两种根管冲洗液对狗牙根管内细菌抗菌作用的实验研究

目的观察2%洗必泰溶液和3%双氧水2种根管冲洗液对狗牙根管内粪肠球菌、溶血链球菌、微小消化链球菌、中间普氏菌及具核酸杆菌的影响,为临床根管治疗提供参考。方法选择成年健康杂种狗3只,共有24个实验牙,48个实验牙根。于狗牙根管内接种粪肠球菌、溶血链球菌、微小消化链球菌、中间普氏菌及具核酸杆菌。对狗牙完成根管治疗。于治疗后12个月拍摄根尖X线片,并记录牙齿和根尖周组织的临床表现。将患牙随机分为3组,每组7颗患牙,去除根管内充填物并进行根管预备,实验一组用2%洗必泰溶液冲洗根管,实验二组用3%双氧水冲洗根管,对照组用0.9%NaC l溶液冲洗根管。分别在根管预备前及根管预备冲洗后对根管内细菌取样,培养,鉴定并记录细菌菌落数量,测定根管内细菌变化情况。结果根管预备冲洗后3组根管内的细菌量均较根管预备前显著下降（P〈0.05）。2%洗必泰溶液和3%双氧水2种根管冲洗液的杀菌效果明显好于0.9%NaC l溶液（P〈0.05）,2%洗必泰溶液明显好于3%双氧水（P〈0.05）。结论2%洗必泰溶液是有效的根管冲洗药物,可明显减少狗牙根管内粪肠球菌、溶血链球菌、微小消化链球菌、中间普氏菌及具核酸杆菌的数量,但不能完全清除根管内的细菌。     

Synergism between Chlorhexidine and Sulphadiazine

Chlorhexidine and sulphadiazine react synergistically against strains of Pseudomonas. Proteus and Staphylococcus , with high factors of synergy. The impermeability of these strains to sulphadiazine is destroyed by low concentrations of chlorhexidine, permitting the accumulation of sulphadiazine which then inhibits protein synthesis. The combination of these drugs is bactericidal.     

Mechanism of resistance of Bacillus subtilis spores to chlorhexidine

Chlorhexidine diacetate (CHA) was rather more sporicidal at 20C to ureadithreitol-sodium lauryl sulphate (UDS)-treated spores of Bacillus subtilis NCTC 8236 than to urea-dithiothreitol (UDT)-treated or normal (untreated) spores. UDS spores adsorbed more CHA from solution than did the other two forms. No differences in hydrophobicity, as determined by hydrophobic interaction chromatography (HIC) or bacterial adherence to hydrocarbon (BATH), could be detected between the three spore types. Germinating spores took up much less CHA than did outgrowing spores. Germinating cells were considerably more hydrophobic, as measured by the BATH technique, than outgrowing cells or normal spores. Chlorhexidine diacetate increased the apparent hydrophobicity of the two latter forms, but this effect could be partially reversed by subsequent exposure to a non-ionic surfactant.     

Mechanism of resistance of Bacillus subtilis spores to chlorhexidine

Chlorhexidine diacetate (CHA) was rather more sporicidal at 20 degrees C to urea-dithreitol-sodium lauryl sulphate (UDS)-treated spores of Bacillus subtilis NCTC 8236 than to urea-dithiothreitol (UDT)-treated or normal (untreated) spores. UDS spores adsorbed more CHA from solution than did the other two forms. No differences in hydrophobicity, as determined by hydrophobic interaction chromatography (HIC) or bacterial adherence to hydrocarbon (BATH), could be detected between the three spore types. Germinating spores took up much less CHA than did outgrowing spores. Germinating cells were considerably more hydrophobic, as measured by the BATH technique, than outgrowing cells or normal spores. Chlorhexidine diacetate increased the apparent hydrophobicity of the two latter forms, but this effect could be partially reversed by subsequent exposure to a non-ionic surfactant.     

A Study of Chlorhexidine Gel Treatment in an Oral Hygiene Program for Elderly Patients in Long Term Care1

An investigation was made to measure the effectiveness of one of the newer agents used in promotion of oral hygiene, i.e., Chlorhexidine gel. The study was designed with elderly people in long term care.     

The mechanism of action of chlorhexidine

Chlorhexidine did not inhibit ATPase in intact cells of Escherichia coli K12 W1317i-, even at bactericidal concentrations, and ATP hydrolysis was greatest at the highest concentration (40 mg/l), even though no net uptake of substrate occurred. Like dinitrophenol and tribrominated salicylanilide, polymyxin and chlorhexidine collapsed the membrane potential at inhibitory concentrations. Membrane disruption, and not ATPase inactivation, is considered the lethal event in chlorhexidine action.     

Influence of potassium chloride upon the binding and antibacterial activity of chlorhesidine diacetate and (ethoxy)5 octyl phenol (Triton X45) towards Bacillus megaterium KM-.

Chlorhexidine (0.5-0.65 microM) and Triton X45 (30-40 microM) added to exponential phase Bacillus megaterium KM- cultures was growth inhibitory. The presence of KCl (0.05-0.35 M) in the medium did not significantly affect growth rate in the absence of drug, yet reduced the growth inhibitory activity of the chlorhexidine and enhanced that of Triton X45. These effects were maximal at KCl concentrations of 0.2 M and above, when complete protection towards chlorhexidine and lysis of the cultures in the presence of Triton X45 were observed. Time-survivor curves in the presence of chlorhexidine (0.7-1.0 microM) gave LT90 values of 1.5-2.0 h in the absence of KCl, yet its inclusion (0.35 M) totally inhibited this low level bactericidal activity. Drug absorption by whole cell and isolated cell wall preparations was determined in the presence and absence of KCl (0.35 M). Chlorhexidine uptake by intact cells was reduced by approximately 50% in the presence of salt whereas that of Triton X45 increased by a similar fraction. Uptake of chlorhexidine by the cell wall fraction accounted for approximately 50% of that for the whole cells and was relatively unaffected by the presence of KCl. Conversely, absorption of Triton X45 by the cell wall fraction accounted for most of the uptake by whole cells and increased markedly in the presence of salts.     

Anti-mycobacterial activity of biocides

The effects of different biocides on the growth and viability of Mycobacterium tuberculosis and other mycobacteria were studied. Mycobacterium phlei was the most sensitive of the test strains with a strain of the M. avium intracellulare (MAI) complex the most resistant. Chlorhexidine diacetate, quaternary ammonium compounds, a phenolic and esters of para (4)-hydroxybenzoic acid were inhibitory but not lethal to MAI, whereas 2% glutaraldehyde was bactericidal against all strains.     

Efficacy of chlorhexidine cleansing in reducing contamination of bagged urine specimens

To determine the effectiveness of precleansing with chlorhexidine gluconate-cetrimide in reducing the contamination rate of bagged urine specimens, 62 infants admitted to a children''s hospital were randomly assigned to either receive (32 infants) or not receive (30) cleansing before bag application. Perimeatal swabs were taken before bag application and, in the treated group, after cleansing. Of the specimens from the treated group 69% were found to be contaminated, compared with 73% of those from the no-cleansing group. Chlorhexidine was ineffective in eliminating the perimeatal flora in 75% of the infants. The same organisms were present on the perimeatal swab and in the urine specimen in 95% of the infants in the treated group and 96% of those in the no-cleansing group. To estimate the contamination rate of urine specimens routinely cultured in the laboratory, 200 consecutive specimens (142 midstream and 58 bagged) were cultured. The contamination rate of the midstream urine specimens was 15%, compared with 66% for the bagged speciments. The cost of laboratory processing of contaminated bagged urine specimens at the hospital in 1983 may have been as high as $13 365. Chlorhexidine cleansing does not appear to be cost-effective. Further randomized controlled studies are needed to evaluate the effectiveness of other cleansing agents in reducing the contamination rate of bagged urine specimens.     

Action of chlorhexidine on buddingCandida albicans: Scanning and transmission electron microscopic study

Chlorhexidine is widely used as a bacterial drug whose method of action has been well described in bacteria. Its fungicidal properties have been proved. We show here the effects of a sublethal dose of a preparation of digluconate of chlorhexidine on buddingCandida albicans. A fungistatic action is revealed by a decrease in the percentage of budding cells, and two main types of alterations can be observed with transmission electron microscopy (T.E.M.): a loss of cytoplasmic components and a coagulation of nucleoproteins. With scanning electron microscopy (S.E.M.), the cell walls show morphological modifications.     

Effect of chlorhexidine/EDTA/Tris against bacterial isolates from clinical specimens

Chlorhexidine/EDTA/Tris was more active compared with chlorhexidine against the following species of organisms: Acinetobacter species, Citrobacter species, Enterobacter species, Escherichia coli, Proteus mirabilis, Providence species, Pseudomonas species, Staphylococcus aureus, Staphylococcus epidermidis and Streptococcus faecalis, when tested in isosensitest agar. The addition of 20% serum to the medium reduced its effectiveness mainly against Providence species, Proteus species, and Streptococcus faecalis. However, the potential for this solution as a bladder instillation or topical antiseptic should be considered because of its reduced side effects compared with chlorhexidine alone, and its increased general effectiveness against all isolates tested.     

Reversal of the surface effects of chlorhexidine diacetate on cells of Providencia stuartii

Chlorhexidine diacetate (CHA) increased the hydrophobicity of the cell surface of cells of three strains of Providencia stuartii. Removal of at least some of the CHA from the cells by washing them with an appropriate antidote partially reversed the hydrophobicity-increasing action of the biguanide. The effects of other treatments on cell surface hydrophobicity were examined with these strains and, for comparison, with two strains each of Escherichia coli and Pseudomonas aeruginosa: ethyl-enediamine tetraacetic acid affected all strains, although not to the same extent, whereas thermal injury (55°C) produced marked changes only with the two E. coli strains.     

The effect of a novel anti-adherent compound on the adherence of oral streptococci to hydroxyapatite

The effect of the copolymer M239, 144 with and without chlorhexidine on the adherence of oral streptococci to saliva-coated hydroxyapatite was investigated. At 1% w/v M239, 144 reduced the adherence of Streptococcus sanguis NCTC 7863 by 94%. It had a moderate effect on the adherence of other Strep. sanguis strains and a Streptococcus gordonii strain but had no effect on the adherence of Streptococcus oralis or Streptococcus mutans. Chlorhexidine did not influence the anti-adhesive properties of 1% w/v M239, 144.     

Reversal of the surface effects of chlorhexidine diacetate on cells of Providencia stuartii

Chlorhexidine diacetate (CHA) increased the hydrophobicity of the cell surface of cells of three strains of Providencia stuartii. Removal of at least some of the CHA from the cells by washing them with an appropriate antidote partially reversed the hydrophobicity-increasing action of the biguanide. The effects of other treatments on cell surface hydrophobicity were examined with these strains and, for comparison, with two strains each of Escherichia coli and Pseudomonas aeruginosa: ethylenediamine tetraacetic acid affected all strains, although not to the same extent, whereas thermal injury (55 degrees C) produced marked changes only with the two E. coli strains.     

Inhibition of acetylpolyamine and spermine oxidases by the polyamine analogue chlorhexidine

Acetylpolyamine and spermine oxidases are involved in the catabolism of polyamines. The discovery of selective inhibitors of these enzymes represents an important tool for the development of novel anti-neoplastic drugs. Here, a comparative study on acetylpolyamine and spermine oxidases inhibition by the polyamine analogue chlorhexidine is reported. Chlorhexidine is an antiseptic diamide, commonly used as a bactericidal and bacteriostatic agent. Docking simulations indicate that chlorhexidine binding to these enzymes is compatible with the stereochemical properties of both acetylpolyamine oxidase and spermine oxidase active sites. In fact, chlorhexidine is predicted to establish several polar and hydrophobic interactions with the active site residues of both enzymes, with binding energy values ranging from ?7.6 to ?10.6 kcal/mol. In agreement with this hypothesis, inhibition studies indicate that chlorhexidine behaves as a strong competitive inhibitor of both enzymes, values of K_i being 0.10 μM and 0.55 μM for acetylpolyamine oxidase and spermine oxidase, respectively.     

Action de la chlorhexidine sur l'expression de la virulence de Candida albicans

Candida albicans is an opportunistic yeast. Its pathogenicity is linked to the susceptibility of the host surface as well as to particular factors of the strain: adhesion, filamentous growth and secretion of proteolytic enzymes. Chlorhexidine digluconate is an antiseptic with fungicidal properties. The action of the antiseptic on the growth of the yeast shows a minimal inhibitory concentration (MIC) at 50 μg·mL⁻¹ and a minimal fungicidal concentration (MFC) at 100 μg·mL⁻¹. The consequences of antiseptic treatment are studied using two indicators of pathogenicity: filamentation and the secretion of acid proteinase. Concerning the morphological indicator, a complete inhibition of filamentation for antiseptic concentration far below the MIC is observed; concerning the biochemical indicator, the results show a maintenance of proteolytic activity for concentration equal to the MIC and a disappearance of this activity between the MIC and the MFC. Concerning the proteolytic activity, Skim Milk (Difco) was substituted for bovine serum albumin with success. This mixture of casein allows to use a cheaper and more easily available substrate.     

Effect of chlorhexidine on a chlorhexidine-sensitive and a chlorhexidine-resistant strain of Providencia stuartii

The sensitivity and resistance of three strains of Providencia stuartii to various antibacterial agents, and especially to chlorhexidine, are described. Providencia stuartii Pv 2 was the most sensitive, and Pv 67 the most resistant, to chlorhexidine and to polymyxin B. These two strains took up approximately equal amounts of chlorhexidine from solution, but the biguanide had a considerably greater effect on the electrophoretic mobility of cells of strain Pv 2. Greater inner membrane damage (determined by the leakage of K⁺ and of pentoses) occurred with Pv 2. Chlorhexidine at 20 μg/ml achieved a 2-log reduction and 50 μg/ml a > 7-log reduction in viable numbers in strain Pv 2 over a 120 min contact period at 20C. In contrast, these concentrations induced < 0.5 log reduction in strain Pv 67.     

Regional specificity of chlorhexidine effects on taste perception

Chlorhexidine (CHX) gluconate, a bitter bis-biguanide antiseptic, reduces the intensity of the salty taste of NaCl and bitter taste of quinine in humans. This study addresses regional specificity of CHX's effects on taste. Perceptual intensity and quality were measured for separate taste bud containing oral loci innervated either by afferent fibers of cranial nerve (CN) VII or CN IX. Measurements were obtained following three 1-min oral rinses with either 1.34 mM CHX or water, the control rinse. CHX rinse reduced the intensity of NaCl more at the tongue tip and palate than at posterior oral sites. Thus, fungiform and palatal salt-taste receptors may differ from salt-taste receptors of the foliate and circumvallate taste papillae. The intensity of quinine.HCl was reduced equally by CHX at all sites tested but was frequently tasteless on the less sensitive anterior sites, suggesting quinine receptor diversity. In rodents, a portion of NaCl-taste receptors in the receptive field of CN VII is sensitive to the epithelial Na+ channel blocker amiloride and a portion is amiloride insensitive; all CN IX receptors are amiloride insensitive. The current results are the first to suggest that there may also be distinct, regionally specific populations of NaCl-taste receptors in humans.     

Location of chlorhexidine in DMPC model membranes: a neutron diffraction study

Chlorhexidine (CHX) is an effective anti-bacterial agent whose mode of action is thought to be the disruption of the cell membrane. It is known to partition into phospholipid bilayers of aqueous model-membrane preparations. Neutron diffraction data taken at 36 °C on the location of CHX in phosphatidylcholine (PC) bilayers is presented. The center of mass of the deuterated hydrocarbon chain of CHX is found to reside 16 Å from the center of the bilayer in 1,2-dimyristoyl-sn-glycero-3-phosphatidylcholine (14:0–14:0 PC). This places the drug near the glycerol backbone of the lipid, and suggests a mode of action whereby the molecule is bent in half and inserts wedge-like into the lipid matrix. This mechanism is distinct from detergent-like mechanisms of membrane disruption and more similar to some anti-microbial peptide action, where peptides insert obliquely into the bilayer headgroup region to disrupt its structure.     

Comparative clinical data for gingivitis treatment using gels from Ocimum sanctum (Tulsi) and chlorhexidine (CHX)

Ocimum sanctum (Tulsi) has various properties like anti bacterial, anti inflammatory, anti oxidant for curing diseases. It is a plant with known medicinal value in Indian system of medicine. Therefore, it is of interest to evaluate the effectiveness of Ocimum sanctum with Chlorhexidine (CHX) which is a standard material for the treatment of gingivitis. We used 30 gingivitis subjects divided into 2 groups. Group I used Tulsi gel (n= 15) and Group II used CHX gel (n = 15) for treatment. Tulsi and CHX gel use was advised for 1 month. The Clinical parameters assessed were gingival Index (GI), plaque Index (PI), probing depth (PD) and clinical attachment loss (CAL) assessed at a time interval of 30 days. Statistical analysis was completed using the SPSS software 23.0. Data showed that GI and PD for Tulsi and CHX in pre and post groups are not significant with p > 0.05. Moreover, PI is not significant with p>0.05 among pre Tulsi, pre CHX and post CHX. However, data is significant with p<0.05 for Tulsi group. CAL is significant with p<0.05 among pre/post Tulsi groups. However, this is not significant with p>0.05 among pre/post CHX groups. Data shows that 2% of Tulsi is effective in reducing gingival bleeding and inflammation. Thus, clinical data shows that Tulsi gel is promising for the treatment of gingivitis.