Chlorhexidine Gluconate Rinse Research Articles

Preoperatif Oral Klorheksidinin Açık Kalp Cerrahisi Sonrası Ventilatör İlişkili Pnömoni ve YBÜ Mortalitesi Üzerine Etkisi

Objective: Ventilator-associated pneumonia (VAP) is the most frequent nosocomial infection in the intensive care unit (ICU). VAP develops 10-20% of patients in 48 hours of mechanical ventilation. In this study, it was aimed to determine the effect of preoperative oral chlorhexidine rinse on VAP and mortality in patients undergoing open cardiac surgery. Methods: 300 patients who were planned to undergo elective open cardiac surgery were included in this study. Patients were prospectively randomized into two groups by a computer software. Group 1: Patients brushing their teeth and then gargling with 0.12% chlorhexidine before bedtime at the last night before surgery and 15 minutes before going to the operating room. Group 2, It consisted of patients only brushing their teeth. Results: VAP was seen in 3 patients (2.12%) in Group 1 and in 12 (8.10%) patients in Group 2 (p<0.02). Duration of intubation was 15±7.40 hours for Group 1 and 23 32.01 for Group 2. These differences were statistically significant (p <0.01). Although duration of ICU stay and hospital stay in Group 1 are shorter than in Group 2 but it was not statistically significant (p>0.05). There was no difference in mortality (p>0.05). Conclusion: Consequently, chlorhexidine gluconate rinse before elective cardiac surgery reduced the VAP rate and duration of intubation but did not change the mortality rate and the length of ICU and hospital stay. On the other hand we think these results would be change in large multicentric studies.

A comparative analysis of staining characteristics of mouthrinses on provisional acrylic resin: An in vitro study

Aim and Objective: Provisionalization is essential for tooth protection and treatment outcome evaluation. Utmost care should be taken to maintain the soft tissue health when provisionals are cemented. Mouthrinses are commonly used as an adjunct to protect against caries and periodontal diseases. Thesesolutions are responsible for discolouration of provisional materials. In the present study, the aim is to assess the staining potentials of a chlorhexidine gluconate rinse, a benzydamine hydrochloride rinse and a tea tree oil rinse on a provisional acrylic material in vitro by application of a digital system for colour analysis Materials and Method: In this study, the staining potentials of a tea tree oil, a chlorhexidine gluconate rinse, and a benzydamine hydrochloride rinse was investigated; whereas distilled water was used as the control. Results: Color change of a commercially available provisional restorative material was evaluated after 24 hours immersion in three different mouthrinses. ∆E values obtained were 1.76 for chlorhexidine gluconate, 1.55 for benzydamine hydrochloride and 1.88 for TTO. Conclusion: Within the limitations of the current study, it is concluded that benzydamine hydrochloride exerts the least perceptible change in colour of bisacryl composite provisional resin material. Clinical Relevance to Interdisciplinary Dentistry Dentistry today is vastly different from what it was before. Today it is in the era of interdisciplinary approach from independent to interdependent. It is more result oriented and more successful when any case or situation is handled combined by interdisciplinary experts. Action and role of mouthrinses and their interdisciplinary outcome is evaluated in the present study.

A Comparative Evaluation of the Antibacterial Efficacy of Honey In Vitro and Antiplaque Efficacy in a 4‐Day Plaque Regrowth Model In Vivo: Preliminary Results

Honey has a potent broad-spectrum antibacterial action that may make it suitable for "anti-infective" treatment of periodontal disease. The aims of this study are as follows: 1) to evaluate the antibacterial efficacy of honey against oral bacteria and compare the same with 0.2% chlorhexidine; and 2) to compare antiplaque efficacy in vivo with chlorhexidine. The study was conducted in two parts. In the in vitro part, the inhibitory effects of three test agents, 0.2% chlorhexidine gluconate, honey mouthwash, and saline, against six oral bacteria at concentrations of 1, 2, 4, 8, 16, 32, 64, 128, 256, and 512 μg/mL were tested in duplicate. The minimum inhibitory concentration (MIC) was set as the lowest concentration of the agent that completely inhibited the growth of the test species. The in vivo part consisted of a double-masked parallel clinical trial based on a 4-day plaque regrowth model. Sixty-six volunteers, 20 to 24 years of age, participated in the study, and the plaque scores were compared at baseline and at the end of 4 days. The Kruskal-Wallis test was used for significance, and the Mann-Whitney U test was used for pairwise comparison of the groups. The mean plaque scores were 1.77 ± 0.86, 1.64 ± 0.90, and 3.27 ± 0.83 for groups 1, 2, and 3, respectively. The honey mouthrinse effectively inhibited the six tested microorganisms. The chlorhexidine gluconate rinse had the lowest MICs compared with honey and saline rinses for all test species examined. The in vivo results revealed that plaque formation was inhibited/reduced by chlorhexidine and honey rinses. Honey has antibacterial action against tested oral microorganisms and also has antiplaque action.

A Randomized Clinical Trial of Anticaries Therapies Targeted according to Risk Assessment (Caries Management by Risk Assessment)

This randomized parallel group clinical trial assessed whether combined antibacterial and fluoride therapy benefits the balance between caries pathological and protective factors. Eligible, enrolled adults (n = 231), with 1–7 baseline cavitated teeth, attending a dental school clinic were randomly assigned to a control or intervention group. Salivary mutans streptococci (MS), lactobacilli (LB), fluoride (F) level, and resulting caries risk status (low or high) assays were determined at baseline and every 6 months. After baseline, all cavitated teeth were restored. An examiner masked to group conducted caries exams at baseline and 2 years after completing restorations. The intervention group used fluoride dentifrice (1,100 ppm F as NaF), 0.12% chlorhexidine gluconate rinse based upon bacterial challenge (MS and LB), and 0.05% NaF rinse based upon salivary F. For the primary outcome, mean caries increment, no statistically significant difference was observed (24% difference between control and intervention groups, p = 0.101). However, the supplemental adjusted zero-inflated Poisson caries increment (change in DMFS) model showed the intervention group had a statistically significantly 24% lower mean than the control group (p = 0.020). Overall, caries risk reduced significantly in intervention versus control over 2 years (baseline adjusted generalized linear mixed models odds ratio, aOR = 3.45; 95% CI: 1.67, 7.13). Change in MS bacterial challenge differed significantly between groups (aOR = 6.70; 95% CI: 2.96, 15.13) but not for LB or F. Targeted antibacterial and fluoride therapy based on salivary microbial and fluoride levels favorably altered the balance between pathological and protective caries risk factors.

Use of itraconazole and either lime sulphur or Malaseb Concentrate Rinse® to treat shelter cats naturally infected with Microsporum canis: an open field trial

In an open non-randomized study, 90 cats with severe dermatophytosis were treated with 21 days of oral itraconazole at 10 mg/kg and one of three topical antifungal rinses applied twice weekly: lime sulphur (LSO); reformulated lime sulphur with an odour-masking agent (LSR); or a 0.2% miconazole nitrate and 0.2% chlorhexidine gluconate rinse (MC). Weekly examinations and fungal cultures were used to monitor the cats' response to therapy. If at day 42 of treatment cats were still strongly fungal culture positive and/or developing new lesions, they were retreated with oral itraconazole and LSO. Cats were not prevented from licking the solutions and none developed oral ulcerations. Thirty-one cats were treated with LSO, 27 with LSR and 32 with MC. The median number of days to cure was 30 (range 10-69 days) and 34 (range 23-80 days) for LSO and LSR, respectively. Thirty-two cats were treated with MC, and 13 of 32 cats required repeat treatment because of persistent culture-positive status and development of new lesions. Median number of days of treatment for the 19 cats that cured with MC was 48 (range 14-93 days). When the number of days to cure was compared between the groups, there was a significant difference between cats treated with LSO and LSR (P=0.029) and cats treated with LSO and MC (P=0.031), but no significant difference between the number of days to cure for cats treated with LSR and MC (P=0.91).

Impact of chlorhexidine mouth rinse use on postextraction infection via nitric oxide pathway

Nitric oxide (NO) has been linked to inflammatory reactions, tissue destruction, host defense, and wound healing in oral diseases. It is known that arginase enzyme controls the synthesis of NO through arginine depletion. This study evaluated the arginase-NO pathway alteration in response to tissue injury after dental extraction surgery and the effect of postoperative use of 0.2% chlorhexidine gluconate rinse (CHX). This study included 28 individuals who had impacted mandibular third molars. They were randomly divided into two groups. Group A was comprised of 13 individuals who used postoperative CHX (0.2%) rinse, while group B included 15 individuals who did not use postoperative CHX rinse. For each patient, periodontal inflammatory status was evaluated. Salivary and gingival tissue samples were obtained before and 1 h and 1 week after the surgery to determine the NO level and arginase activity using spectrophotometric methods. NO level of tissue samples displayed an insignificant decrease in both groups postoperatively. However, arginase activity of tissue samples was significantly higher in group B compared to group A 1 week after surgery (p <or= 0.01). There were no significant changes in salivary arginase activity and NO level in both groups before or after the third molar surgery. Results indicated that good oral hygiene following periodontal treatment prior to third molar surgery was related to an increase in arginase activity, which may improve wound healing. However, use of CHX rinse following periodontal treatment had no pronounced effect on the arginase-NO pathway.

Antimicrobial Effectiveness of an Herbal Mouthrinse Compared With an Essential Oil and a Chlorhexidine Mouthrinse

The authors investigated mouthrinses' antimicrobial effectiveness against predominant oral bacteria, as determined by the minimum inhibitory concentration (MIC). Specifically, they evaluated an herbal mouthrinse, an essential oil rinse and a 0.12 percent chlorhexidine gluconate rinse. The authors assessed the inhibitory effects of the three test agents against 40 oral bacteria at concentrations of 1, 2, 4, 8, 16, 32, 64, 128, 256 and 512 micrograms per millliter. They inoculated plates containing basal medium and the test agents with suspensions of the test species and incubated them anaerobically at 35 degrees C. The authors interpreted the MIC as the lowest concentration of the agent that completely inhibited the growth of the test species. The herbal mouthrinse inhibited the growth of most of the 40 test species. Compared with the essential oil mouthrinse, the herbal mouthrinse exhibited significantly lower MICs for Actinomyces species, periodontal pathogens Eubacterium nodatum, Tannerella forsythia and Prevotella species, as well as the cariogenic pathogen Streptococcus mutans. The chlorhexidine gluconate rinse had the lowest MICs compared with the essential oil rinse and the herbal rinse for all test species examined. Although less potent than the chlorhexidine gluconate rinse, the herbal rinse was more effective than the essential oil rinse in inhibiting the growth of oral bacteria in vitro. The data suggest that the herbal mouthrinse may provide oral health benefits by inhibiting the growth of periodontal and cariogenic pathogens. In vivo clinical testing is essential to confirm in vitro results.

Digital analysis of mouthrinses’ staining characteristics on provisional acrylic resins

Provisional restorations are expected to be both aestethically and physically durable during the preparation of permanent restorations. In this study, the staining properties of mouthrinses containing chlorhexidine gluconate, benzydamine hydrochloride and a hybrid mouthrinse were investigated on light and dark shades of a provisional acrylic resin. Totally 80 specimens were prepared and were photographed digitally to obtain the baseline L*, a*, b* values. Each sample was immersed in test solutions for 12 h which was equivalent time to 1 year of mouthrinse use, and the post-treatment images of the test materials were acquired. All L*, a*, b* values were analysed by a graphic software, and the total colour change (DeltaE*) of each specimen was calculated. Also the same colour analyses were performed on all test solutions to establish their colour parameters. Analysis of variance and Tukey's tests were used for statistical analyses and alpha was 0.05. All test solutions produced perceptible staining on the provisional material, with DeltaE values over 3.7. In both shades, hybrid rinse caused the highest staining (DeltaE=5.705), and was followed by chlorhexidine gluconate rinse, with DeltaE value of 4.120. The third highest staining was observed with benzydamine hydrochloride rinse (DeltaE=3.959), whereas the control caused the least staining (DeltaE=3.095). The lighter shade provisional material resulted with clinically observable staining even when immersed in distilled water; however, the dark shades showed clinically perceptible staining solely with the hybrid mouthrinse. In this study, the shade of the acrylic material was the determinator of the staining process.

Effect of chlorhexidine gluconate rinse for treatment and prevention of oral candidiasis in HIV-infected children: a pilot study

Effect of chlorhexidine gluconate rinse for treatment and prevention of oral candidiasis in HIV-infected children: a pilot study

Efficacy of chlorhexidine gluconate rinse for treatment and prevention of oral candidiasis in HIV-infected children: a pilot study.

We evaluated the effect of chlorhexidine (CHX) 0.12% rinses on the clinical and microbiologic manifestations of oral candidiasis in HIV-infected children. This was a cross-sectional, clinical intervention study of 38 HIV-positive children. Inclusion in the study was based on oral examination and positive oral culture for Candida. At baseline, subjects with no clinical lesions but who were culture-positive for Candida (N = 9) were placed on preventive therapy of CHX q.d. for 90 days. Subjects with clinical oral candidiasis (N = 9) were placed on therapeutic CHX b.i.d. All 38 subjects received oral exams at monthly intervals. At 90 days oral mucosal samples were again taken for Candida. Colony-forming units (CFU) were determined before and after CHX treatment. Of 18 culture-positive subjects, 12 were included in the CFU analyses. After 3 months of CHX oral rinse therapy, Candida was undetectable in 3 children; another 8 showed an average 2-fold reduction in CFU. In 1 child the number of CFU increased modestly. Overall, the average pre- and posttreatment mean CFU was 6.18 +/- 2.19 and 2.73 +/- 3.15, respectively (P = .009). Five patients with clinical oral candidiasis at baseline, including all 3 who had pseudomembranous candidiasis, were free of signs of disease at the end of the study. This study suggests that the topical disinfectant CHX may be a promising agent for treating and preventing oral candidiasis in HIV-infected children.

Effect of chlorhexidine rinse on the incidence of dry socket in impacted mandibular third molar extraction sites

This nonrandomized prospective study was conducted in a private practice setting to determine the effect of a 0.12% chlorhexidine gluconate rinse (Peridex, Proctor and Gamble, Cincinnati, Ohio) on the incidence of dry socket after removal of impacted mandibular third molars. Over a 3-year period, 371 patients (total of 654 impacted mandibular third molars) received either no treatment (group 1), 2 weeks of twice daily Peridex rinse postsurgery (group 2), or one rinse presurgery (group 3). The group that used Peridex twice daily for 2 weeks after surgery (group 2) showed a significant reduction (56%) in the incidence of dry socket when compared with either the group that did not rinse (group 1) or the group that rinsed only once just before surgery (group 3). The incidence of dry socket was higher in smokers and in females who used oral contraceptives. Twice daily use of Peridex for 2 weeks also yielded significant reductions in dry socket in smokers, nonsmokers, and in females who did not use oral contraceptives. Results from this study demonstrate that the use of Peridex for 2 weeks after surgery is effective in prevention of dry socket after surgical extraction of impacted molars.

The effect of a chlorhexidine rinse on the incidence of alveolar osteitis following the surgical removal of impacted mandibular third molars

A prospective randomized double-blind placebo-controlled study was conducted with 139 patients (278 bilaterally impacted mandibular third molars) to determine the effect of a perioperative 0.12% chlorhexidine gluconate rinse on the incidence of alveolar osteitis following surgical removal of impacted mandibular third molars. A statistically significant 60% reduction in the incidence of alveolar osteitis was obtained in the chlorhexidine group compared with the placebo group. In most subgroups analyzed, chlorhexidine was associated with at least a 50% reduction in alveolar osteitis compared with control groups.

Microbiological effects of mouthrinses containing antimicrobials.

A number of mouthrinse formulations containing antimicrobials have been evaluated to determine their effectiveness as antiplaque and/or antigingivitis agents. These have included the bis-biguanides, phenols, quaternary ammonium compounds, oxygenating compounds, plant extracts, fluorides, antibiotics and antimicrobial combinations. These mouthrinses have often been tested as adjuncts to normal oral hygiene procedures as well as in the experimental gingivitis model. 2 agents in particularly, chlorhexidine gluconate and listerine, have been shown to both inhibit or reduce plaque accumulation and the severity of gingivitis. Chlorhexidine has been reported to reduce the accumulation of plaque by approximately 60% and the severity of gingivitis by 50-80% as determined by improvements in clinical indices. A 0.12% chlorhexidine gluconate rinse resulted in significant reductions after both 3 and 6 months use in the numbers of total anaerobes, total aerobes, streptococci, and actinomyces recovered from supragingival plaque. Listerine has been reported to retard the development of plaque by 45 to 56% and to reduce existing plaque by 39 to 48%. Gingivitis scores were reduced as much as 59%. Microbial studies have shown that the effect of listerine is exerted against the total microbial mass and results in an overall decrease in both the biomass and the activity. Long-term use of neither mouthrinse, chlorhexidine or listerine, resulted in the emergence of opportunistic or oral pathogens. Preliminary data obtained following the use of a novel mouthrinse consisting of a combination of povidone-iodine and hydrogen peroxide appears promising. This combination was more effective than was more effective than either single component alone in reducing gingivitis scores.(ABSTRACT TRUNCATED AT 250 WORDS)