Addy M, Moran J
J Biomed Mater Res. 1984 Jul-Aug;18(6):631-41. doi: 10.1002/jbm.820180605.
Clinical and in vitro studies have implicated dietary components as major aetiological factors in staining of teeth and acrylic materials associated with chlorhexidine use, a local side effect not unique to this antiseptic. These experiments studied the precipitation and surface staining reactions of the cationic antiseptics alexidine, cetyl pyridinium chloride (CPC), chlorhexidine, and hexetidine, with the beverage tea. All of the antiseptics precipitated a standard tea solution and for alexidine and chlorhexidine acetate and gluconate, this was at concentrations greater than 100 mumol/L, for hexetidine greater than 200 mumol/L, and for CPC greater than 400 mumol/L. With the exception of CPC precipitation was reduced with decreasing pH and for chlorhexidine was inhibited below pH 3. The addition of polymethylmethacrylate (PMMA) to the antiseptic solutions increased the precipitation concentrations by an amount calculated to be adsorbed by polymer. Acrylic blocks treated with equimolar solutions of the antiseptics became progressively and significantly more stained by tea than control specimens over a 5-day period. Alexidine induced significantly greater staining and hexetidine significantly less than the other antiseptics. Staining was pH dependent and significantly reduced as the pH decreased. Both stain and precipitates were insoluble in strong acids and alkalis. It is concluded that staining observed clinically may represent a precipitation reaction with the complexing of antiseptics with dietary chromogenic material.
临床研究和体外研究表明,饮食成分是牙齿染色以及与洗必泰使用相关的丙烯酸材料染色的主要病因,这种局部副作用并非该防腐剂所特有。这些实验研究了阳离子防腐剂阿来西定、西吡氯铵(CPC)、洗必泰和己脒定与茶饮料的沉淀和表面染色反应。所有防腐剂均使标准茶溶液产生沉淀,对于阿来西定、醋酸洗必泰和葡萄糖酸洗必泰,沉淀浓度大于100 μmol/L,对于己脒定大于200 μmol/L,对于CPC大于400 μmol/L。除CPC外,沉淀随着pH值降低而减少,对于洗必泰,在pH值低于3时沉淀受到抑制。向防腐剂溶液中添加聚甲基丙烯酸甲酯(PMMA)会使沉淀浓度增加,增加量经计算为聚合物吸附量。用等摩尔浓度的防腐剂溶液处理的丙烯酸块在5天内比对照样本被茶染色的程度逐渐且显著加深。阿来西定引起的染色明显更严重;己脒定引起的染色明显比其他防腐剂少。染色与pH值有关,随着pH值降低显著减少。染色和沉淀在强酸和强碱中均不溶解。结论是临床观察到的染色可能代表防腐剂与饮食中发色物质络合的沉淀反应。