Chlorhexidine Group Research Articles

Effect of Pomegranate Mouthrinse on Gingival Health

Aim: To evaluate the efficacy of Punica granatum mouthrinse as compared to 0.12% chlorhexidine (CHX) on periodontal health. Settings and Design: This was a randomized controlled trial among patients aged ≥40 years selected from the outpatient department of Sudha Rustagi College of Dental Sciences and Research. Methodology: Fifty subjects diagnosed with chronic generalized gingivitis were selected and randomly divided into two groups, i.e., P. granatum mouthrinse group and CHX group. The mouthrinse extract was prepared using peel of P. granatum fruit. Patients were advised to use their prescribed mouthwash for 21 days. Clinical evaluation was done at baseline, 7 days, 14 days, and 21 days using the gingival index and the plaque index. Statistical Analysis Used: SPSS Inc 21 software (Statistical Package for the Social Sciences) was used. For inferential statistics, Friedman test, Wilcoxon signed-rank test, and Mann–Whitney U-test were used. Results: There was significant improvement in gingival status in both the sites. Subjects using P. granatum rinse showed significant improvement in gingival scores as compared with CHX. In contrast, P. granatum was shown not to be so effective in reducing plaque scores. Conclusions: P. granatum rinse is beneficial in improving gingival status due to its profound styptic action, with sufficient reduction in plaque scores.

Microbial resistance to oral antiseptics used in hospitalized patients: A systematic scoping review of randomized clinical trials.

To evaluate the prevalence and proportions of bacteria resistant to oral antiseptics used in hospitalized patients. A review of randomized clinical trials (RCTs) was led by implementing the PRISMA extension for scoping reviews including various databases. MeSH terms and keywords were used to assess only RCTs with antiseptic-resistant outcomes. Fourth RCTs met the selection criteria. These trials studied 399 hospitalized patients for respiratory infections or cardiovascular disease. Methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii were predominant pathogens in the chlorhexidine group. It was found that Veillonella parvula and Campylobacter gracilis (57% of the isolates) had resistance to triclosan, while 67% of Pseudomonas, Acinetobacter, and Enterobacter species presented resistance to chlorhexidine. However, an increase in minimal inhibitory concentrations of triclosan or chlorhexidine during the follow-up period was not observed. Moreover, chlorhexidine reduced the amount of S. aureus in dental plaque and the oropharyngeal colonization by aerobic microorganisms; nonetheless, it was unsatisfactory to decrease the occurrence of respiratory infections. No adverse events were reported. Resistance of V. parvula and C. gracilis to triclosan, and Pseudomonas, Acinetobacter, and Enterobacter species to chlorhexidine were perceived. However, these resistances did not increase during the follow-up period.

Effect of probiotic mouthwashes in comparison to chlorhexidine on periodontal health

Aim: To evaluate and compare the efficacy of Chlorhexidine and Probiotic mouthwashes in reducing plaque accumulation and gingivitis. Materials and methods: PubMed, Ovid SP, Embase, and Google Scholar databases were searched from years 1980 upto April 2020 for potential papers using relevant MeSH terms and pre-specified inclusion and exclusion criteria by two independent reviewers. Studies comparing Probiotics and Chlorhexidine in mouthwash form were included and evaluated for outcomes such as plaque score, gingival score. Results: A total of eleven articles were included for qualitative analysis, among them seven studies qualified for quantitative analysis. Random effects model was carried out to perform meta-analysis, basing on heterogeneity. Plaque index (PI): Significant reduction of plaque scores post-intervention were found when compared to baseline in both Probiotic mouthwash group [p=0.00001, MD: 0.87, 95% CI: 0.41 to 1.33] and chlorhexidine mouthwash groups [p=0.00001, MD: 0.97, 95% CI: 0.66 to 1.28]. No significant intergroup difference was found between Chlorhexidine and Probiotic mouthwash groups (p= 0.73). Gingival index (GI): Significant reduction of gingival index scores post-intervention were found when compared to baseline in both Probiotic mouthwash group [p=0.001, MD: 0.48, 95% CI: 0.19 to 0.77] and chlorhexidine mouthwash groups [p=0.0001, MD: 0.46, 95% CI: 0.23 to 0.68].

Journey to a confident smile: Management of hyperpigmented lips with 940 nm diode laser along with topical vitamin C - A case series

To evaluate and compare the effects of subgingival application of ozone gel and chlorhexidine gel in combination with traditional mechanical therapy in patients with plaque induced gingivitis undergoing orthodontic therapy. 20 subjects aged 15-40 were randomized by a simple method of alternatively assigning them to the test and control group in 1:1 ratio. In the control group 10 patients undergoing Orthodontics treatment with inflamed gingiva were selected for scaling and 1 ml of 0.2% Chlorhexidine gel was delivered subgingivally. In the test group10 patients undergoing Orthodontic treatment with inflamed gingiva were selected for scaling and 1 ml of Ozone (70 mcg/ml) gel was delivered subgingivally. Both the therapeutic approach showed significant (p<0.05) reduction in plaque index, gingival index and sulcus bleeding index when compared from baseline to 3 months. Both the therapeutic approaches led to significant reduction in microbiological colony count when compared from baseline to 3 months. On intergroup comparison Ozone Group showed higher reduction in GI, PI, SBI as compared to Chlorhexidine group but the difference was statistically non-significant. ozone gel can be an effective and practical alternative to chlorhexidine gel.

Does potassium iodide help in the microbial reduction of oral microcosm biofilms after photodynamic therapy with methylene blue and red laser?

ObjectiveTo evaluate the efficacy of methylene blue (MB)-mediated antimicrobial photodynamic therapy (aPDT) doped with potassium iodide (KI) against oral microcosms biofilms cultured in dentin. MethodsA saliva-glycerol stock formed from pooled human saliva was diluted in McBain artificial saliva with 1% sucrose (1:1), inoculated on bovine dentin blocks, and refreshed daily for 5 days. The biofilms were divided (n = 9/group) and treated with 0.9% NaCl (C), 0.2% chlorhexidine (CX), 0.01% MB + low-power laser 15 J, 88 mW, 180 s (PL), and 0.01% MB + 50 mM KI + laser (PKIL). Serial dilution was performed, and cellular viability (CFU/mL) was evaluated for total microorganisms, total lactobacilli, total streptococci, and S. mutans. Additional biofilms were cultured and treated (n = 4) for biomass determination (%BMR). The microscopic structure of the biofilms was observed by SEM. One-way ANOVA and Tukey tests were conducted (α=5%). ResultsTotal microorganisms and total streptococci significantly reduced in biofilms treated with CX and PKIL when compared to C, but the CX, PKIL, and PL treatments did not differ from each other. Total lactobacilli and S. mutans showed a significant reduction in the CX, PL, and PKIL groups when compared to C, but with no difference between them. Biomass analysis showed a significantly reduction for CX and PKIL compared to C. SEM micrographs showed noticeable changes in bacterial membrane integrity for the PKIL and CX groups. ConclusionThe addition of KI to methylene blue-mediated aPDT in microcosm biofilms was effective in reducing oral microorganisms, but the effect was group dependent.

Flavonoid Baicalein Suppresses Oral Biofilms and Protects Enamel Hardness to Combat Dental Caries.

The objectives of this study were to investigate the effects of a novel method using flavonoids to inhibit Streptococcus mutans (S. mutans), Candida albicans (C. albicans) and dual-species biofilms and to protect enamel hardness in a biofilm-based caries model for the first time. Several flavonoids, including baicalein, naringenin and catechin, were tested. Gold-standard chlorhexidine (CHX) and untreated (UC) groups served as controls. Optimal concentrations were determined by cytotoxicity assay. Biofilm MTT, colony-forming-units (CFUs), biofilm biomass, lactic acid and polysaccharide production were evaluated. Real-time-polymerase-chain reaction (qRT-PCR) was used to determine gene expressions in biofilms. Demineralization of human enamel was induced via S. mutans-C. albicans biofilms, and enamel hardness was measured. Compared to CHX and UC groups, the baicalein group achieved the greatest reduction in S. mutans, C. albicans and S. mutans-C. albicans biofilms, yielding the least metabolic activity, polysaccharide synthesis and lactic acid production (p < 0.05). The biofilm CFU was decreased in baicalein group by 5 logs, 4 logs, 5 logs, for S. mutans, C. albicans and S. mutans-C. albicans biofilms, respectively, compared to UC group. When tested in a S. mutans-C. albicans in vitro caries model, the baicalein group substantially reduced enamel demineralization under biofilms, yielding an enamel hardness that was 2.75 times greater than that of UC group. Hence, the novel baicalein method is promising to inhibit dental caries by reducing biofilm formation and protecting enamel hardness.

In vitro Effect of Photodynamic Therapy with Curcumin and Methylene Blue Photosensitizers on Staphylococcus Aureus.

Staphylococcus aureus (S.A) can colonize in the skin, nasal cavity, and oral cavity. In the oral cavity, it can cause dental caries and periodontal disease. Mouthwashes can be used as an adjunct to mechanical plaque control methods to decrease the load of oral microorganisms. Chlorhexidine (CHX) is a commonly used antimicrobial mouthwash with side effects such as changing the sense of taste, tooth discoloration, oral mucosal burning, allergy, and xerostomia. It also has adverse systemic effects, if swallowed. This study aimed to assess the effect of photodynamic therapy (PDT) with curcumin and methylene blue (MB) photosensitizers and different laser parameters on S.A colony count. In this in vitro experimental study, 99 samples of standard-strain S.A were subjected to PDT with curcumin and MB photosensitizers with/without irradiation of 660 and 445 nm laser with different exposure parameters, and CHX in 9 groups (n=11). The samples were cultured in microplates containing Mueller-Hinton agar, and the number of colony forming units (CFUs) was counted after 24 h of incubation at 37°C. Data were analyzed by the Kruskal-Wallis and Dunn tests. The minimum colony count was noted in CHX group (CFUs=0) followed by MB and 660nm diode laser group irradiated for 100 s (CFUs=147.2727±169.35707). The difference in this respect was significant between MB+660nm diode laser for 100 s and other groups (p< 0.05) except for the MB + 660 nm diode laser for 60 s group. CHX is superior to laser for elimination of S.A. However, PDT with 660 nm diode laser + MB has considerable antimicrobial efficacy against S.A; increasing the duration of laser irradiation enhances the antimicrobial effect.

Comparative Evaluation of the Antibacterial Efficacy of Chlorhexidine and 810 nm Diode Laser in the Disinfection of Root Canals Contaminated With Enterococcus faecalis: An In Vitro Study.

Introduction: This study compared the antibacterial efficacy of three different root canal irrigants, sodium hypochlorite, chlorhexidine and 810 nm diode laser and diode laser in combination with chlorhexidine in root canals contaminated with Enterococcus faecalis.Methods: Fifty extracted mandibular first premolars were decoronated at the cementoenamel junction and cut at the apical end; biomechanical preparation was done, autoclaved and contaminated with Enterococcus faecalis. The specimens were divided into five groups containing 10 teeth each: group I: saline (negative control), group II: 2.5% sodium hypochlorite, group III: 2% chlorhexidine gluconate solution, group IV: diode laser, and group V: diode laser in combination with 2% chlorhexidine. Disinfection was carried out, after which dentinal shavings were collected from the specimens of each group. Antimicrobial efficacy was tested by counting the colony-forming units of viable Enterococcus faecalis on the agar plates. One-way ANOVA and Scheffe’s post hoc test were done to analyse the results.Results: Diode laser with chlorhexidine group showed minimum colony-forming units followed by the diode laser group. The post hoc test showed a statistically significant difference between saline, 2.5% sodium hypochlorite and 2% chlorhexidine groups (P = 0.001) and a non-significant difference between diode laser and diode laser with chlorhexidine group (P = 0.997).Conclusions: Diode laser can be used as a root canal disinfectant alone or in combination with chlorhexidine.

Comparison of antimicrobial efficacy of chemical mouthwash and herbal mouthwash

Background: The use of mouth rinse for oral hygiene maintenance has been advocated as an adjuvant to mechanical aids of plaque removal. The aim of this study was to compare the antimicrobial effect of herbal and chemical mouth rinse on bacterial accumulation on orthodontic arch wires. Materials and Methods: The study sample consisted of 15 numbers of 0.016 Nickel Titanium (NiTi) arch wires removed from patients' mouths, which were split into three segments of 1 cm each. Wires were dipped in solutions of Chlorhexidine (Group A), Befresh Herbal (Group B) and Distilled water (Group C) individually for 30 seconds and then in normal saline for one minute. 0.5microlitre of this saline solution was inoculated in a Brain heart infusion medium (BHI) for 24 hours and then examined for bacterial count. The obtained results were subjected to One-way ANOVA, Bonferroni and post hoc tests for statistical analysis. Results: Group A showed the maximum reduction in the bacterial colony forming units (CFU) after 24 hours with a mean value of 65.67cfu. Group B showed a mean value of 336.87cfu. There was a statistically significant difference between the Chlorhexidine group and the Control group.

Clinical and microbiological efficacy of hyaluronic acid gel compared to chlorhexidine in the treatment of gingivitis

Background and objectives: Chemotherapeutic agents have the potential to inhibit plaque growth, reduce gingivitis and improve oral health beyond tooth brushing alone. The aim of this study is to compare the therapeutic effectiveness of 0.2% hyaluronic acid-containing gel (Gengigel) with a 0.2% chlorhexidine containing gel effect, in the treatment of plaque induced gingivitis. Methods: This cross-sectional analytical case control study involved 150 generally healthy patients, age ranging 20-40 years, with gingivitis. The patients were divided in two groups, after scaling and polishing, 75 patients in each. The first group was given 0.2% hyaluronic acid containing gel and the second group was given 0.2 % chlorhexidine containing gel. Clinical examination, which included bleeding on probing, plaque index at the baseline, after 7 days and after 21 days were calculated. Antimicrobial properties of both gels in the saliva were measured by agar diffusion method. Results: No significant difference was detected between the two groups regarding the mean ranks of the Plaque index difference after a week (chlorhexidine group = 0.81, hyaluronic acid group = 0.89) and after three weeks (0.58, 0.54 respectively). The mean of the difference in Bleeding index after one week in the chlorhexidine group (39.44) were significantly higher than those (32.87) of the group of hyaluronic acid, But the difference was not significant after three weeks (37.40 and 37.27 respectively). The chlorhexidine group inhibition zone (19.2) was significantly higher than the hyaluronic acid group (10.6) Conclusions: in this study, the adjunctive use of 0.2 percent hyaluronic acid gel is comparable to 0.2 percent chlorhexidine gel for gingivitis treatment.

Effectiveness of Different Antimicrobial Agents on Malodor Prevention in Two-Stage Dental Implants: A Double-Blinded Randomized Clinical Trial.

Opening of a healing abutment in two-stage implant systems is usually followed by a bad smell. Previous studies have found that presence of bacteria in microleakages of the implant-abutment interface results in further malodor. However, studies focusing on preventive treatments for this issue are scarce. Therefore, the aim of this study is to evaluate the effectiveness of two antimicrobial agents on prevention of malodor followed by opening the healing abutments. Current double-blinded randomized clinical trial was performed on 51 eligible patients who were referred for their exposure surgery. They were divided equally into three parallel groups. In two groups, either chlorhexidine or tetracycline was added to the internal surface of the fixtures before screwing the healing abutments. One group did not receive any intervention. Three to 4 weeks later malodor was scored by sniffing the healing abutments immediately after uncovering them (odorless = 0/odor = 1). The three groups were then compared regarding malodor scores. Our findings showed that malodor was more frequent in the control group (58.82%) in comparison with groups of intervention (17.65 and 23.53%). There was a statistically significant difference between malodor in patients in whom antimicrobial agents (chlorhexidine and tetracycline) were used in their implants and the control group (p-value = 0.023). However, malodor in the chlorhexidine group and tetracycline group did not show any significant difference (p-value = 1). Based upon the data from this study, it appears that local antimicrobial agents including chlorhexidine and tetracycline result in less malodor production within the implant-abutment interface. A specific type of malodor is commonly seen after opening the healing abutment of a two-stage dental implant. Not only this issue is noticed by the dentist, but also annoyed the patient. Using local antimicrobial agents in the fixtures is likely to be a simple, easily applicable solution that satisfies both patients and dentists, and eliminates the possibility of further inflammation.

Comparing the effectiveness of boric acid and chlorhexidine irrigation as an adjunct to mechanical periodontal therapy in chronic periodontitis patients – A randomized clinical trial

Introduction: Oral health is a part of the overall health and has a significant impact on both the physical and the psychological state. Dental caries and periodontal disease are the two major oral diseases that affect the human population worldwide. Aim: The aim of the study is to compare the effectiveness of boric acid and chlorhexidine (CHX) irrigation as an adjunct to scaling and root planing in chronic periodontitis patients visiting VS Dental College and Hospital, Bengaluru. Materials and Methodology: A total of 123 subjects were randomly allocated to three groups (group 1 - boric acid, group 2 - CHX, group 3 - distilled water as a control group). The study subjects were assessed for all the clinical parameters at baseline and 1 and 3 months after the intervention. ANOVA test was used to compare the results between the groups. Results: The mean age among group 1 was 50 ± 5.1 years, in group 2 was 49 ± 5.4 years, and in group 3 was 48 ± 7.1 years. There was a significant reduction in plaque scores, gingival scores, and bleeding on probing scores in the boric acid group compared to distilled water group and CHX group at 1 and 3 months after treatment. Probing depths (PDs) and clinical attachment level scores are significantly decreased from baseline level to 1 and 3 months after intervention in the boric acid group compared to the CHX group and distilled water group. Conclusion: Boric acid or CHX can be used effectively in periodontal pockets as an adjunct to nonsurgical periodontal treatment compared with conventional treatment.

Effect of pretreatment with matrix metalloproteinase inhibitors on the durability of bond strength of fiber posts to radicular dentin.

ObjectivesApplication of matrix metalloproteinases inhibitors has been suggested to improve the durability of resin–dentin bonding. The purpose of this study was to evaluate the effect of dimethyl sulfoxide (DMSO), carbodiimide (EDC), and chlorhexidine (CHX) treatment on the push‐out bond strength of fiber posts to radicular dentin.Materials and Methods24 extracted premolars were assigned randomly to 4 groups after root canal treatment and post space preparation (n = 6). In the first, second, and third groups, radicular dentin was treated with 1 ml of 5% DMSO, 0.3 M EDC, and 2% CHX, respectively. The fourth group (control) received no treatment. The root canals were primed with ED primer II, and the fiber posts were cemented with Panavia F2.0. In each group, half of the specimens were subjected to the push‐out test and the other half to 3000 thermal cycles before testing. Data were analyzed using two‐way analysis of variance via SPSS version 20 (p < .05).ResultsAmong the nonthermocycled specimens, the values of push‐out bond strength were observed in the control, EDC, CHX, and DMSO groups, in decreasing order. Among the thermocycled specimens, the values were observed in the control, EDC, DMSO, and CHX groups in decreasing order. Thermocycling had a significant adverse effect on the push‐out bond strength (p = .015), but the effect of material (p = .375), and the interaction effect of material and thermocycling (p = .998) were not significant.ConclusionsApplication of CHX, DMSO, and EDC had no significant effect on the bond strength of fiber posts to radicular dentin.

Antimicrobial efficacy, optical properties and flexural strength following antimicrobial photodynamic therapy over vacuum-formed orthodontic retainers

Background and aimsVacuum-formed retainers (VFRs) are widely used in dental practices because of their superior esthetics. However, simultaneous maintenance of their hygiene, mechanical and optical properties is challenging. This study aimed to evaluate and compare the disinfection efficacy of antimicrobial photodynamic therapy (aPDT), chlorhexidine (CHX), sodium hypochlorite (NaOCl) and water over VFRs specimens, along with their effect on flexural strength and color stability. Materials and methodsFabricated VFRs of thicknesses 1 mm and 2 mm were contaminated with S. mutans and C. albicans. Brain Heart Infusion agar was used to seed Streptococcus Mutans whereas Candida Albicans was seeded in Sabourand Dextrose Agar. The contaminated retainers were divided into four groups and decontaminated using four different treatment protocols: aPDT, CHX, NaOCl and water, with 10 specimens per group. Microbial viability following decontamination, was assayed using MTT. To assess the color stability, pre and post decontamination color difference of 10 specimens was recorded using a spectrophotometer by blinding technique. The flexural strength of 10 specimens was measured using a universal testing machine by a standardized 3-point flexural strength (FS) test. ResultaPDT showed the highest reduction in the viability of S. mutans (28%) and C. albicans (20%) species in 1 mm thickness group while the second highest reduction following disinfection with CHX (40%) in followed by NaOCl disinfection (50%). On comparison between 1 mm and 2 mm, a statistically significant difference was noted for S. mutans in aPDT (p = 0.033) and NaOCl (p = 0.028) groups, and for C. albicans, a significant difference was noted within NaOCl (p = 0.001) and CHX (p = 0.043) groups. For FS, a statistically significant difference (p < 0.05) was observed between aPDT and the rest of the groups, whereas there was no statistically significant difference in the flexural strength between the CHX, NaOCl and water groups (p > 0.05) in both 1 mm and 2 mm specimens. Between 1 mm and 2 mm specimens, no statistically significant difference in the mean color difference was noted after any disinfection protocol (p > 0.05). ConclusionAntimicrobial photodynamic therapy showed a remarkable reduction in candidal and bacterial viability over VFRs. aPDT treated VFR specimens showed increased flexural strength and a higher color difference post treatment compared to other reagents.

Efficacy of Curcumin Mouth Wash on Gingival Inflammation in Patients with Chronic Gingivitis

Objective: For gingival disease, various modalities of treatment are available. Turmeric is a novel product obtained from plants that plays a vital role in treating gingival and periodontal diseases. This study aims to evaluate the anti-plaque and anti-inflammatory property effects of curcumin mouthwash (0.1%) on participants with plaque-induced gingivitis. &#x0D; Methods: From eighty subjects, sixty participants with generalized gingivitis received meticulous scaling and polishing (S&amp;P) and were divided randomly into 3 groups: Curcumin (CU), Chlorhexidine (CHX), and control (S&amp;P) groups. Clinical parameters: PI, GI, BOP, and salivary IL-1β were assessed at baseline and after 4 weeks of therapy. The rest of the twenty patients with clinically healthy gingiva. &#x0D; Results: The results showed a significant reduction in the mean values of PI, GI, BOP, and Il-1β levels after 4 weeks of therapy as compared to baseline in all 3 groups (p≤0.05), with the highest mean reduction of GI, BOP, and IL-1 β scores detected in the CU when compared to the CHX and S&amp;P groups, and the highest mean reduction of PI scores detected in the CHX group in comparison to the CU and S&amp;P groups (p≤0.05), with significant differences, existed between the 3 groups (p≤0.05). &#x0D; Conclusions: CU was more effective than CHX when anti-inflammatory property effects were considered, while CHX was more effective than CU when anti-plaque property effects were considered. Therefore, CU mouthwash can be considered an effective alternative antigingivitis agent to CHX due to its anti-plaque and anti-inflammatory property effects.

Recovery of Streptococcus Mutans Biofilm after Photodynamic Therapy with Erythrosine and LED Light Source

The aim of this study was to evaluate the effects of erythrosine-mediated photodynamic therapy (PDT) on Streptococcus mutans biofilm recovery by counting its colony-forming units (CFUs) and via confocal laser scanning microscopy analysis at different time points following PDT. In PDT, photosensitizer was an erythrosine. S. mutans ATCC25175 biofilms were irradiated using an LED curing light. Chlorhexidine (CHX) was used as positive control. After each antimicrobial treatment, samples were cultured to allow biofilm recovery. Viability was measured by calculating the CFU counts after treatment and after every 3 hours for up to 24 hours. Immediately after treatment, the PDT and CHX groups showed equally significant decreases in S. mutans CFU counts compared to the negative control. After 12 hours of reculture, the PDT group showed no significant difference in the decrease in CFU count compared to the negative control, whereas the CHX group showed significantly lower CFU counts throughout the 24-hour period. Erythrosine-mediated PDT can effectively inhibit S. mutans biofilm formation. However, biofilm recovery occurred earlier in the CHX group after PDT. This study provides insights into the clinical effectiveness of PDT in preventing dental caries.

The effect of different intracanal medicaments on the dislodgement resistance of mineral trioxide aggregate

BackgroundThis study aimed to assess the effect of different commercially used calcium hydroxide [Ca(OH)2], the mixture of Ca(OH)2 + silver nanoparticles (AgNPs), and other intracanal medicaments on dislodgement resistance of mineral trioxide aggregate (MTA) to root canal dentin in short- and long-term application.MethodsForty-six human single-rooted maxillary teeth were sectioned horizontally at mid-root into 1 mm thick slices. The lumen of the slices was standardized using #2–#5 Gates Glidden drills to a standard diameter of 1.3 mm in all samples. After smear layer removal, the samples were randomly divided into eight groups (n = 20) and treated with the following medicaments; Ca(OH)2 paste, Calcipex, Metapex, chlorhexidine (CHX), Ca(OH)2/CHX paste, Ca(OH)2/AgNPs, triple antibiotic paste and control group (normal saline). The samples were then incubated at 37 °C with 100% humidity for 1 week. Next, half of the teeth in each group (n = 10) were removed from the incubator and washed in an ultrasonic bath. ProRoot MTA was placed in the canal lumen and the samples were incubated at 37 °C and 100% humidity for 48 h to allow complete setting of MTA. The remaining half in each group (n = 10) was subjected to the same process after 1 month of application of medicaments. The dislodgement resistance of MTA to root dentin was measured. The data were analysed using two-way ANOVA and Tukey’s post hoc test.ResultsNo significant difference was noted in dislodgement resistance of samples after 1 week and 1 month in any group (P > 0.05). The only significant difference was noted between the control and CHX groups and the higher dislodgement resistance was recorded in the CHX group (P = 0.006). No other significant differences were noted between the groups (P > 0.05).ConclusionDuration of application and the type of intracanal medicament do not affect the dislodgement resistance of MTA to root dentin. Although there was no statistically significant difference in the dislodgment resistance of MTA between the medicaments, CHX had a promising effect.

Evaluation of dentinal tubule penetration of Irritrol and chlorhexidine irrigating solutions activated using EDDY and photon-initiated photoacoustic streaming

The aim of the study was to compare the penetration depth and percentage of Irritrol and chlorhexidine (CHX) solutions into dentinal tubules using conventional needle irrigation (CI), EDDY, and photon-induced photoacoustic streaming (PIPS). Sixty oval shaped mandibular premolar teeth were divided into two main groups according to the irrigating solutions as follows; Irritrol and CHX, which were later randomly divided into three subgroups according to the activation technique; CI, EDDY and PIPS (n = 10). Following the irrigation activation procedures, all roots were horizontally sectioned at 3 (apical), 8 (middle), and 13 (coronal) mm from the root apex and then examined with confocal laser scanning microscope (CLSM). Penetration depth (µm) and penetration percentage (%) as determined from the images were analyzed using LSM Image Browser software (Zeiss) and Image J analysis software (V. 1.44p; National Institutes of Health, Bethesda, MD), respectively. Data were statistically analyzed using Kruskal–Wallis and Mann–Whitney U tests were performed for multiple comparisons. In both Irritrol and CHX groups, the PIPS activation system demonstrated the highest values for irrigant penetration depth and penetration percentage compared with the other activation methods. Activation of the CHX and Irritrol the final irrigating solutions with PIPS activation technique improved the penetration depth and percentage solutions into the dentinal tubules.

Effectiveness of different cord care interventions on omphalitis prevention among neonates in Nakuru County Hospital, Kenya

Background: Sepsis among newborns is common and a major cause of neonatal deaths in developing countries. Annually, about 4 million neonatal deaths occur around the world. Of these, more than 30% are caused by infections majority of which start as umbilical cord infections. Topical umbilical cord care can reduce omphalitis (umbilical cord infection) and neonatal mortality among newborns. Objective: This study aimed to compare the incidence of omphalitis in different cord care interventions (Dry, Chlorhexidine, and Alcohol) in Nakuru County, Kenya. Methodology: A randomized controlled trial was carried out between July 2018 and June 2019. A total of 540 newborns were randomly assigned to receive 1 of 3 cord care regimens; twice cord cleansing with 4% chlorhexidine (Group 1), twice cord cleansing with 70% alcohol (Group 2), and dry cord care (Group 3) as control. Results: The risk of omphalitis was significantly reduced in the chlorhexidine group than in dry and alcohol cord care groups. The incidence of omphalitis was 1.95 times more likely to occur among the dry cord care group [AOR = 1.95; 95% CI = 1.13-3.38; p = 0.017] compared to the chlorhexidine group. Similarly, babies in the alcohol group were nearly 2 times more likely to develop omphalitis [AOR = 1.98; 95% CI = 1.15-33.40; p = 0.014] compared to those in the chlorhexidine group. Conclusion and recommendation: Chlorhexidine topical cord care significantly reduces the risk of umbilical infection in neonates when compared to both topical alcohol application and dry cord care approach. It should be recommended to be used topically for the prevention of omphalitis in our setup.

A comparative study to assess the effectiveness of curcumin, mucosamin, and chlorhexidine in chemotherapy-induced oral mucositis

BackgroundOral mucositis is one of the most frequent and challenging side effects of chemotherapy. At present, none of the guidelines recommend the use of various mouthwashes available for the treatment of oral mucositis. MethodsThis study was designed to evaluate the efficacy of curcumin, mucosamin, and chlorhexidine in the treatment of chemotherapy-induced oral mucositis. In this randomized and double-blind study, 71 patients over 18 years, who received chemotherapy and suffered from chemotherapy-induced oral mucositis, were randomized into curcumin, mucosamin, and chlorhexidine groups. The World Health Organization (WHO) Oral Toxicity Scale, the Oral Mucositis Assessment Scale (OMAS), and the Numerical Rating Scale (NRS) were used to evaluate oral mucositis. The main endpoint included the onset of complete recovery after starting the treatment. FindingsBased on the WHO, OMAS for erythema, and NRS criteria, complete recovery was achieved from the third day in the curcumin group, which was significantly earlier compared to the other two groups (P < 0.05). The OMAS score for ulceration represented an improvement from day 5 in the curcumin group, which was significantly faster compared to the other two groups (P = 0.04). ConclusionsOur results indicated that all three approaches were effective in improving oral mucositis; however, curcumin could result in faster recovery in comparison with mucosamin and chlorhexidine. The use of curcumin in the treatment of oral mucositis appears to be a viable intervention for reducing potential compromise to treatment and improving the quality of life.