M.J.M. Schaeken

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

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<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.

Effects of Varnishes Containing Chlorhexidine on the Human Dental Plaque Flora

This study describes the effects of varnishes containing 0%, 10%, 20%, or 40% chlorhexidine diacetate on the microflora of human fissure dental plaque. Sandarac, a natural resin, was used as the varnish base. Ten subjects, each with at least four sound fissures harboring high levels of Streptococcus mutans, participated in the study. The fissures in each of the individuals were randomly assigned to four experimental groups, in each of which one of the varnishes was tested. The varnish treatment consisted of a single application of a small amount of varnish onto the fissures. Apart from the selected fissures, the rest of the dentition was left untreated. All chlorhexidine-containing varnishes selectively suppressed S. mutans in fissure plaque, and had no effect on total viable counts or on the numbers of Actinomyces viscosus/naeslundii and Streptococcus sanguis beyond one week. The extent of the suppression depended upon the concentration of chlorhexidine in the varnish, 40% chlorhexidine varnish giving the greatest suppression of S. mutans. At 22 weeks, after a single treatment with varnish containing 40% chlorhexidine, mean S. mutans counts were more than ten times lower than in the control or 10%chlorhexidine varnish group. At that time, S. mutans was still undetectable in five out of ten experimental fissures in this group. The results suggested that sandarac varnishes containing high concentrations of chlorhexidine can be used successfully for long-term suppression of S. mutans in dental fissures.

Effects of Sustained-release Chlorhexidine Acetate on the Human Dental Plaque Flora

The aim of this study was to determine the effect on the human dental plaque flora of a varnish containing chlorhexidine diacetate. The in vitro release of chlorhexidine acetate from the varnish preparation was relatively fast on the first day, followed by a substantial decline in the subsequent three days. In a clinical experiment, 26 volunteers were randomly distributed over four experimental groups. After a dental prophylaxis, the subjects were treated with a single application of a placebo varnish (group I), a fluoride varnish (group II), a chlorhexidine varnish (group III), or a fluoride-plus-chlorhexidine varnish (group IV). Saliva and pooled plaque samples from approximal surfaces were taken before (baseline) and one, two, three, four, and six weeks after the treatments. No suppression was found of total cultivable flora or S. sanguis after the experimental treatments. Application of the fluoride varnish did not suppress the A. viscosus/naeslundii or S. mutans levels in the dental plaque. Chlorhexidine suppressed A. viscosus/naeslundii until two weeks after the treatment. S. mutans was significantly suppressed until four weeks after a single chlorhexidine application. While in some subjects S. mutans was effectively suppressed over the whole experimental period, in others S. mutans recovered quickly. In five subjects in whom S. mutans recovered quickly, the dentition was treated twice with chlorhexidine varnish, with an interval of one week between the treatments. After two chlorhexidine treatments, S. mutans in saliva and on the teeth was suppressed more strongly than after a single treatment. However, the second chlorhexidine treatment could not prevent the return of S. mutans in the approximal areas to its original level.

Microflora of plaque from sound and carious root surfaces.

In 47 patients plaque samples were taken from sound and carious root surfaces. The carious surfaces were categorized as soft or hard. In total, 70 sound, 29 hard carious and 36 soft carious surfaces w

Caries control in overdenture patients 18 month evaluation on fluoride and chlorhexidine therapies

The aim of this study was to test the clinical effects of preventive regimens using fluoride and chlorhexidine on caries development in abutment teeth in patients with overdentures. 30 patients with immediate overdentures were distributed at random among three experimental groups. In these groups three different gels (placebo, fluoride, and chlorhexidine-fluoride) were tested by daily application. The patients were recalled at 6-month intervals for a period of 18 months. The life table survival ratios at patient level showed that in the chlorhexidine group caries development in the abutments was significantly reduced. In this group no caries developed. On comparison with the control group (placebo), no preventive effects of the gel were noticed for those in the fluoride group.