This double-blind controlled clinical and microbiological study was carried out to determine the effects of mouthwash preparation containing the mixture of herbal extract on developing plaque and gingivitis in the experimental gingivitis model. Following a 2-week normalization period, 34 dental students were distributed randomly into 1 of 3 treatment groups. They rinsed, under supervision, two times daily for 3 weeks with either normal saline(CT), 0.1% chlorhexidine(CH), or the mixture of herbal extract (HT), but refrained from any oral hygiene measures. The Plaque Index(PlI), the Gingival Index(GI), and the amount of Gingival Crevicular Fluid(GCF) were measured at week 0, 1, 2, and 3 of the experimental period, while the assessment of total wet weight of plaque and the phase contrast microscopic examination of plaque were performed at the end of experimental period(3 weeks). Subjects using mouthrinse preparation containing the mixture of herbal extract demonstrated negligible, if any, changes in the accumulation and microbial composition of plaque compared to those using normal saline, while the reduction of gingival inflammation by this mixture was highly significant and comparable to that of chlorhexidine. The results of this study indicate that the preparation containing the mixture of herbal extract do not provide any antiplaque benefits but is very effective in inhibiting the development of and in reducing existing experimental gingivitis when used as mouthrinse. Further research is needed to determine whether a significant reduction of gingival inflammation without a concomitant decrease in plaque accumulation is of clinical importance.
Chlorhexidine ; Gingivitis* ; Humans ; Inflammation ; Oral Hygiene ; Organization and Administration ; Students, Dental

This study evaluated the efficacy and safety of medical shampoo containing terbinafine hydrochloride and chlorhexidine gluconate in dogs with dermatophytos is complicated with bacterial infection. Although several studies in dogs and cats with fungal dermatitis have found that oral administration of terbinafine is effective for controlling clinical signs, the topical form of terbinafine has rarely been studied in dogs and cats. Therefore, this study evaluated the efficacy of medical shampoo containing terbinafine hydrochloride and chlorhexidine gluconate in dogs with dermatophytos is complicated with bacterial infection. Eight dogs infected with Microsporum spp. complicated with bacterial infection were enrolled in this study. These dogs were further blindly divided into Group 1 (no treatment, fourdogs) and group 2 (treated with medical shampoo with terbinafine/chlorhexidine, four dogs). Clinical improvement was evaluated using bacterial and fungal cultural evaluation combined with clinical evaluation. This study found that the medical shampoo has sufficient efficacy to treat varying degrees of dermatophytosis complicated with bacterial infection in dogs, although the speed of improvement differed according to the degree and type of infection. Our study also found that combined therapy using antifungal and antibacterial agents can improve clinical signs more effectively and rapidly, suggesting that concurrent bacterial infection plays a significant role in the development of dermatitis.
Administration, Oral ; Animals ; Anti-Bacterial Agents ; Bacterial Infections* ; Cats ; Chlorhexidine* ; Dermatitis ; Dogs* ; Microsporum ; Naphthalenes ; Tinea*

PURPOSE: Intravesical instillation of bacillus Calmette-Guerin(BCG) is an established and effective therapy for the superficial bladder carcinoma. The viability of BCG is crucial for the induction of a local immune response as well as effective therapy of recurrent superfical bladder carcinoma. Lubricants are used to facilitate catheterization during intravesical instillation of BCG. Moreover bacteriostatic components contained in them have potential to reduce the viability of the BCG. To verify this assumption, inhibitory effect of four commercially available lubricants on the BCG growth was analyzed. MATERIALS AND METHOD: Four different lubricants and their components were co-incubated with Connaught strain BCG and the resultant growth of BCG was assessed. RESULTS: Significant impairment of BCG viability with lubricants was noted. Chlorhexidine digluconate which is the component of lubricant was considered as responsible for this inhibition. CONCLUSIONS: During intravesical BCG, lubricants might reduce the number of viable BCG in clinical use. For this reason, during intravesical immunotherapy with BCG small amounts of lubricants should be used for urethral catheterization and use of lubricant which does not contain bacteriostatic agent should be considered.
Administration, Intravesical ; Bacillus* ; Catheterization ; Catheters ; Chlorhexidine ; Immunotherapy ; Lubricants ; Mycobacterium bovis ; Thiram ; Urinary Bladder ; Urinary Catheterization ; Urinary Catheters

Chlorhexidine is widely used as an antiseptic and disinfectant in medical and nonmedical environments. Although the sensitization rate seems to be low, its ubiquitous use raises the possibility of sensitization in many patients and medical care workers. We describe a patient with anaphylaxis during digital rectal examination with chlorhexidine jelly. Urticaria, angioedema, dyspnea, and hypotension developed within a few minutes of the rectal examination. The patient fully recovered after treatment with epinephrine and corticosteroids. Skin tests for chlorhexidine were undertaken 5 weeks later, showing positive prick and intradermal skin tests. Within 30 min of the skin test, the patient complained of febrile sensation, chest tightness, angioedema, and urticaria on the face and trunk. An enzyme allergosorbent test for latex was negative. We present this case to alert clinicians about hypersensitivity to chlorhexidine that could potentially be life-threatening. We suggest that chlorhexidine should be recognized as a causative agent of anaphylaxis during procedural interventions.
Administration, Topical ; Adrenal Cortex Hormones/administration & dosage ; Anaphylaxis/*chemically induced/drug therapy ; Anti-Infective Agents, Local/administration & dosage/*adverse effects ; Chlorhexidine/administration & dosage/*adverse effects ; *Digital Rectal Examination ; Epinephrine/administration & dosage ; Humans ; Male ; Middle Aged ; Sympathomimetics/administration & dosage

INTRODUCTIONThe surgeon uses different methods of surgical hand antisepsis with the aim of reducing surgical site infections. To date, there are no local studies comparing the efficacy of iodine hand scrub against newer alcohol-based hand rubs with active ingredients. Our pilot study compares a traditional aqueous hand scrub using 7.5% Povidone iodine (PVP-I) against a hand rub using Avagard: 61% ethyl alcohol, 1% chlorhexidine gluconate. The outcome measure is the number of Colony Forming Units (CFU) cultured from 10-digit fingertip imprints on agar plates.

MATERIALS AND METHODSTen volunteers underwent 2 hand preparation protocols, with a 30-minute interval in between-Protocol A (3-minute of aqueous scrub using PVP-I) and Protocol B (3-minute of hand rub, until dry, using Avagard). In each protocol, fingertip imprints were obtained immediately after hand preparation (t(0)). The volunteers proceeded to don sterile gloves and performed specific tasks (suturing). At one hour, the gloves were removed and a second set of imprints was obtained (t(1)).

RESULTSFour sets of fingertip imprints were obtained. All 10 participants complied with the supervised hand preparation procedures for each protocol. CFUs of initial fingertip imprints (t(0)): The median CFU counts for initial imprint was significantly higher in the PVP-I treatment (median = 6, Inter Quartile Range (IQR) = 33) compared to the Avagard treatment (median = 0, IQR = 0, P <0.001). CFUs of fingertip imprint at 1 hour (t(1)): The median CFU counts for second imprint (t(1)) was significantly higher in the PVP-I treatment (median = 0.5, IQR = 11) compared to the Avagard treatment (median = 0, IQR = 0, P = 0.009). Our results suggest that the Avagard was more efficacious than aqueous PVP-I scrub at reducing baseline colony counts and sustaining this antisepsis effect.

CONCLUSIONAlcohol hand rub with an active compound, demonstrated superior efficacy in CFU reduction. Based on our results, and those pooled from other authors, we suggest that alcohol-based hand rubs could be included in the operating theatre as an alternative to traditional surgical scrub for surgical hand antisepsis.

Alcohols ; administration & dosage ; Anti-Infective Agents, Local ; administration & dosage ; Antisepsis ; methods ; Chlorhexidine ; administration & dosage ; analogs & derivatives ; Cohort Studies ; Hand ; microbiology ; Hand Disinfection ; methods ; Humans ; Pilot Projects ; Povidone-Iodine ; administration & dosage ; Singapore

OBJECTIVETo analyze the flow of four irrigations in a root canal with different needle-insertion depth by using a computational fluid dynamics (CFD) model in order to provide a reference to the needle placement in clinical practice.

METHODSThe density and viscosity of 5.25% sodium hypochlorite (A), 3% sodium hypochlorite (B), 17% ethylenediaminetetraacetic acid (EDTA, C), 2% chlorhexidine (D) were measured. A CFD model by ICEM software was used to simulate irrigant flow from an open-ended flat needle positioned at the depth of 1, 3, 5 mm to the physiological apical within the root canal. Velocity, wall shear stress and pressure in the root canal were evaluated after setting the computing conditions with FLUENT14.0 software.

RESULTSAll the wall shear stress generated by four fluids was at peak when the needle was positioned 1 mm to the physiological apical, which were 6.72 × 10³ Pa(A), 6.35 × 10³ Pa(B), 7.47 × 10³ Pa(C), 5.26 × 10³ Pa(D), respectively. With the distance increasing, wall shear stress gradually decreased. The wall shear stress of A, B, C, D was 2.31 × 10³, 2.05 × 10³, 2.59 × 10³ and 1.81 × 10³ Pa, respectively in 3 mm group. The wall shear stress of A, B, C, D was 2.16 × 10³, 1.91 × 10³, 2.42 × 10³, 1.71 × 10³ Pa, respectively in 5 mm group.

CONCLUSIONSIt was recommended that the distance between the needle and physiological apical is 1-3 mm when flushing the root canal. The injection speed of 17% EDTA should be slower than that of the other three solutions.

Chlorhexidine ; administration & dosage ; Dental Pulp Cavity ; Edetic Acid ; administration & dosage ; Humans ; Hydrodynamics ; Needles ; Rheology ; Root Canal Irrigants ; administration & dosage ; Root Canal Preparation ; Root Canal Therapy ; instrumentation ; Sodium Hypochlorite ; administration & dosage ; Software

The chitosan thermosensitive hydrogel is liquid at room temperature but gels rapidly when heated to body temperature. This hydrogel are wildly used for cell encapsulation, drug delivery or tissue-engineered scaffolds. The system can sustain the release of macromolecules over a period of several hours to a few days. However, with low-molecular-weight compounds, the release is generally completed within 24 h. To prepare a functional chitosan thermosensitive hydrogel for slow release both broad-spectrum antibiotic chlorhexidine and growth factor recombined human bone morphogenetic protein-2 (rhBMP-2), The beta-cyclodextrin was used to prepare an inclusion complex with chlorhexidine, and then the latter was incorporated into the chitosan thermosensitive hydrogel system. Simultaneously, rhBMP-2 was added into the hydrogel system. By HAAKE viscosity measuring instrument, we contrasted the viscoelastic properties of system with or without objective factors. And the in vitro release kinetics of chlorhexidine and rhBMP-2 was investigated by HPLC (high performance liquid chromatography) and ELISA (enzyme-linked immunosorbent assay) respectively. The results showed that the addition of chlorhexidine/beta-cyclodextrin inclusion complex to the thermosensitive solution did not change the gelling behavior of the thermosensitive system. Further, the in vitro release profiles demonstrated that the release rate of chlorhexidine and rhBMP-2 from hydrogel became slower, controlled delivery over at least 1 month. By first preparing chlorhexidine/beta-cyclodextrin inclusion complex, and then mixing the IC and rhBMP-2 into the chitosan thermosensitive hydrogel, a functional chitosan thermosensitive hydrogel system with ability of slow release both rhBMP-2 and chlorhexidine is successfully made.
Bone Morphogenetic Protein 2 ; Bone Morphogenetic Proteins ; administration & dosage ; Chitosan ; chemistry ; Chlorhexidine ; administration & dosage ; Delayed-Action Preparations ; chemical synthesis ; Drug Carriers ; chemistry ; Drug Combinations ; Hydrogels ; chemistry ; Recombinant Proteins ; administration & dosage ; Temperature ; Transforming Growth Factor beta ; administration & dosage

OBJECTIVETo evaluate the inhibitory effects of topical application of specific immunoglobulin yolk antibodies (IgY) to mutans streptococci on composition of human dental plaque.

METHODSA total of 24 healthy adult volunteers were selected and randomly distributed into three experimental groups. After a supragingival scaling, the subjects were treated with an application of IgY containing spray (test group, n = 9), a 0.15% chlorhexidine(CH) spray(positive control group, n = 9) or a placebo phosphate buffered saline(PBS) spray without any active ingredients(negative control group, n = 6) three times daily for three weeks. Pooled plaque samples from the smooth surfaces of teeth were collected for microbiologic analysis before administration (baseline, day 0), during treatment(days 7, 14 and 21) and after withdrawal of the agents(days 28, 42 and 56) and plaque index were recorded. Microbial cultivation were performed by serially diluting the samples with PBS solution an cultivating the aliquots on mitis salivarius agar(MS) and MS supplemented with bacitracin (MSB) for oral streptococci and mutans streptococci respectively. The number of colony-forming unit (CFU) per plate was counted and the percentage of mutans streptococci per oral streptococci in dental plaque were determined. The effect of IgY on colonization of mutans streptococci were analyzed by an analysis of variance (ANOVA).

RESULTSThe plaque indexes remained unchanged, but mutans streptococci in dental plaque was suppressed significantly following a short term(three weeks) application of IgY, and low level of mutans streptococci persisted for at least 5 weeks after withdrawal of IgY.

CONCLUSIONThe results suggest that the immunization with specific immunoglobulin yolk against mutans streptococci could be useful for long term suppression of mutans streptococci colonization in human dental plaque.

Adult ; Animals ; Anti-Infective Agents, Local ; administration & dosage ; Chickens ; Chlorhexidine ; administration & dosage ; Colony Count, Microbial ; Dental Caries ; prevention & control ; Dental Plaque ; microbiology ; Humans ; Immunoglobulins ; pharmacology ; Mouth ; microbiology ; Mouthwashes ; Streptococcus mutans ; drug effects ; isolation & purification

In an effort to characterize, on the molecular scale, the Acanthamoeba initially isolated from the cornea of an amoebic keratitis patient associated with overnight-wear orthokeratology lens in Korea, we conducted mitochondrial DNA restriction fragment length polymorphism, 18S rDNA sequencing, and drug sensitivity analyses on the isolate (KA/PE1). The patient was treated with polyhexamethylene biguanide, chlorhexidine and oral itraconazole, which resulted in resolution of the patient's ocular inflammation. The majority of the molecular characteristics of the KA/PE1 were determined to be identical, or quite similar, to those of A. castellanii Ma strain, which had been isolated also from amoebic keratitis. The risk of Acanthamoeba keratitis as a potential complication of overnight orthokeratology is briefly discussed.
*Sequence Analysis, DNA ; RNA, Ribosomal, 18S/genetics ; Polymorphism, Restriction Fragment Length ; Parasitic Sensitivity Tests ; Myopia/therapy ; Itraconazole/administration & dosage ; Humans ; Female ; Disinfectants/administration & dosage ; DNA, Ribosomal/analysis ; DNA, Protozoan/analysis ; DNA, Mitochondrial/analysis ; Contact Lenses/*adverse effects ; Chlorhexidine/administration & dosage ; Biguanides/administration & dosage ; Astigmatism/therapy ; Antiprotozoal Agents/administration & dosage ; Animals ; Adolescent ; Acanthamoeba Keratitis/drug therapy/*parasitology ; Acanthamoeba/classification/*genetics/*isolation & purification

OBJECTIVETo evaluate the effect of concentration of chlorhexidine on bonding durability of dentine and resin.

METHODSForty extracted third molars were randomly allocated into five groups, which include one control group and four test groups. Teeth dentin surfaces in each group were treated with one of the following solution, 1.5 microl water (control), 0.02%, 0.2%, 2% and 20% chlorhexidine. Single Bond 2 adhesive was applied to the dentin surface according to manufacturer's recommendations. Then 5 mm thickness of composite (Z250) was built up on the dentin of each molar. The teeth were sectioned into microtensile samples and subdivided into two subgroups, 16 samples each. Samples in subgroup II and I were tested after being stored in distilled water for 24 h and 6 month respectively. Each fractured sample was examined with SEM.

RESULTSNo significant differences of 24 h bonding strength were found among the five groups. There were significant difference in bonding strength between 0.2%, 2% chlorhexidine groups [(24.68 ± 5.26) and (23.19 ± 5.26) MPa] and the control group [(19.10 ± 4.67) MPa] after 6 month (P = 0.007,0.045), and significant differences were also found between 0.2%, 2% and 0.02% chlorhexidine group [(19.01 ± 6.87) MPa, P = 0.006, 0.041). Most of the fractured modes were mixed or interface failures after 24 h of water storage, and the mixed failure increased after six month of water storage. In the 0.2%, 2% and 20% chlorhexidine treated group, most of the failure was found at the top of hybrid layer, while in the 0.02% group, it was found in the base part of hybrid layer.

CONCLUSIONSChlorhexidine could increase the bonding durability of resin and dentine. Higher than 0.2%, concentration of chlorhexidine couldn't improve bonding durability.

Bisphenol A-Glycidyl Methacrylate ; chemistry ; Chlorhexidine ; administration & dosage ; chemistry ; Composite Resins ; chemistry ; Dental Bonding ; Dental Stress Analysis ; Dentin ; ultrastructure ; Dentin-Bonding Agents ; chemistry ; Dose-Response Relationship, Drug ; Humans ; Microscopy, Electron, Scanning ; Molar, Third ; Random Allocation ; Surface Properties ; Tensile Strength