Analysis of Chlorhexidine Modified Cement in Orthodontic Patients: A Double-Blinded, Randomized, Controlled Trial

Abstract

Objectives The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX) for the purpose of cementing bands to the teeth of orthodontic patients. Materials and Methods Ten patients, between the ages of 19 and 33 years, in the initial stage of orthodontic treatment, were randomly designated to two groups using the split-mouth design (n = 10). One group (GICEX) had bands cemented with GIC modified by CLX and a Control group (GIC), evaluated at time intervals before (T0), 3 months (T3), and 6 months (T6) after cementation. Total microbiological counts were performed, and color stability of tooth enamel, salivary pH, and the adhesive remnant index (ARI) were evaluated. Statistical Analysis The Friedman and Dunn’s tests, Mann–Whitney, one-way analysis of variance, and Tukey, and paired and non-paired t-tests (p< 0.05) were used. Results In T3, there was evidence of significant reduction in the quantity of colony forming unit (CFU) in GICEX group in comparison with the Control (p = 0.041). In T6, the quantity of CFU was similar to the quantity in T3 and significantly different to control (p = 0.045); Control group demonstrated a similar quantity of CFU between the experimental time intervals (p = 0.066). Salivary pH demonstrated significant difference only between the time intervals T0 and T6 (p = 0.022). The tooth enamel color (p = 0.366) and ARI (p = 0.343) values demonstrated no significant changes. Conclusion The incorporation of CLX into GIC demonstrated effective antibacterial action, allowed a good bond of the cement to the enamel, a high rate of survival of the bands, did not change the color of the tooth enamel, and maintained the salivary pH at physiological levels.

Physical/mechanical and antibacterial properties of orthodontic adhesives containing Sr-bioactive glass nanoparticles, calcium phosphate, and andrographolide

“…The addition of antibacterial agents was expected to reduce biofilm colonization around orthodontic brackets. Studies have shown that the addition of chlorhexidine into orthodontic cements enhances antibacterial actions without affecting the bonding performance 19 , 20 . However, severe allergic reactions to chlorhexidine have remained a major concern 21 .…”

Physical/Mechanical and Antibacterial Properties of Orthodontic Adhesives Containing Calcium Phosphate and Nisin

“…Various antibacterial fillers were incorporated into the adhesives, such as chlorhexidine [16] to promote the antibacterial actions of the materials. The concerns with chlorhexidine are the risk of causing a severe allergic reaction [17,18] and the development of antibiotic resistance [19,20], which is a current global health threat.…”

Influence of chlorhexidine digluconate on biocompatibility of cements: Morphological and immunohistochemistry analysis

“…The incorporation of CHX into GICs generated a cytotoxic potential in the short term, was capable of causing tissue damage by inflammation, which reduced the rapid healing response. This suggested that because of its substantivity, the CHX released at the GIC surface may have had an antibacterial effect, as a result of the superficial erosion (Hoszek & Ericson, 2008) that allowed bacterial inhibition (Lessa et al, 2010; Rolla & Melsen, 1975), which was reinforced in the analysis over time (Araújo et al, 2021). Clinical experiments with humans could check the efficacy of what appears to be a notoriously promising method for formulating a GIC with antibacterial efficacy for cementing purposes.…”