Chlorhexidine Group Research Articles

Effectiveness of the Topical Application of 4% Chlorhexidine on Umbilical Cord Bacterial Colonization – A Non-Randomized Control Study

Newborns have the highest risk of death in the first 4 weeks of their life. Umbilical cord of a child is an important site for microorganism colonization and also forms a portal of entry for invasive pathogens. This study focuses on the bacterial colonization with 2 separate cord care regimens: dry cord and 4% chlorhexidine care group. This is a randomized control time-bound study conducted at a tertiary health care centre in Mangalore. A total of 144 newborns fulfilling the inclusion criteria were included and then divided randomly into two groups: dry cord care and 4% chlorhexidine. Two swabs were collected, baseline swab (swab 1) within 3 hours of birth and second swab (swab 2) at 120± 10 hours of birth and these samples were cultured for gram negative and positive organisms. Results were evaluvated with Chi-Square test. Out of 144 samples, in 115 showed no growth at the baseline and only 29 showed growth. In the dry cord care group, 38.9% showed growth of microorganism in comparison with chlorhexidine group which was 1.4% in swab 1 (baseline) and in swab 2, 87.5% in dry cord care group and 18.1% in chlrohexidine group in swab 2 respectively. It was observed that methicilin susceptible Staphylococcus aureus (MSSA) and methicillin resistant Staphylococcus aureus (MRSA) were the most common microorganisms isolated with others being Pseudomonas species, coagulase-negative Staphylococci (CoNS), Enterobacter species and Citrobacter species. Use of 4% chlorhexidine is effective in reducing colonization of bacteria and infection in comparison with dry cord care method. Therefore, decontamination of the umbilical cord with 4% of chlorhexidine should be recommended in a newborn child. However, both cord care methods did not lead to any infections.

Clinical Efficacy of Andrographis paniculata Extracted Scrub Compared With 4% Chlorhexidine Scrub in Burn Wounds: A Prospective Randomized Controlled Trial

Objective: The primary objective of this study is to compare the healing rate between AP soap and 4% Chlorhexidine solution in superficial second-degree burn wounds. The secondary objectives include the analgesic effect and moisturization of these two products. Materials and Methods: Data was collected between 2019 and 2021. Patients aged 18 years and above, with superficial second-degree burns including at least 20% of TBSA, and admitted to the Burn Unit within 24 hours of injury were included. They were randomly assigned to two groups: Andrographis paniculata with Perilla oil liquid soap group (AP group) and 4% Chlorhexidine group (control group). The measurements included percentage of epithelialization, pain score during wound cleansing, itching score after wound cleansing, and dry skin specified symptoms. All patients received standard care for burn wound treatment. Results: A total enrollment was 23 patients in this study (12 in the AP group and 11 in the control group). The median age was 38.5 years. There were no statistically significant differences in age, %TBSA, and initial wound size between both groups (p > 0.05). Although the healing time was similar in both groups, (18.5 vs. 20.1, p=0.347), the AP group had a significantly lower pain score than the control group (4.7 vs. 5.4, p=0.020). Moreover, the AP group demonstrated significant improvements in itching score and SRRC score at 14 days compared to the control group (5.1 vs. 6.0, p 0.039 and 1.08 vs. 1.55, p 0.020, respectively). There were no adverse effects during this study. Conclusion: Patients treated with Andrographis paniculata with Perilla oil liquid soap experienced less pain and better moisturization compared to those treated with the standard 4% chlorhexidine solution, while achieving a comparable healing rate. A future large-scale prospective trial is recommended.

The Effect of Various Disinfection Methods on The Tensile Bond Strength of Soft Lining Material

Disinfection of dentures and resilient denture liners were preferred for cross-contamination treatment and better safety. Nevertheless, it has been found that these techniques affect the physical and mechanical properties of denture liners. Objective: To evaluate the impact of various disinfection methods on the tensile bond strength of acrylic soft liner. Material and Methods: 25 samples were made, then divided randomly into five groups (4 disinfection groups as well as a control group), after the daily disinfection procedure, distilled water was used to store the samples at room temperature. After 30 days, a universal testing device (Gester, China) was used to assess the tens ile bond strength. The machine applied force to the specim ens at a crosshead constant speed of 5 mm/minute until failure was recorded. Statistics software (SPSS) was used to analyze the measurements. Results: After 30 days of regular ex posure to different disinfection methods, a greater mean value for bond strength showed in the control group while the lesse r value was in the chlorhexidine group. No significant difference was found between the control and Protefix tablet groups. The sodium hypochlorite and microwave groups had no significant difference between them, but they were significantly different from the control, Protefix tablet, and chlorhexidine groups. the chlorhexidine group was significantly different from the control and other disinfected groups. Conclusion: All disinfected soft liners revealed a decrease i n tensile bond strength, which was not significant with the protefix cleansing tablet but significant with the chlorhexidine, sodium hypochlorite, and microwave regimes.

The Effect of Microwave Irradiation and Some Denture Cleansers on The Bond Strength of Soft Liner to CAD/CAM-Milled Acrylic Resin

Disinfection of dentures and denture liners was desired for cross-contamination prevention and improved safety. Nonetheless, it has been discovered that these procedures impact the physical and mechanical features of denture liners.To assess the impact of different disinfection procedures on the tensile bond strength of an acrylic-based soft liner with CAD/CAM-based acrylic denture resin. Material and Methods: 25 specimens were collected and randomly divided into five groups (sodium hypochlorite, chlorohexidine, cleansing tablet, microwave, and control groups), following the daily disinfection protocol, the samples were stored at room temperature (23±2°C) in distilled water. After 30 days, the tensile bond strength was determined using universal testing equipment (Gester, China). The specimens were subjected to force by the machine at a steady crosshead speed of 5 mm/minute till the failure was recorded. The data were analyzed using statistics software (SPSS). Results: Showed that the control group had a higher mean value for bond strength, whereas the chlorhexidine group had a lower value. There was no significant difference between the control and cleansing tablet groups. However, they were significantly different from the microwave, CHX, and NaOCl groups. The NaOCl soft liner group is significantly different from all the other groups. No significant difference is found between microwave and CHX disinfected liner groups. Conclusion: The tensile bond strength of all disinfected soft liners decreased as compared with the control, which was not significant with the protefix tab but significant with the NaOCl, CHX, and microwave groups.

Comparison of the effectiveness of red ginseng herbal mouth rinse with chlorhexidine and saline in oral cancer patients: A pilot double-blinded randomized control trial.

Red ginseng is an herb with many medicinal properties and aids as a mouth rinse with fewer side effects than chlorhexidine. The study aimed to compare the efficacy of red ginseng herbal mouth rinses with those of chlorhexidine and saline in oral cancer patients. The present pilot study was a double-blinded randomized control trial with 45 histopathologically diagnosed oral squamous cell carcinoma patients divided into three groups: two intervention groups (herbal and chlorhexidine mouth rinse) and one control group (saline). Saliva samples for each patient were collected at baseline and after 14 days of using the mouth rinses. A microbiological examination of salivary samples was done by analysing total oral bacterial load along with specific counts for Porphyromonas gingivalis and Fusobacterium nucleatum at baseline and after the usage of mouth rinse. The data normality was analysed using the Shapiro-Wilk test, and following the normal distribution of data, parametric tests were employed. Paired t-test and one-way analysis of variance, followed by post hoc Bonferroni test, were used for inter-group and intra-group differences. There was a significant mean difference in total colony count, Fusobacterium nucleatum, and Porphyromonas gingivalis with oral hygiene index and gingival index improvement in the red ginseng herbal mouth rinse group when compared to the chlorhexidine and saline groups. In this study, red ginseng mouth rinse exhibited an increased antibacterial effect compared to chlorhexidine and saline. Hence, red ginseng mouth rinse can be used in oral cancer patients to maintain oral health, thereby improving the prognosis of these patients.

Effectiveness of chlorhexidine versus povidone-iodine for preventing surgical site wound infection: A meta-analysis.

A systematic evaluation was conducted to assess the efficacy of two disinfectants, chlorhexidine and povidone-iodine, as primary components in preventing surgical site infection (SSI). A comprehensive computerised search was performed in the PubMed, EMBASE, Web of Science, Cochrane Library, CNKI and Wanfang databases for randomised controlled trials (RCTs) on chlorhexidine and povidone-iodine disinfection for the prevention of SSI from inception until July 2023. Two independent researchers completed literature screening, data extraction and quality assessment of the included studies. The meta-analysis was conducted using RevMan 5.4 software. Ultimately, 20 RCTs were included, which included 13 133 patients, with 6460 patients in the chlorhexidine group and 6673 patients in the povidone-iodine group. The meta-analysis results revealed that the incidence rate of surgical site wound infections [odds ratio (OR): 0.67, 95% confidence interval (CI): 0.58-0.78, p < 0.001)], superficial SSI rate (OR: 0.59, 95% CI: 0.46-0.75, p < 0.001) and deep SSI rate (OR: 0.49, 95% CI: 0.31-0.79, p = 0.003) were all lower in patients subjected to chlorhexidine disinfection compared to those patients receiving povidone-iodine disinfection. Existing evidence suggests that chlorhexidine is more effective than povidone-iodine at preventing SSI. However, owing to the potential quality limitations of the included studies, further validation through high-quality large-scale RCTs is warranted.

Effect of chlorhexidine and benzalkonium chloride on the long-term push-out bond strength of fiber posts.

Fiber posts are widely used in endodontically treated teeth with extensive loss of coronal structure. The purpose of this study was to investigate immediate and the long-term effects of chlorhexidine (CHX) and benzalkonium chloride (BAC) application, on the push-out bond strength of fiber posts. Sixty mandibular premolars were decoronated, and root canal treatment was performed. After post space preparation, the specimens were divided into three groups according to the post space-surface pretreatment (n = 20); no surface treatment (control group-Group 1), 2% CHX application (Group 2), and 1% BAC application (Group 3). A self-curing adhesive cement and an etch and rinse adhesive were used for the cementation of posts. Three sections (one cervical, one middle, and one apical) of 1 mm thickness were prepared from each specimen. A push-out test was performed immediately on the half of the specimen sections (n = 10). The other half of the specimen sections were subjected to 20.000 thermal cycles before applying the push-out test (n = 10). The failure mode of each specimen was observed under a stereomicroscope at ×40 magnification. The data were analyzed by one-way analysis of variance (ANOVA), Tukey Honestly significant difference (HSD), and Tamhane tests (P = 0.05). The cervical thirds displayed the highest, and the apical thirds showed the lowest values in all groups (P < 0.05), except the control-aged group (P = 0.554). The aged control groups' values were found to be significantly lower than the aged CHX and BAC groups (P < 0.001). Aging significantly reduced the bond strength values of specimens in control groups (P < 0.001). However, aging did not significantly affect the push-out bond strength values of CHX and BAC groups (P > 0.050). The failure types were adhesive between the post and cement (type 1) in all groups, except control-aged group (type 2). The application of 2% chlorhexidine or 1% BAC may be an essential step that can be taken to preserve the bond strength of fiber posts.

Effect of Delayed Endodontic Sealing with Dentin Biomodification on Fracture Resistance of Endodontically Treated Teeth

Aim: Endodontically treated teeth display altered tooth structure pertaining to various chemical irrigants and intracanal medicaments. To prevent the compromised adhesive bond, dentin biomodification is indicated. This study was designed to evaluate the influence of dentin biomodification on the fracture resistance of root canal-treated teeth following Delayed Endodontic Sealing (DES). Materials and Methods: In 50 maxillary central incisors, Class III cavities along with access cavities were prepared. The samples were randomly divided into five groups. Group 1: Intact teeth ( N = 10), Group 2: Immediate Endodontic Sealing (IES) ( N = 10); Group 3: DES after irrigation with 3% NaOCl ( N = 10); Group 4: DES with 2% chlorhexidine (CHX) as a biomodifier ( N = 10) and Group 5: DES with 5% grape seed extract (GSE) as a biomodifier ( N = 10). In Group 2 samples, composite restorations were done prior to irrigation with 3% sodium hypochlorite (NaOCl). Group 3 samples received root canal irrigation with 3% NaOCl for 1 min, etch and rinse procedure and composite restorations. In Groups 4 and 5, dentin biomodification was done prior to composite restorations. Teeth were subjected to fracture resistance tests. Statistical analysis was carried out employing analysis of variance (ANOVA) and Tukey’s post hoc tests ( p &lt; .05). Results: IES group demonstrated the highest fracture resistance, with a significant difference statistically ( p &lt; .05) when compared with the DES groups. DES modified with GSE resulted in significantly superior fracture resistance compared to DES only, but no statistical difference was present between the CHX and grape seed-treated DES groups. Conclusion: DES with the use of dentin biomodifiers such as 5% GSE and 2% CHX increased the fracture resistance of root canal-treated teeth compared to DES only.

Comparative evaluation of mouthwashes containing propolis and chlorhexidine for controlling inflammation resulting from plaque accumulation in patients with chronic gingivitis.

Limited data are available on the effect of mouthwashes containing Iranian propolis on plaque index (PI) and gingival index (GI) in patients with chronic gingivitis. The present study compared the effects of propolis and chlorhexidine (CHX) mouthwashes in patients with chronic gingivitis due to plaque accumulation. In the present interventional study, 28 patients 18‒50 years of age with generalized chronic gingivitis were assigned to two groups (n=14). Periodontal parameters, including PI and GI, were determined in all the subjects at baseline. Groups A and B received CHX and propolis mouthwashes, respectively. All the subjects used the mouthwashes for two weeks. Then all the parameters were evaluated gain. Independent t-test was used to compare the periodontal parameters between the two groups. Paired t-test was used for intra-group comparisons. Statistical significance was defined at P<0.05. Two weeks after using the mouthwashes, the mean PI in the CHX group (21.71±1.63) was significantly lower than that in the propolis group (33.91±5.96). However, the mean PI and GI in the propolis group decreased significantly compared to the baseline (P=0.00). Propolis significantly decreased the mean plaque and gingival inflammation in patients with chronic gingivitis. Although the reduction in PI in the propolis group was a little less than in the CHX group, the efficacy of propolis in reducing GI was comparable to CHX.

Comparison of Endophthalmitis Rates after Alcohol-Based Chlorhexidine and Povidone-Iodine Antisepsis for Intravitreal Injections

Intravitreal injections (IVIs) are the most frequently performed intraocular procedure in Canada. Povidone-iodine (PI) is the current gold standard for antisepsis for IVI and is widely used; chlorhexidine (CH) is a possible alternative antiseptic agent. This study aims to compare rates of endophthalmitis after IVI with 0.05% chlorhexidine with a 4% alcohol base antisepsis to rates of endophthalmitis after IVI with 10% PI antisepsis. Retrospective cohort study. Eyes that received IVI between May 2019 and October 2022 at a group retina practice in Edmonton, Canada. Eyes at a single center received focal conjunctival application of either 10% PI antisepsis or 0.05% CH in 4% alcohol antisepsis for 30 seconds before each IVI. Rates of endophthalmitis between the PI and CH groups. A total of 170 952 IVIs were performed during the study period. A total of 31 135 were performed using CH prophylaxis compared with 139 817 with PI prophylaxis. Among all IVIs there were 49 total cases of endophthalmitis, 29 in the PI group (0.021%) and 20 in the CH group (0.064%). There was a statistically significant difference in the rates of endophthalmitis between the 2 groups (P < 0.001). The odds ratio for developing endophthalmitis with CH antisepsis was 3.1 (95% confidence interval, 1.9-5.2) compared with PI antisepsis. There were increased odds of developing endophthalmitis with aflibercept injection compared with bevacizumab (odds ratio, 3.48; 95% confidence interval, 2.09-7.24). There is a statistically significant difference in rates of endophthalmitis between alcohol-based CH and PI antisepsis for IVI in our patient population utilizing the methods discussed. In our center, alcohol-based CH is now considered a second-line antiseptic agent. Further studies are warranted to further assess the endophthalmitis rate utilizing these 2 antiseptic agents. Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.

The Comparative Efficacy of Tea Tree Oil Body Wash versus Chlorhexidine Body Wash to Prevent Colonization with Methicillin-Resistant Staphylo-coccus Aureus in a Pediatric Unit

Background: Methicillin-resistant Staphylococcus Aureus (MRSA) stands for methicillin-resistant Staphylococcus aureus, a type of bacteria that is resistant to several antibiotics. Non-intact skin, such as when there are abrasions or incisions, is often the site of an MRSA infection. MRSA has become endemic in hospitals over the past years. The current recommendation for MRSA decolonization is to use a daily chlorohexidine skin wash for five days. Tea Tree Oil (TTO) can also be considered for the eradication of MRSA on the skin. However, no study has evaluated the TTO potential for MRSA decolonization in hospitalized children.&#x0D; Methods:In this single-center, comparative prospective, open-label clinical trial, the effect of TTO body wash on MRSA decolonization was compared to that of chlorhexidine body wash at Loghman-e-Hakim Hospital (Tehran, Iran). Several samples were taken from the catheter sites of children for MRSA detection. Patients were assigned to receive either TTO or chlorhexidine. After five days of applying the solutions, resampling was conducted to assess the colonization of MRSA.&#x0D; Results: Both TTO and chlorhexidine groups showed favorable results for MRSA decolonization. From 382 patients, 91 were MRSA-positive (about 23.82%), and of these 91 patients, 41 (45%) were female and 59 (55%) were male. The mean ± SD of the growth inhibition zone against MRSA was 19.20 ± 3.73 and 33.41 ± 9.53 for chlorhexidine and TTO, respectively.&#x0D; Conclusion: TTO body wash proved to be more effective than chlorhexidine in MRSA decolonization in hospitalized children. Implementation of such decolonization can improve patients’ outcomes and prevent MRSA transmission.

Effect of Chlorhexidine and Tea Tree Oil on Reducing the Number of Oral Microorganisms.

Thus, the aim of this study was to compare the effect of using two preoperative mouthwashes (0.12% chlorhexidine and 0.2% tea tree oil) on the number of colonies of oral microorganisms. Forty participants who needed to be rehabilitated with dental implants were included in this study. They were randomly divided into two groups (chlorhexidine group and tea tree group; n = 20, each). For each group, saliva samples were collected at four different times: T0 (initially)-before using the mouthwash, T1-after 1 minute of using the mouthwash, T10-after 10 minutes of using the mouthwash, and T60-after 60 minutes of using the mouthwash. At T0 and T1, saliva samples were collected before implant placement surgery, and at T10 and T60, saliva samples were collected during surgery. In each group, one saliva sample was collected at each evaluated time point for each patient, totaling 4 saliva collections per patient. MSB agar (Mitis-Salivarius-Bacitracin) and BHI agar (Brain Heart Infusion) culture media were used in each group. Microbial colony counts were performed using a magnifying glass and recorded in CFU (colony forming units)/mL. Statistical analyses were performed using the Friedman, Mann-Whitney U and Wilcoxon tests (p < 0.05). Based on MSB agar culture medium, at T0, the number of Streptococcus mutans colonies in the chlorhexidine group was significantly higher compared with the tea tree group (p <0.05; MSB agar). The chlorhexidine group showed significantly lower CFU/mL values for Streptococcus mutans at T1, T10, and T60 compared with the tea tree group (p <0.05; MSB agar). Based on BHI agar culture medium, at T0, the chlorhexidine group showed a significantly lower value of CFU/mL compared with the tea tree group (p < 0.05; BHI agar). At T1, T10, and T60, the chlorhexidine group showed significantly lower CFU/mL values compared with the tea tree group (p <0.05; BHI agar). Chlorhexidine is more indicated as a preoperative mouthwash than tea tree oil, due to its significantly more effective antimicrobial action.

Comparison of the Efficacy of Two Different Mouthwashes in Gingivitis Patients: A Clinical Study

INTRODUCTION: Adequate plaque control becomes essential for reducing the progression of periodontal disease. Plaque management consists several mechanical procedures and chemical agents that retard the formation of plaque. AIM: To compare clinical outcomes of chlorhexidine gluconate mouthwash and Hiora herbal mouthwash in gingivitis patients. MATERIALS AND METHOD: The study was conducted among 30 patients. Patients were randomly divided into two groups, Group I used Chlorhexidine mouthwash and Group II received Hiora mouthwash. Clinical parameters such as Plaque Index (PI), Gingival Index (GI), Probing depth (PD) and Clinical Attachment Loss (LA) were recorded just before initiation of oral prophylaxis. After completion of oral prophylaxis, patients were advised to use mouthwash and were recalled after two weeks for further recording of clinical parameters. The collected data was thus statistically analysed to arrive at the results using SPSS version 24.0 and applying the student's t-test. RESULTS: Both the groups reported significant improvement in clinical parameters. When two mouthwashes were compared, a statistically significant difference in the mean value of PI (0.02) and GI (0.01), CAL and PD between the two experimental groups whereas no significant differences were observed before and after therapeutic interventions. CONCLUSION: The study concluded that herbal mouthwash are comparably effective in comparison to other conventional mouthwash in controlling dental biofilm

Comparative efficacy of topical povidone-iodine and chlorhexidine gel on dental plaque regrowth in toddlers: A randomized controlled trial.

This study aimed to compare and evaluate the efficacy of topical use of povidone-iodine (PVP-I) solution and chlorhexidine (CHX) gel on dental plaque regrowth after 3 and 7 days in toddlers aged 24-36 months. A randomized controlled trial that included 45 healthy toddlers aged 24-36 months, who were randomly assigned to three groups. The first group received a placebo (distilled water (DW)) (negative control). The second group received topical CHX gel (0.2% w/v) (positive control). The third group received topical PVP-I solution (10% w/v). Plaque accumulation was measured at the baseline (t0 ), after 3 days (t1 ) and after 7 days (t2 ) using the Turesky-modified Quigley-Hein plaque index (TMQHPI). Oral hygiene practices were prohibited during the trial period. The trial ID is ACTRN12623000567628. In the DW group, the mean of the TMQHPI score was 1.89 ± 0.67 at t0 and decreased to 1.45 ± 0.66 at t1 (p = .028). Similarly, in the CHX group, the mean of the TMQHPI score was 1.83 ± 1.06 at t0 and decreased to 1.02 ± 0.99 at t1 (p = .033). Regarding the PVP-I group, the mean of the TMQHPI score went from 1.84 ± 0.85 to 1.01 ± 0.61 at t1 and then increased to 1.57 ± 0.74 at t2 . Those changes were statistically significant (p = .001) and (p = .002), respectively. No statistically significant difference was noted between TMQHPI scores at t0 (p = .789). Regarding t1 and t2 , no statistically significant difference was found between the three groups (p > .05). CHX and PVP-I efficacy lasted only for 3 days, and PVP-I was not superior to CHX in terms of plaque control in toddlers. However, further studies are needed to determine the long-term efficacy of these antiplaque agents in toddlers.

Effect of Antibacterial Agents on Dentin Bond Strength of Bioactive Restorative Materials.

Treating dentin surfaces with antibacterial agents prior to bonding bioactive restorations might affect their mechanical properties. In this study, we evaluated the effect of silver diamine fluoride (SDF) and chlorhexidine (CHX) on the shear bond strength (SBS) of bioactive restorative materials. Dentin discs were treated with SDF for 60 s or CHX for 20 s and bonded with four restorative materials, namely Activa Bioactive Restorative (AB), Beautifil II (BF), Fuji II LC (FJ), and Surefil One (SO). Control discs were bonded without treatment (n = 10). SBS was determined using a universal testing machine, and a scanning electron microscope (SEM) was used for the evaluation of the failure mode and the cross-sectional examination of adhesive interfaces. The SBS of each material between different treatments and of the different materials within each treatment were compared via a Kruskal-Wallis test. The SBS of AB and BF was significantly higher than that of FJ and SO in the control and CHX groups (p < 0.01). In the latter, SBS was higher in FJ than SO (p < 0.01). SO had a higher value with SDF compared to CHX (p = 0.01). The SBS of SDF-treated FJ was higher than that of the control (p < 0.01). SEM showed a more homogenous and improved interface of FJ and SO with SDF. Neither CHX nor SDF compromised the dentin bonding of bioactive restorative materials.

Evaluating the Efficacy of Green Tea and Chlorhexidine Mouthwashes in Relieving Post-extraction Complications like Pain and Hemorrhage

This cross-sectional observational study aimed to evaluate the effectiveness of green tea and chlorhexidine mouthwashes in reducing post-extraction complications such as pain and bleeding. The studied sample consisted of 80 people with an average age of 43.67 (±4.78) years. Tooth extraction is shown to all participants. After the tooth extraction, the green tea group was advised to bite the pictures of the gauge into the green tea, take a bite, and rinse their mouths with green tea mouthwash the next day. Subjects with another group bite soaked in chlorhexidine saline solution after tooth extraction and chlorhexidine mouthwash. Operation time, hemostasis time, VAS pain after tooth extraction and total number of analgesics were recorded. Descriptive statistics were calculated and chi-square t-tests and independent samples were performed using SPSS 22. The results showed that there was no significant difference in age, sex, and time of surgery between the two groups. The mean VAS was significantly lower in the green tea group compared to the chlorhexidine group. In addition, the green tea group also showed a shorter time for complete hemostasis and less analgesic consumption than the chlorhexidine group. It can be concluded that green tea is significantly effective in reducing the time of complete hemostasis and pain after tooth extraction. Thus, by conducting additional studies, green tea can be found to be therapeutically useful for the treatment of post-extraction bleeding and pain.

Central-line associated bloodstream infections in intensive care units before and after implementation of daily antiseptic bathing with chlorhexidine or octenidine: a post-hoc analysis of a cluster-randomised controlled trial

BackgroundsAntiseptic bathing did not reduce central-line (CL) associated bloodstream infection (CLABSI) rates in intensive care units (ICU) according to a recent cluster randomised controlled trial (cRCT). However, this analysis did not consider baseline infection rates. Our post-hoc analysis of this cRCT aimed to use a before-after comparison to examine the effect of daily bathing with chlorhexidine, octenidine or water and soap (control) on ICU-attributable CLABSI rates.MethodsA post-hoc analysis of a multi-center cRCT was done. ICUs that did not yet perform routine antiseptic bathing were randomly assigned to one of three study groups applying daily bathing with 2% chlorhexidine-impregnated cloths, 0.08% octenidine wash mitts or water and soap (control) for 12 months. Baseline data was assessed 12 months before the intervention started when all ICUs routinely used water and soap. Poisson regression and generalised estimating equation models were applied to identify changes of CLABSI rates per 1000 CL days between intervention and baseline periods in each study group.ResultsThe cRCT was conducted in 72 ICUs (24 per study group) including 76,139 patients in the baseline and 76,815 patients in the intervention period. In the chlorhexidine group, incidence density of CLABSI was reduced from 1.48 to 0.90 CLABSI per 1000 CL days comparing baseline versus intervention period (P = 0.0085). No reduction was observed in the octenidine group (1.26 versus 1.47 CLABSI per 1000 CL days, P = 0.8735) and the control group (1.20 versus 1.17, P = 0.3298). Adjusted incidence rate ratios (intervention versus baseline) were 0.63 (95%CI 0.46–0.87, P = 0.0172) in the chlorhexidine, 1.17 (95% CI 0.79–1.72, P = 0.5111) in the octenidine and 0.98 (95% CI 0.60–1.58, P = 0.9190) in the control group. Chlorhexidine bathing reduced CLABSI with gram-positive bacteria, mainly coagulase-negative staphylococci (CoNS).ConclusionsIn this post-hoc analysis of a cRCT, the application of 2% chlorhexidine-impregnated cloths reduced ICU-attributable CLABSI. This preventive effect of chlorhexidine was restricted to CLABSI caused by gram-positive pathogens (CoNS). In contrast, 0.08% octenidine wash mitts did not reduce CLABSI rates in ICUs.Trial registration Registration number DRKS00010475, registration date August 18, 2016.

Biocompatibility, Surface Morphology, and Bacterial Load of Dental Implant Abutments following Decontamination Protocols: An In-Vitro Study.

The long-term success of dental implant rehabilitation depends significantly on proper peri-implant soft tissue integration. Therefore, decontamination of abutments prior to their connection to the implant is beneficial to enhance soft tissue attachment and to aid in maintaining marginal bone around the implant. Consequently, different implant abutment decontamination protocols were evaluated regarding biocompatibility, surface morphology, and bacterial load. The protocols evaluated were autoclave sterilization, ultrasonic washing, steam cleaning, chlorhexidine chemical decontamination, and sodium hypochlorite chemical decontamination. The control groups included: (1) implant abutments prepared and polished in a dental lab without decontamination and (2) unprepared implant abutments obtained directly from the company. Surface analysis was performed using scanning electron microscopy (SEM). Biocompatibility was evaluated using XTT cell viability and proliferation assays. Biofilm biomass and viable counts (CFU/mL) (n = 5 for each test) were used for surface bacterial load evaluation. Surface analysis revealed areas of debris and accumulation of materials, such as iron, cobalt, chromium, and other metals, in all abutments prepared by the lab and with all decontamination protocols. Steam cleaning was the most efficient method for reducing contamination. Chlorhexidine and sodium hypochlorite left residual materials on the abutments. XTT results showed that the chlorhexidine group (M = 0.7005, SD = 0.2995) had the lowest values (p < 0.001) (autoclave: M = 3.6354, SD = 0.1510; ultrasonic: M = 3.4077, SD = 0.3730; steam: M = 3.2903, SD = 0.2172; NaOCl: M = 3.5377, SD = 0.0927; prep non-decont.: M = 3.4815, SD = 0.2326; factory: M = 3.6173, SD = 0.0392). Bacterial growth (CFU/mL) was high in the abutments treated with steam cleaning and ultrasonic bath: 2.93 × 109, SD = 1.68 × 1012 and 1.83 × 109, SD = 3.95 × 1010, respectively. Abutments treated with chlorhexidine showed higher toxicity to cells, while all other samples showed similar effects to the control. In conclusion, steam cleaning seemed to be the most efficient method for reducing debris and metallic contamination. Bacterial load can be reduced using autoclaving, chlorhexidine, and NaOCl.

Does continuous chemical disinfection affect mechanical properties of CAD/CAM PMMA?

This study was aimed at analyzing the effect of disinfectants on the roughness and mechanical properties of computer-aided design/computer-aided manufacturing (CAD/CAM) polymethylmethacrylate (PMMA) dentures. Two groups of denture base resins were tested: heat-polymerized and milled blocks. The specimens were shaped (n=80) for flexural strength (FS), flexural modulus (FM), and (n=240) for the properties of roughness (Ra) and microhardness alterations (KHN). They were categorized into the following groups based on immersion: control (deionized water), H1 (1% sodium hypochlorite), H05 (0.5% sodium hypochlorite), and C2 (2% chlorhexidine) groups. The immersion periods were 0 (T0), 130 (T1), and 260 (T2) cycles. Statistical analyses were performed for flexural properties using the three-way analysis of variance (ANOVA). Microhardness and surface roughness were analyzed using repeatedmeasures ANOVA. A significance level of 5% was set. CAD/CAM PMMA showed higher FS (P = .001) and FM (P < .001) than conventional PMMA. The KHN value was superior to the conventional PMMA (P < .001). The chemical solution affected the surface roughness of both resins (P = .007). The CAD/CAM PMMA block showed increased Ra values when H1 was used. Cycling separately increased the FS of conventional PMMA (T1 vs. baseline; P < .05). However, the FM of CAD/CAM PMMA was higher (T1 and T2 vs. baseline; P < .05). The time factor increased the microhardness of both resins (T2 vs. baseline; P < .05). The CAD/CAM resin showed higher values compared to conventional PMMA in all tests, regardless of the chemical solution used; however, the values obtained for both resins were clinically acceptable. Int J Prosthodont 2023. doi: 10.11607/ijp.8301.

The effect of intraoperative immersion solutions on acellular dermal matrix: Biofilm formation and mechanical property

Acellular dermal matrix (ADM) is generally used on implant-based breast operations; However, it can increase surgical site infection. Many immersion solutions are applied to ADM, however, the most effective solution is unknown. The purpose of this study is to determine the effect of different solutions on the biofilm formation and mechanical properties of ADM. Aseptic porcine-derived ADMs were immersed in 5 different solutions for 30min; sterile normal saline, 10% povidone-iodine, 0.5% chlorhexidine, antibiotics (cefazolin, gentamicin, and vancomycin), and taurolidine. They are transferred to 10ml suspension of methicillin-sensitive/resistant Staphylococcus aureus (MSSA/MRSA) or Staphylococcus epidermidis and an overnight culture was performed. After rinsing and sonication to obtain the biofilm on ADM, colony forming unit (CFU) was measured. In addition, the maximum load before ADM deformation and the elongation length of ADM at the start of the maximum load was determined. Regardless of strains, povidone-iodine, chlorhexidine, and taurolidine group had lower CFUs than the saline group with statistical significance. Meanwhile, the antibiotics group did not show statistical difference from the saline group. Moreover, only taurolidine group showed higher tensile strength (MRSA, p=0.0003; S. epidermidis, p=0.0023) and elongation length (MSSA, p=0.0015) than the saline group. The antibiotics and chlorhexidine group yielded lower tensile strength and elongation length than the povidone-iodine and taurolidine groups. It was suggested that the 10% povidone-iodine or taurolidine solution is effective. In contrast, the antibiotics solution could be considered as an effective intraoperative solution.