes inflammation of the gums. Chlorhexidine is regarded as the gold standard agent due to its chemical substantivity and clinical efficacy in chemical plaque control. Nowadays, herbal products are widely substituting synthetic antimicrobials due to their minimal side effects and cost effectiveness. Murraya koenigii (curry leaf) is an easily available green leaf in the Indian subcontinent, known for its antimicrobial, antioxidative, and cytotoxic activity. Objective: This study was aimed to evaluate the effectiveness of M. koenigii gel in reduction of plaque and gingivitis when compared with commercially available Chlorhexidine (Hexigel) gel. Materials and Method: This single center, randomized controlled clinical trial was carried out among 40 participants with moderate gingivitis. After scaling, they were divided into two groups: Group I (control) and Group II (Test) [n=20] and were instructed to use Chlorhexidine gel and M. koenigii gel respectively. Clinical parameters (PI & GI) were recorded on baseline and 15 days later. Student’s paired t‑test and independent t-test were used for intra and inter group comparison of clinical parameters. Results: On intra-group comparison, both the groups showed a statistically significant difference (P = 0.001). Inter-group comparison, showed no statistically significant difference between the two groups. (P > 0.05) Conclusion: M. koenigii gel is equally effective as Chlorhexidine gel, in treating plaque induced gingivitis.

Effect of Chlorhexidine and Ozone Gel on Microleakage and Shear Bond Strength of Dentin Bonding Agents in Composite Resin Restorations of Primary Teeth

Aim: This study aimed to investigate the effects of two antimicrobial agents on shear bond strength and microleakage of composite resin restorations in primary teeth. Methods: Sixty extracted primary molars and canines were assigned to three different groups according to the dentin surface pretreatment (2% chlorhexidine gluconate gel, ozone gel, and control group) and two subgroups (sound and caries-affected dentin) for shear bond strength tests. For the microleakage test process, a class V cavity was prepared on the buccal surface of the teeth and restored with composite resin. Then, all the teeth were cut buccolingually. The depth of stain penetration in each specimen was measured separately according to the scale. The data have been analyzed using SPSS 24 software. Results: In both sound and caries-affected dentin, ozone gel exhibited higher shear bond strength than chlorhexidine gel and the control group (P<0.001). Chlorhexidine gel had no significant effect on the shear bond strength of sound dentin (P=0.561), but it reduced it in the caries-affected dentin (P<0.001). With both disinfectants, the shear bond strength of the caries-affected dentin was significantly lower than that of the sound dentin. The application of chlorhexidine gel to caries-affected dentin resulted in more microleakage than sound dentin. In addition, the amount of microleakage in the ozone gel group was similar in both types of dentin. Conclusion: In both sound and caries-affected dentin, ozone gel was associated with higher shear bond strength than chlorhexidine gel; furthermore, chlorhexidine increased microleakage and ozone gel decreased it.

Chlorhexidine gluconate-coated gel pad dressings for prevention of central venous catheter-related bloodstream infections in patients with hematologic diseases or autologous stem cell transplantation: A registry-based matched-pair analysis.

Chlorhexidine gluconate (CHG)-coated gel pad dressings for central venous catheter (CVC) may prevent CVC-related bloodstream infections (CRBSI). However, real-world data showing beneficial effects in patients with hematologic malignancies are scarce. In a matched-pair analysis with data from a multicenter CVC registry, non-tunneled jugular and subclavian vein CVC in adults with hematologic malignancies or germ cell tumors (including patients receiving autologous hematopoietic stem cell transplantation [ASCT]) with CHG were compared with non-CHG dressings. The primary endpoint was definite CRBSI rate within 14 days (dCRBSI14) of CVC insertion; secondary endpoints were combined rate of definite or probable CRBSI within 14 days (dpCRBSI14), overall (dpCRBSI), and CRBSI incidences of all estimates. In total, 2070 CVCs were assessed. There was no statistically significant difference in dCRBSI14 (2.3% vs. 3.5%) between patients with and without CHG gel dressings. Likewise, with regards to dpCRBSI14 (6.2% vs. 6.3%) and the overall dpCRBSI rate (9.2% vs. 10.5%), no significant difference was detected. Furthermore, dCRBSI14 incidence (2.0 vs. 3.2/1000 CVC days), dpCRBSI14 incidence (5.4 vs. 5.6/1000 CVC days), and overall CRBSI incidence (5.5 vs. 6.0/1000 CVC days) showed no significant differences. CRBSI rates were not reduced by the use of CHG gel dressings in patients with hematologic malignancies and/or ASCT.

Efficacy of methylene blue and curcumin mediated antimicrobial photodynamic therapy in the treatment of indirect pulp capping in permanent molar teeth

PurposeThis study aimed to evaluate the adhesive bond strength and antibacterial efficacy of methylene blue (MB)-mediated antimicrobial photodynamic therapy (aPDT) and curcumin (CUR)-mediated aPDT versus the conventional disinfectants, such as chlorhexidine gluconate (CHX) gel and sodium hypochlorite (NaOCl), for indirect pulp capping (IPC) treatment of permanent molars. MethodsOne Hundred grossly carious human permanent molars were collected through non-traumatic extraction. All specimens were embedded in polyvinyl cross-sections to the cemento-enamel junction. The cavity preparation was conducted by grinding the samples using silicon carbide discs. After culturing Streptococcus mutans (S. mutans), a 10 µL of S. mutans suspension (106 colony forming units/mL) was transferred in each tooth cavity and anaerobically incubated for 48 h at 37 °C. All specimens were randomly divided into 5 groups: Group-I: samples treated IPC; Group-II: samples treated with 2% CHX gel; Group-III: samples treated with 6% NaOCl; Group-IV: irradiation of prepared cavity with MB-mediated aPDT; and Group-V: irradiation of prepared cavity with CUR-mediated aPDT. After disinfection methods, the universal adhesive was used, and all specimens were restored using giomer. Eventually, confocal laser scanning microscopy, shear bond strength (SBS), micro-tensile bond strength (μTBS), four-point bending strength (4P-BS) analyses were performed, and the data were analyzed statistically. ResultsAt baseline, the highest SBS (48.8 ± 6.5 MPa), μTBS (54.3 ± 3.9 MPa), and 4P-BS (123 ± 32 MPa) scores were demonstrated by the samples treated with MB-mediated aPDT. However, after 12 months of storage, the highest SBS (42.3 ± 3.9 MPa) and μTBS (45.2 ± 6.6 MPa) scores were shown by samples treated with MB-mediated aPDT, while CUR-mediated aPDT treated samples demonstrated the highest 4P-BS scores (70 ± 18 MPa). Moreover, the highest antibacterial activity against S. mutans was shown by the samples treated with MB-mediated aPDT. ConclusionsThe application of aPDT, especially MB-mediated, demonstrated superior SBS, μTBS, and 4P-BS values as well as antibacterial activity against S. mutans as compared to 2% CHX gel and 6% NaOCl as cavity disinfectants for IPC treatment of permanent molars.

Comparative Evaluation of Antimicrobial Efficacy of Fluoride-Based and Self-Assembling Peptide P11-4-based Tooth Remineralization Agents on Streptococcus mutans: A Microbiological Study.

Dental caries is a biofilm-related oral disease that continues to afflict the majority of the world's population. The disease results from an interaction between specific bacteria and dietary constituents within a biofilm known as dental plaque. Among the cariogenic microorganisms, Streptococcus mutans (S. mutans) plays pivotal role in caries-inducing processes. Evaluate and compare the antimicrobial efficacy of self-assembling peptide P11-4-based tooth remineralization agents on S. mutans. An in vitro microbiological study. The antibacterial efficacy of self-assembling peptide P11-4 gel (Group 1), fluoride enhanced hydroxyapatite gel (Group 2), acidulated phosphate fluoride gel (Group 3), chlorhexidine gluconate gel 1.0% w/w (Group 4; positive control), and normal saline (Group 5; negative control) was performed using time-kill assay over a period of 24 h and the number of S. mutans colony-forming units (CFUs) were calculated. Statistical analysis was done using Kruskal-Wallis test and Mann-Whitney post hoc Test. The level of significance was set at P < 0.05. Group 1 showed mean CFUs (× 103) of 841.33 ± 3.51, Group 2 showed 10035.33 ± 60.68, Group 3 showed 1058.00 ± 56.96, Group 4 showed 0.00 ± 0.00, and Group 5 showed mean CFUs with 15226.67 ± 96.67. The difference in the mean CFUs (× 103) between different groups was statistically significant at P < 0.001. The self-assembling peptide P11-4-based tooth remineralization agent exhibited an inhibitory influence on S. mutans and hence formation of cariogenic bacteria dominant biofilm can thus be affected by its application.

Comparative Effectiveness of 2 Chlorhexidine Gluconate-Containing Dressings in Reducing Central Line-Associated Bloodstream Infections, Hospital Stay, and Costs.

Chlorhexidine gluconate (CHG)-containing dressings are recommended to prevent central line associated bloodstream infections (CLABSIs) and other catheter-related infections. This study compared the effect of 2 CHG dressings on CLABSI, cost of care, and contact dermatitis. A retrospective analysis was conducted using the Premier Healthcare Database of hospitalized patients (n = 53 149) with central venous catheters (CVCs) and receiving either a transparent CHG gel dressing (n = 14 488) or an opaque CHG sponge dressing (n = 38 661) between January 2019 and September 2020. Two cohorts (n = 14 488 each), CHG-Gel and CHG-Sponge, were matched 1:1 using a propensity score method on 33 patient and facility characteristics. CLABSI and contact dermatitis rates, hospital length of stay (LOS), and hospitalization costs were compared using mixed-effect multiple regression. This approach effectively controlled for random clustering effects across hospitals and patients' Diagnosis-Related Group (DRG) classifications. CHG gel dressings were associated with a 41% decrease in CLABSI rates (P = .0008) compared to CHG sponge dressings (0.35%vs 0.60%). A 0.4-day shorter LOS (9.53vs 9.90 days, P = .0001) and a cost saving of $3576 per hospital stay ($40 197 vs $43 774, P = .0179) was observed with CHG gel dressing use. There was no statistically significant difference in contact dermatitis rates (P = .7854) between the CHG-Gel and CHG-Sponge cohorts. The findings of this study suggest that the use of CHG gel dressings may be more effective in reducing the risk of CLABSIs and associated clinical costs compared to CHG sponge dressings in hospitalized patients. Moreover, there appears to be no significant discrepancy in contact dermatitis rates between CHG gel and CHG sponge dressings. Healthcare providers may consider using CHG gel dressings as a standard practice for patients with CVCs to reduce the risk of infections and improve patient outcomes.

Clinical Efficacy of 1% CHX Gluconate Gel and 0.12% CHX Solution: A Randomized Controlled Trial.

Chlorhexidine (CHX) is an effective antibacterial agent and is used in dental treatment in several formulations. The aim of this study was to compare the effectiveness of CHX solution and CHX gel on dental plaque inhibition and gingivitis relief by a randomized clinical trial. Thirty-eight participants were randomly divided into two groups: control group (0.12% CHX solution) and test group (1% CHX gel). Participants were provided with CHX products and were instructed to use each product in the morning and evening for 1 week. Clinical results were evaluated by analyzing the collected data of Turesky et al. the modified Quigley-Hein Plaque Index (TQHPI), gingival index (GI) and the BANA test. Measurements were conducted 4 weeks and 8 weeks after using chlorhexidine products. The results were analyzed using repeated measured ANOVA and paired t-test. TQHPI and GI were significantly different after treatments in both groups (p < 0.001). The GI decreased more in the test group compared to the control group 4 weeks and 8 weeks later. In both groups, the BANA score also significantly decreased (p < 0.001) after 8 weeks, though the BANA score decreased relatively more in the CHX gel group than the CHX solution group. These results suggest that 1% CHX gel is more effective in reducing gingivitis and bacteria of periodontal disease than the 0.12% CHX solution. Therefore, the 1% CHX gel is expected to be actively used for non-surgical treatment of periodontal disease patients.

THE EFFECTIVENESS OF PHALERIA MACROCARPA’S LEAF NANOEMULSION GEL ON STAPHYLOCOCCUS AUREUS BIOFILM THICKNESS (IN VITRO)

Background: Periodontal disease often occurs in the oral cavity with 75.6-78.3% at the age of 35-44 years. One of the causes of periodontal disease is the accumulation of Staphylococcus aureus biofilm in the early colonization of the formation of the dental pellicle. Phaleria macrocarpa, also known as Gods Crown, is a traditional plant with antibacterial properties that can be used in the health sector. Nanoemulsion gel technology has the advantage of increasing the stability of the material. Aim the study to determine the ratio of the effectiveness of Phaleria macrocarpa’s leaf nanoemulsion gel 10%, 20%, 30% to decrease Staphylococcus aureus biofilm thickness. Method: This research method was in vitro experimental laboratory research using a post-test control design. Thirty samples were divided into five groups: Phaleria macrocarpa’s leaf nanoemulsion gel 10%, 20%, 30%, positive control using chlorhexidine gluconate 0.2% and negative control using aqua dest. Samples were incubated for 4 and 8 hours. Optical density readings were carried out to see the biofilm thickness after being given a Gods Crown leaves nanoemulsion gel Results: The mean of Phaleria macrocarpa’s leaf nanoemulsion gel, 30%, produced the lowest average optical density value. The incubation time of 4 hours resulted in a lower optical density value than 8 hours. The Kruskal-Wallis was p&gt;0.05 showed there was no difference in biofilm thickness in each group. Conclusion: the effectiveness of the nanoemulsion group of Dewa crown leaf gel with a concentration of 30% was better than the 0.2% chlorhexidine gluconate gel and sterile distilled water group.

Microbial analysis of endodontic infections in teeth with post-treatment apical periodontitis before and after medication.

This study aimed to determine the intraradicular microbiota of previously root canal-treated teeth with apical periodontitis and to investigate the antibacterial effectiveness of different intracanal medicaments. Sixteen patients with post-treatment apical periodontitis were allocated into two groups according to the intracanal medicament used: calcium hydroxide (CH) and 2% chlorhexidine gluconate gel (CHX) group. Total bacterial loads, as well as the amount of Enterococcus faecalis (E. faecalis) were determined before (S1) and after (S2) chemomechanical preparation and finally, after intracanal medication (S3) by means of ddPCR. The unpaired t test was used to compare parametric. S3-total bacteria copy number of the CH group was lower than the CHX group (p<0.05). There was no statistical difference between the CHX- and the CH groups in terms of E.faecalis copy number (p>0.05). But in terms of total bacteria, CH is better than CHX. Consequently, CH can be used to optimise the antibacterial efficiency of chemomechanical preparation in previously root canal-treated teeth with apical periodontitis.

Efficacy of Ozone Oil Compared with Chlorhexidine Gluconate Gel (1% w/w) for the Treatment of Gingivitis

Background:Ozone oil has both antimicrobial and antiinflammatory properties. This study was undertaken to compare the efficacy of ozone oil with chlorhexidine gluconate 1.0% w/w gel for the treatment of gingivitis.Methods:A triple-blind, controlled trial with parallel design was conducted for 28 days as a pilot study. Thirty participants aged 14–17 years were recruited. After baseline data collection involving gingival index (GI) and plaque index (PI), the products were distributed, scaling of teeth was done, and oral hygiene instructions were given. The participants were asked to apply the gel and oil topically and followed up on days 7 and 28.Results:A statistically significant difference (P&lt; 0.01) was seen within the ozone and chlorhexidine groups at the end of 28 days, showing a reduction in the plaque and gingival scores. At day 28, the reduction in plaque and gingival score was significant for the chlorhexidine group. It was found that chlorhexidine gel showed a greater reduction in the clinical parameters than the ozone oil, which was statistically significant but clinically similar. Both the products showed a substantial reduction in plaque scores. The participants from both the groups showed an improvement, having mild gingivitis post intervention.Conclusion:Ozone oil showed a significant reduction in the clinical parameters of PI and GI similar to chlorhexidine gel, thereby signifying its antimicrobial and antiinflammatory effects on the gingival tissues without any adverse effects, implicating the possession of properties required by a chemotherapeutic agent.

Comparative evaluation of antimicrobial efficacy of bioactive glass, 1% chlorhexidine gluconate with calcium hydroxide and 1% chlorhexidine gluconate, as intracanal medicament in primary molars: An in vivo study

Aims: To compare the antimicrobial efficacy of Bioactive glass, combination of 1% Chlorhexidine gluconate gel and Calcium hydroxide powder and 1% Chlorhexidine gluconate gel as intracanal medicament in primary molars.Settings and Design: In vivo study design Methods and Material: The present study was conducted in the Department of Pediatric and Preventive Dentistry, Krishnadevaraya College of Dental Sciences and Hospital, Bengaluru. This study included 48 subjects within the age group ranging from 4-11 years who were indicated for multi visit Pulpectomy. These subjects were randomly divided into three experimental groups, containing sixteen samples per group. Group 1: Bioactive glass; Group 2:1% Chlorhexidine gel and Calcium hydroxide powder; Group 3:1% Chlorhexidine gel. Under rubber dam isolation, following lesion sterilization S0 sample was obtained. Following access opening and working length, sample S1 was obtained and the respective medicament was placed inside the canals after cleaning and shaping and a double seal was done with ZOE and GIC. Patient was recalled after a period of 5 to 7 days and the medicaments were flushed under isolation and sample S2 was obtained. Pulpectomy procedure was then completed. S0, S1, S2 samples were subjected to microbiological analysis and the total bacterial count in CFU/ml was calculated.Statistical analysis used: Kruskal Wallis Test and One-way ANOVA.Results: The mean percentage of reduction of bacterial count from S1- S2 (Before and after placement of medicament) with Group 1: Bioactive glass was 75.7%, with Group 2:1% Chlorhexidine gluconate and calcium hydroxide was 52% and Group 3:1% Chlorhexidine gluconate was 28.6%, revealing that bioactive glass has the superior antibacterial efficacy when compared with other groups. Antibacterial efficacy of bioactive glass was significant in both primary maxillary and mandibular first molar and second molar proving it to work best for all types of root anatomy in mixed dentition population. Superior clinical and microbiological results were found when bioactive glass was used as intracanal medicament in both intraoral and extra oral abscess cases in primary molars.Conclusions: Bioactive glass; intracanal medicament; primary dentition; primary molar; mixed dentition.

A pilot study to evaluate the effectiveness of adjunctive use of two antimicrobial topical gels in chronic gingivitis

BackgroundGingivitis is one of the most prevalent oral disease in humans. The most important etiological factor of gingivitis is dental plaque. Plaque control procedures comprises of several mechanical and chemical methods. Many studies have advocated that chemical plaque control methods can be used successfully as an adjunct to mechanical plaque control procedures. Thus, the aim of this pilot study is to evaluate the effectiveness of two topical antimicrobial gels as an adjunct to mechanical plaque control over a period of 2 weeks in treatment of chronic gingivitis patients. Material and MethodsThis is a single blind, two arm parallel design pilot clinical study including 60 systemically healthy patients with 1) chronic generalized gingivitis (MGI>1), 2) probing depth ≤ 3mm and 3) zero clinical attachment loss. The study participants were randomly assigned into two groups i.e., Group I- Chlorhexidine Gluconate (CHX) gel, Group II- combination gel of Chlorhexidine gluconate and Metronidazole (CHX-MTZ) gel. Clinical parameters viz. Gingival Index (GI) and Modified Sulcus bleeding index (MSBI) were recorded firstly at baseline after Scaling and Root Planing(SRP), and secondly at the end of the study period of two weeks. Intra and inter-group comparisons of clinical parameters were done using appropriate statistical tests. ResultsThere was high significant reduction in GI and MSBI scores at the end of 2 weeks period in both the groups. Further, combination gel of Group II (CHX+MTZ) was found to be statistically more effective as compared to Group I (CHX) used alone. ConclusionsOur study suggests that Chemotherapeutic agents like CHX and combination CHX-MTZ Gel are clinically effective as adjunct to Scaling and Root Planning(SRP) in treatment of Chronic Gingivitis. Further, post statistical comparative analysis has proved CHX-MTZ combination gel regime to be more clinically effective than CHX gel used alone in treatment of Chronic Gingivitis as adjunct to SRP. Key words:Scaling and Root Planning (SRP), Chronic Gingivitis, Chlorhexidine Gluconate (CHX) gel, Combination (CHX+MTZ) Gel, Metronidazole (MTZ).

Evaluation of Plaque Removal Efficacy of Dental Floss with/without Chlorhexidine Gel Coating in Patients with Gingivitis - A Clinical and Microbological Study

BACKGROUND: Chlorhexidine has shown anti-plaque and antimicrobial effects when used as a mouthwash and appears to be effective when used as a topical antiseptic agent.&#x0D; AIM: The present study aimed to compare the efficacy of chlorhexidine gel coated dental floss with that of uncoated dental floss.&#x0D; METHODS: This parallel, single-blinded, randomized controlled clinical trial Included 30 patients with moderate to severe gingivitis. The total population was randomly divided into three groups, with ten patients in each group. Group A received dental floss with 1% chlorhexidine gel, and Group B received only dental floss, while in Group C no dental floss was provided. All thirty volunteers were provided with standard toothpaste and toothbrush. Clinical parameters such as gingival index, plaque index, and bleeding index were recorded along with supragingival plaque sample collection for microbiological culture. Subjects were recalled after 15 days and clinical and microbiological analysis was performed. All parameters were re-assessed at the follow up visit after two weeks.&#x0D; RESULTS: All the groups showed a significant reduction in values of plaque index, gingival index, and bleeding index, as well as the microbial counts post-enrollment in the study. A significant reduction in the bleeding indices was noticed in Group A in comparison to C (p &lt; 0.05).&#x0D; CONCLUSIONS: The use of dental floss coated with 1% chlorhexidine gluconate gel was effective as an interproximal aid for patients with moderate to severe gingivitis.

Materials Sealing Preventing Biofilm Formation in Implant/Abutment Joints: Which Is the Most Effective? A Systematic Review and Meta-Analysis.

The purpose of this systematic review was to evaluate the literature available for materials exhibiting the best efficacy in preventing biofilm formation in the interior of implants. We searched PubMed/MEDLINE, Scopus, and Cochrane databases. This review is registered with the PROSPERO database and followed the suitability of the PRISMA protocol. The initial search resulted in 326 articles from the databases. After they were read, 8 articles remained, and the inclusion and exclusion criteria were applied. Six of these 8 articles were classified as in vitro and 2 were classified as in situ. The regions of the implants evaluated ranged from the interface of the pieces to the occlusal upper access of the abutment. The implant connections evaluated the Morse taper, external connection, and internal connection. Meta-analysis of the quantitative data was performed at a significance level of .05. Cotton exhibited poor control of infiltration, even in combination with other materials. Isolated gutta-percha (GP) and polytetrafluoroethylene (PTFE) tape with composite resin (CR) or GP performed better as physical barriers. The best results for chemical barriers were observed by the application of 1% chlorhexidine gluconate (CG) gel, thymol varnish, and the deposition of Ag films onto the surface. The applied meta-analysis did not show a significant difference in comparison between the different types of implant connections (P > .05). The application of CG and thymol varnish antimicrobials was effective in preventing biofilm formation and easy clinical execution; these could be used in combination with CR, GP, and PTFE.

COMPARISON OF THE ANTIMICROBIAL EFFECTS OF SIX DIFFERENT INTRACANAL MEDICAMENTS ON ENTEROCOCCUS FAECALIS

Aim: to investigate the antimicrobial effects of six different intracanal medicaments on Enterococcus faecalis. Material & Methods: An agar well diffusion test was used to determine the efficacy of the experimental medicaments in removing E. faecalis (ATCC 29212). Medicaments were divided into 7 groups; calcium hydroxide (Ca(OH)2) with saline, Ca(OH)2 with anaesthetic solution, Ca(OH)2 with propylene glycol, commercially available premixed Ca(OH)2 paste, chlorhexidine gluconate gel, triple antibiotic paste (metronidazole, ciprofloxacin, doxicycline) with propylen glycol and talk powder with saline as negative control group. The diameters of the growth inhibition zones for each group were measured after 24 and 48 hours. Differences between groups were analysed using Kruskal-Wallis and Mann-Whitney U tests, and intragroup differences were analysed using Wilcoxon sign test. Results: Diameter of the inhibition zone observed for the triple antibiotic paste was significantly larger (p<0.01) and the diameter of the inhibition zone observed for the chlorhexidine gluconate gel was significantly smaller in comparison to the other tested medicaments (p<0.05). Conclusion: All of the tested medicaments were found to be effective on E. faecalis. However the results suggest that the triple antibiotic paste would be the preferred medicament against E. faecalis as it has the greatest antibacterial effect among the tested medicaments.

An in vivo comparative evaluation of antimicrobial efficacy of chitosan, chlorhexidine gluconate gel and their combination as an intracanal medicament against Enterococcus faecalis in failed endodontic cases using real time polymerase chain reaction (qPCR)

AimTo evaluate the in vivo antibacterial efficacy of 2% chlorhexidine gel (CHX), 2% chitosan (CS) gel and their combination as an intracanal medicament against Enterococcus faecalis during endodontic retreatment procedure, with the use of qPCR. MethodA total of 45 single rooted permanent teeth were selected from 28 systemically healthy patients (mean age of 43 years). After complete disinfection and access opening as well as gutta-percha (GP) removal, the first microbiological pretreatment sample (S1) was collected. After completion of instrumentation, a post-instrumentation sample (S2) was taken and the teeth were randomly divided into three experimental groups: 2% CHX gel; 2% CS gel; 2% CHX with CS; Fuji IX glass ionomer cement was used to seal the access; after 7 days, the post medication sample (S3) was collected and E. faecalis was quantified using qPCR. ResultsMaximum reduction in bacterial mean CFU (×106) counts was observed between S1 and S2; S2 and S3; S1 and S3 in 2% CHX with chitosan group compared to other groups. Percentage reduction in CFU (×106) counts at different time intervals (S1-S2; S2-S3; S1-S3) was maximum for the 2% CHX with the chitosan group. Comparison of the mean CFU (×106) count within the 2% CHX gel group and the 2% CHX with chitosan group at different time intervals (S1,S2,S3) was found to be highly significant (P = 0.001); whereas in group II, it was significant (P = 0.002). Conclusion2% CHX with chitosan group showed the highest microbial reduction against E. faecalis during retreatment of failed endodontic cases.

Evaluation of Topical Application of &amp;lt;i&amp;gt;Azadirachta indica&amp;lt;/i&amp;gt; (Neem) in Prevention of Gingivitis: A Randomized Control Trial

Background: The purpose of the present study was to envisage the anti-plaque and anti-inflammatory properties of neem (Azadirachta) in the form of a mouth gel. Materials and Methods: A total of 60 subjects (33 males and 27 females) from age group 19 - 35 years, suffering from mild to moderate gingivitis were randomly divided into two groups. Group A (n = 30) participants were advised experimental (neem) gel and Group B (n = 30) participants were advised 0.2% chlorhexidine gel. All the clinical parameters (the gingival index by Loe and Silness [1], Plaque index by Silness and Loe [2] and sulcus bleeding index by Muhlemann H. R. and Sen S. [3]) were recorded at baseline, on the 14th day and 21st day by the same clinician in both groups. Results: on intragroup comparison the gingival index, plaque index and sulcus bleeding index decrease significantly in both the groups in all assessed periods. On intergroup comparison the indices did not differ significantly at baseline but after 2nd and 3rd week, the indices in Group B decrease more than the group A, which was statistically significant. Conclusion: Based on the observations of our study, it can be concluded that chlorhexidine gluconate as well as neem gel can be effectively used as an adjunct to mechanical plaque control in prevention of plaque and gingivitis. chlorhexidine gluconate gel has been found to be more effective when antiplaque and anti-inflammatory properties were considered. The effect of neem observed maybe because of its anti-inflammatory action. The antiplaque action of chlorhexidine gluconate is due to its substantivity. Substantivity of neem is required to be further studied.

Comparing the Effect of Combination of 1% Ornidazole and 0.25% Chlorhexidine Gluconate (Ornigreat™) Gel and Aloe vera Gel in the Treatment of Chronic Periodontitis: A Randomized, Single-Blind, Split-Mouth Study.

Aim and Objective:The aim of this study is to compare the efficiency of subgingivally delivered 1% ornidazole and 0.25% chlorhexidine (CHX) gluconate (Ornigreat™ gel) and Aloe vera (AV) gel in the treatment of chronic periodontitis.Materials and Methods:Twenty chronic periodontitis patients with pocket depths ranging from 4 to 6 mm bilaterally at least in one site were included in the study. After a thorough nonsurgical periodontal therapy, 1% ornidazole and 0.25% CHX gluconate (Ornigreat™ gel) and AV gel were subgingivally delivered into the pocket sites, and the clinical parameters such as plaque index (PI), gingival index (GI), bleeding index (BI), and clinical attachment level (CAL) were evaluated at baseline and after 4 weeks.Results:In both the groups, a reduction in PI, GI, and probing depth readings was evidenced after 4 weeks. A significant improvement was noticed in the BI in the AV group when compared with that of Ornigreat™ group. Taking CAL into consideration, though improvement was there in both the groups, it was not appreciable.Conclusion:AV which is an herbal derivative when subgingivally delivered in the pocket site could be an equally effective and affordable substitute for Ornigreat™ gel.

The Impact of Early Dressing Removal on the Tunneled Central Venous Catheters

Background: There were many studies compared between different types of dressing such as chlorhexidine gluconate gel (CHG), (CHG) disc, gauze dressing and transparent dressing regarding its intact to the skin, infection rate and patients satisfaction. However, there was few studies regarding the impact of removing the dressing on the occurrence of exit site infection of tunneled central venous catheters. Aim: The objective of the current study was to evaluate the impact of early central venous catheter (CVC) dressing removal of the well-healed exit site infections. Methods: It was a quasi-experiment pilot study conducted over 15 months duration in a specialized oncology center. All adult patients who had newly inserted tunneled central venous catheters (CVC) in place were recruited. Patients were distributed to control and experimental group based on first come first served. Patients in the control group (n=8) received the standard protocol of applying (CVC) dressing, while patients in the interventional group (n=8) received the protocol of no dressing. Results: There was no significant difference in the infection rate between the two groups ( P = 1), so that, a total of two cases had developed catheter-related bloodstream infection (CLABSI), one in the control group and the other in the interventional group. Moreover, one patient in the interventional group had developed exit site infection. However, patients with no dressing protocol (interventional group) perceived an improvement in their quality of life and they were satisfied with this protocol. Conclusion: Applying no dressing protocol to a well-healed exit site CVCs showed encouraging results in terms of exit site and bloodstream infections. That is to say; it did not predispose patients to increased risk of infections. Furthermore, patients with no dressing protocol feel more comfortable in their lifestyle.

Comparative evaluation of multiflower honey, jamun honey and chlorhexidine gluconate gel (0.2%) on clinical levels of dental plaque: one week Randomized controlled clinical trial.

Comparative evaluation of multiflower honey, jamun honey and chlorhexidine gluconate gel (0.2%) on clinical levels of dental plaque: one week Randomized controlled clinical trial.