Duque Cristiane, Aida Kelly Limi, Pereira Jesse Augusto, Teixeira Gláucia Schuindt, Caldo-Teixeira Angela Scarparo, Perrone Luciana Rodrigues, Caiaffa Karina Sampaio, Negrini Thais de Cássia, Castilho Aline Rogéria Freire de, Costa Carlos Alberto de Souza
Univ. Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba, Departamento de Odontologia Infantil e Social, Araçatuba, SP, Brasil.
Universidade Federal Fluminense (UFF), Instituto de Saúde de Nova Friburgo, Departamento de Odontologia, Nova Friburgo, RJ, Brasil.
J Appl Oral Sci. 2017 Sep-Oct;25(5):541-550. doi: 10.1590/1678-7757-2016-0195.
Addition of chlorhexidine has enhanced the antimicrobial effect of glass ionomer cement (GIC) indicated to Atraumatic Restorative Treatment (ART); however, the impact of this mixture on the properties of these materials and on the longevity of restorations must be investigated. The aim of this study was to evaluate the effects of incorporating chlorhexidine (CHX) in the in vitro biological and chemical-mechanical properties of GIC and in vivo clinical/ microbiological follow-up of the ART with GIC containing or not CHX.
For in vitro studies, groups were divided into GIC, GIC with 1.25% CHX, and GIC with 2.5% CHX. Antimicrobial activity of GIC was analyzed using agar diffusion and anti-biofilm assays. Cytotoxic effects, compressive tensile strength, microhardness and fluoride (F) release were also evaluated. A randomized controlled trial was conducted on 36 children that received ART either with GIC or GIC with CHX. Saliva and biofilm were collected for mutans streptococci (MS) counts and the survival rate of restorations was checked after 7 days, 3 months and one year after ART. ANOVA/Tukey or Kruskal-Wallis/ Mann-Whitney tests were performed for in vitro tests and in vivo microbiological analysis. The Kaplan-Meier method and Log rank tests were applied to estimate survival percentages of restorations (p<0.05).
Incorporation of 1.25% and 2.5% CHX improved the antimicrobial/anti-biofilm activity of GIC, without affecting F release and mechanical characteristics, but 2.5% CHX was cytotoxic. Survival rate of restorations using GIC with 1.25% CHX was similar to GIC. A significant reduction of MS levels was observed for KM+CHX group in children saliva and biofilm 7 days after treatment.
The incorporation of 1.25% CHX increased the in vitro antimicrobial activity, without changing chemical-mechanical properties of GIC and odontoblast-like cell viability. This combination improved the in vivo short-term microbiological effect without affecting clinical performance of ART restorations.
添加洗必泰可增强玻璃离子水门汀（GIC）用于非创伤性修复治疗（ART）时的抗菌效果；然而，这种混合物对这些材料性能以及修复体寿命的影响必须加以研究。本研究的目的是评估在体外将洗必泰（CHX）加入GIC对其生物学和化学机械性能的影响，以及在体内对含或不含CHX的GIC进行ART修复后的临床/微生物学随访情况。
对于体外研究，将分组为单纯GIC组、含1.25% CHX的GIC组和含2.5% CHX的GIC组。采用琼脂扩散法和抗生物膜试验分析GIC的抗菌活性。还评估了细胞毒性作用、抗压抗张强度、显微硬度和氟（F）释放情况。对36名接受单纯GIC或含CHX的GIC进行ART修复的儿童进行了一项随机对照试验。收集唾液和生物膜用于变形链球菌（MS）计数，并在ART修复后7天、3个月和1年检查修复体的存留率。体外试验和体内微生物学分析采用方差分析/图基检验或克鲁斯卡尔 - 沃利斯/曼 - 惠特尼检验。应用Kaplan - Meier方法和对数秩检验来估计修复体的存留百分比（p<0.05）。
加入1.25%和2.5%的CHX可提高GIC的抗菌/抗生物膜活性，且不影响F释放和机械特性，但2.5%的CHX具有细胞毒性。使用含1.25% CHX的GIC修复体的存留率与单纯GIC相似。治疗7天后，在儿童唾液和生物膜中观察到含CHX的GIC组MS水平显著降低。
加入1.25%的CHX可提高体外抗菌活性，而不改变GIC的化学机械性能和成牙本质细胞样细胞活力。这种组合改善了体内短期微生物学效果，而不影响ART修复体的临床性能。
