Inhibition of Cultivable Bacteria by Chlorhexidine Treatment of Dentin Lesions Treated with the ART Technique

Abstract

The aim of this study was to examine the changes in the cultivable microflora of carious dentin before and after atraumatic restorative treatment (ART) and investigate the inhibitory effect of chlorhexidine-gluconate-based cavity disinfectant in the microflora. Using a split mouth design, 35 primary molar pairs with class II carious lesions in 35 patients (mean age 7.31 ± 0.47 years) were selected. The total viable counts (TVC), Streptococcus mutans and lactobacilli were first measured in the center of the infected demineralized lesion and then from the hard dentine after caries removal by the ART technique. Chlorhexidine-gluconate (2%)-based cavity disinfectant was applied to one of the molar pairs and the other molar received no disinfectant treatment. Thereafter, all of the teeth were restored with glass ionomer cement (GIC). Cavities were reassessed after 6 months and again dentine samples were microbiologically investigated. Removal of carious dentine by ART significantly reduced TVC, S. mutans and lactobacilli. After 6 months, application of chlorhexidine exhibited a greater significant reduction in TVC (p = 0.013), and a significant reduction in S. mutans compared to the nondisinfected group (p < 0.001). A significant reduction in lactobacilli counts was observed in both groups after 6 months, but the difference between the disinfected and nondisinfected groups was not significant (p = 0.056). ART was found to be effective in reducing the cultivable microflora and chlorhexidine-gluconate-based cavity disinfectant might serve as a suitable additional agent in inhibiting the residual bacteria in the dentine.

Antimicrobial activity of alexidine, chlorhexidine and cetrimide against Streptococcus mutans biofilm

“…dentin reduces the number of genotypes of these bacteria, but not their cariogenic potential [9]. Therefore, treatment of dentin with an antibacterial agent, before sealing, is useful in eliminating the harmful effects of residual bacteria or bacterial microleakage [10]. Accordingly, our objective was to determine the ability of several antimicrobials in controlling SM biofilm formed in dentin.…”

“…Microbiological and clinical studies have shown that the number of bacteria decreases during incomplete carious removal followed by adequate cavity sealing, and that lesions are clinically arrested [5][6][7][8][9][10]. Although a limited number of microorganisms persist under restorations a few months after the partial caries removal and sealing [5,8,9], some cariogenic bacteria may be found within the remaining microorganisms, such as Streptococcus mutans, which is currently found on sealed carious dentin [2,[6][7][8][9].…”

“…Among possible strategies, antimicrobial solutions have been recommended to clean the cavity prior to introducing the filling material [10]. Of all available antimicrobials in dentistry, chlorhexidine (CHX) is still the most frequently used agent to reduce plaque aiming at caries control [11].…”

“…Of all available antimicrobials in dentistry, chlorhexidine (CHX) is still the most frequently used agent to reduce plaque aiming at caries control [11]. CHX is widely used as an antimicrobial agent for disinfection before the placement of restorations [10,12]. It has demonstrated its effectiveness against bacteria associated with dental caries, and SM has been shown to be particularly sensitive to CHX [13].…”

Effect of 2% chlorhexidine application on microtensile bond strength of resin composite to dentin using one-step self-etch adhesives

“…1 Chlorhexidine is one of the most widely used broad spectrum antibacterial or antiseptic agents in dentistry. 2 The efficacy of chlorhexidine in caries prevention had been established in clinical trials.…”