Microbiological Changes and Caries-Preventive Effect of an Innovative Varnish Containing Chlorhexidine in Orthodontic Patients

Abstract

The aim of this study was to investigate the effects of Cervitec Plus® on the level of mutans streptococcus (SM) and lactobacillus (LB) colonies and the development of white spot lesions (WSLs) in patients with fixed orthodontic appliances. Informed consent was obtained from 32 volunteers (age 16.5 ± 2.75 years). At baseline, levels of the bacterial colonies were determined in saliva and plaque using a chairside test (CRT Bacteria, Ivoclar-Vivadent, Schaan, Liechtenstein), and the number of WSLs was registered. After placing the fixed appliance, Cervitec Plus® or placebo varnishes (Ivoclar-Vivadent, Schaan, Liechtenstein) were applied monthly around the brackets and tubes, randomly in the right or left (test and placebo) quadrants of the same dental arch. SM and LB colonies in saliva and the SM colonies in plaque were determined on 11–21, 13–23, 15–25, and 16–26 teeth monthly over a 6-month period. At the sixth month, the number of new WSLs was determined. By the end of the study, compared with baseline, the ratio of saliva samples belonging to the low-risk category was significantly higher (p ≤ 0.01) from the 2nd month regarding the SM (76 vs. 52%) and LB (69 vs. 52%); reduction of SM in plaque was significantly greater on the test than placebo sides (6.69 ± 1.71 and 4.45 ± 1.60, respectively; p ≤ 0.01). The mean number of new WSLs was significantly lower in the test (0.06 ± 1.60) than in the placebo quadrants (1.13 ± 1.50, p ≤ 0.01). Conclusion: Monthly use of Cervitec Plus® could result in a significant improvement in oral health of orthodontic patients.

Chlorhexidine hexametaphosphate as a coating for elastomeric ligatures with sustained antimicrobial properties: A laboratory study

“…The aim of the present study was to determine whether it was possible to produce elastomeric ligatures capable of sustained chlorhexidine release. The utility of topical CHX products in reducing microbial colonisation and inhibiting the formation of WSL in orthodontic patients is widely recognised 21,22,23 . CHX digluconate and diacetate have both previously been incorporated into prototype ligatures comprised of three polyurethane layers.…”

Antiadherence and Antimicrobial Properties of Silver Nanoparticles against Streptococcus mutans on Brackets and Wires Used for Orthodontic Treatments

“…Despite hygiene therapies for the control of dental caries/WSLs, the frequency of WSLs in orthodontic treatments remains significantly high. Several studies have demonstrated that from 2% up to 96% of the patients with this kind of therapies could strongly develop conditions to increase the risk of WSLs in subjects with orthodontic appliances [3,[11][12][13]; indicating, in some cases, that more than 50% of subjects with fixed orthodontic appliances might experience an increased risk in the number of WSLs during the orthodontic treatment [14]. This is a clinical problem that might create an unacceptable esthetic alteration that, in some severe cases, may involve restorative treatments [11].…”

“…This is a clinical problem that might create an unacceptable esthetic alteration that, in some severe cases, may involve restorative treatments [11]. Dental protocols for the prevention and control of WSLs based on fluoride tools have been the most successful treatments [12,13]; moreover, other alternative protocols using innovating varnishes have recently demonstrated to have different physicochemical properties to the control of the development of incipient dental caries [14,15]. Recently, silver nanoparticles (AgNPs) have been shown to be materials with excellent antimicrobial properties in a wide variety of microorganisms [6,[16][17][18][19].…”

Microbiomes in Supragingival Biofilms and Saliva of Adolescent Patients with Induced and Naturally Occurring Gingivitis Relative to Gingival Health

“…The patients' characteristics, including the Modi ed Gingival Indices (MGI) characteristic for the gingival condition [35,36], are summarized in Supplementary table 1. Fixed orthodontic appliances were placed on the labial tooth surfaces (more than 1.5 mm from the gingival margin) according to the professional rules with an acid-etch composite system (Transbond XT, 3M Unitek, Neuss, Germany), as in an earlier study [37].…”