Effects of Fluoride and Chlorhexidine on the Microflora of Dental Root Surfaces and Progression of Root-surface Caries

Abstract

The effects of fluoride and chlorhexidine varnishes on the microflora of dental root surfaces and on the progression of root-surface caries were studied. Forty-four patients, surgically treated for advanced periodontal disease, were distributed at random among three groups. All patients received a standardized preventive treatment. Furthermore, the dentition of the patients in the two experimental groups was treated, at three-month intervals, with chlorhexidine and fluoride varnish, respectively. Patients in the control group received no additional treatment. In the experimental groups, plaque samples were collected from selected sound and carious root surfaces at baseline and at three, six, and nine months after the onset of the study. The presence of root-surface caries was scored at baseline and after one year. In addition, the texture, depth, and color of the root-surface lesions were monitored. Mutans streptococci on root surfaces were suppressed significantly (p less than 0.05) during the whole experimental period in the chlorhexidine varnish group, but not in the fluoride varnish group. A non-significant increase in the number of Actinomyces viscosus/naeslundii was noted after treatment with chlorhexidine and fluoride varnish. The increase in the number of decayed and filled root surfaces after one year was significantly lower in the experimental groups than in the control group. After treatment with chlorhexidine varnish, significantly more initial root-surface lesions had hardened than in the other groups.

Systematic Review on Noninvasive Treatment of Root Caries Lesions

“…The median (25th/75th percentiles) follow-up time was 15 (12/24) mo. Eleven studies investigated dentifrices (Jensen and Kohout 1988;Banoczy and Nemes 1991;Baysan et al 2001;Paraskevas et al 2004;Papas et al 2007;Papas et al 2008;Vered et al 2009;Ekstrand et al 2013;Hu et al 2013;Souza et al 2013;Srinivasan et al 2013), 10 rinses (Ripa et al 1987;Banoczy and Nemes 1991;Ravald and Birkhed 1992;Wallace et al 1993;Fure et al 1998;Powell et al 1999;Paraskevas et al 2004;Wyatt and MacEntee 2004;Petersson et al 2007;Wyatt et al 2007), 8 varnishes (Schaeken et al 1991;Ravald and Birkhed 1992;Powell et al 1999;Banting et al 2000;Baca et al 2009;Fure and Lingstrom 2009;Tan et al 2010;Zhang et al 2013), 3 (fluoride) solutions (Fure and Lingstrom 2009;Tan et al 2010;Zhang et al 2013), 3 gels (Ravald and Birkhed 1992;DePaola 1993;Wallace et al 1993), 2 ozone applications (Holmes 2003;Baysan and Lynch 2007), and 1 preventive dental regimes (Mojon et al 1998). Eleven studies investigated both initiation of RCLs and the change of RCLs, 11 analyzed the change of RCLs, and 8 studied initiation of RCLs ...…”

“…Although analyses showed that different chemical agents may be capable of reducing the initiation of RCLs, metaanalyses were performed only for chemical agents with similar interventions and outcome measures investigated in more than 1 study. Analyses could not be performed for varnish containing 22,500 ppm F -(Duraphat), since these studies used Duraphat as a control group without having a second (negative) control group (Ravald and Birkhed 1992;Fure and Lingstrom 2009) or the results were presented according to different indices (DMFRS or texture) and did not report all information required for recalculation (Schaeken et al 1991;Tan et al 2010). For CHX mouth rinses (Powell et al 1999;Wyatt and MacEntee 2004;Wyatt et al 2007) and ozone treatment (Holmes 2003;Baysan and Lynch 2007), recalculation was not possible owing to insufficient data presentation.…”

Proefschriften 25 jaar na dato 21. Bacteriebestrijding met chloorhexidinevernis en probiotica

“…Klinisch bleek dat mutans streptokokken alleen langdurig konden worden onderdrukt door zeer intensieve applicatie van chloorhexidine, bijvoorbeeld door 1% chloorhexidinegel gedurende 14 dagen 5 minuten per dag te appliceren in individuele gebitstrays (Zickert et al, 1982 (Schaeken et al, 1991). Mutans streptokokken herstellen zich na de behandeling slechts zeer langzaam omdat zij gevoeliger zijn voor chloorhexidine dan de meeste andere plaquebacteriën en voor hun groei afhankelijk zijn van koolhydraten uit voedsel.…”

Antimicrobial Effectiveness of a Highly Concentrated Chlorhexidine Varnish Treatment in Teenagers with Fixed Orthodontic Appliances

“…[12][13][14] Numerous studies have examined highly concentrated chlorhexidine varnishes as supersaturated solutions of chlorhexidine diacetate in ethanol, stabilized by the natural resin sandarac. [15][16][17][18][19] In these examinations, the optimal chlorhexidine varnish concentration suggested for suppression of ms amounted to 36% chlorhexidine, as represented by the varnish EC40ா (Dentres, Nijmegen, The Netherlands).…”

“…EC40ா is a highly concentrated chlorhexidine varnish as supersaturated solution of chlorhexidine diacetate in ethanol, stabilized by the natural resin sandarac. 17,[25][26][27][28] The varnish is available in glass ampoules containing approximately 1.5 mL varnish. The ampoules fit into the normal syringe used for anesthesia.…”