Resumen
La clorhexidina se introdujo hace casi siete décadas y tiene una gran variedad de aplicaciones en odontología. Pocos estudios han evaluado la capacidad antimicrobiana y antifúngica de diferentes concentraciones de enjuagues bucales con clorhexidina. Por lo tanto, el objetivo de este estudio fue evaluar in vitro, la capacidad antibacteriana y antifúngica de tres enjuagues bucales disponibles comercialmente en Costa Rica, con diferentes concentraciones de clorhexidina, 0.12%, 0.06% y 0.03%. El método experimental seleccionado fue el método Kirby-Bauer para evaluar el efecto antibacteriano y antifúngico de cada compuesto midiendo el efecto inhibidor sobre Staphylococcus aureus, Enterococcus faecalis, Escherichia coli y Candida albicans, expuestos a la solución antiséptica. Todas las muestras mostraron algún grado de efecto antibacteriano y antifúngico. Aunque proporcionamos resultados in vitro, nuestros hallazgos son de relevancia, ya que todas las especies utilizadas en nuestro experimento son microorganismos que pueden estar presentes en la placa dental. Nuestros resultados respaldan aún más la evidencia de que los regímenes de higiene bucal pueden incluir enjuagues bucales con dosis bajas de clorhexidina y mantener una eficacia antibacteriana y antifúngica razonable.
Citas
Varoni E., Tarce M., Lodi G., Carrassi A. (2012) Chlorhexidine (CHX) in dentistry: state of the art. Minerva Stomatol ; 61 (9): 399-419.
Hjeljord L.G. Rolla G. Bonesvoll (1983) Chlorhexidine-protein interactions. J. Periodontal Res Suppl. 12: 11-16.
Van der Weijden F.A., Van der Sluijs E., Ciancio S.G., Slot D.E. (2015). Can Chemical Mouthwash Agents Achieve Plaque/Gingivitis Control? Dent Clin North Am; 59 (4): 799-829.
Van Strydonck D.A.C., Slot D.E., Van der Velden U., Van der Weij-den F. (2012). Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: a systematic review. J Clin Periodontol ; 39: 1042-1055.
Löe H., Schiott C.R. (1970). The effect of mouthrinses and topical application of chlorhexidine on the development of dental plaque and gingivitis in man. J Periodontal Res ; 5 (2): 79-83.
Escribano M., Herrera D., Morante S., Teughels W., Quirynen M., Sanz M. (2010). Efficacy of a low-concentration chlorhexidine mouth rinse in non-compliant periodontitis patients attending a supportive periodontal care programme: a randomized clinical trial. J Clin Periodontol. ; 37 (3): 266-75.
Sadat Sajadi, F., Moradi, M., Pardakhty, A., Yazdizadeh, R., & Madani, F. (2015). Effect of Fluoride, Chlorhexidine and Fluoride-chlorhexidine Mouthwashes on Salivary Streptococcus mutans Count and the Prevalence of Oral Side Effects. Journal of dental research, dental clinics, dental prospects, 9 (1), 49-52.
de Waal Y.C., Raghoebar G.M., Meijer H.J., Winkel E.G., van Winkelhoff A.J. (2015). Implant decontamination with 2% chlorhexidine during surgical peri-implantitis treatment: a randomized, double-blind, controlled trial. Clin Oral Implants Res ; 26 (9): 1015-23.
Luiz Fernando Noira Passos da Costa, Cristine da Silva Furtado Amaral, Davi da Silva Barbirato, Anna Thereza Thomé Leão, Mariana Fampa Fogacci (2017). Chlorhexidine mouthwash as an adjunct to mechanical therapy in chronic periodontitis: A meta-analysis, The Journal of the American Dental Association ; 148 (5): 308-318.
Winkel E.G., Roldán S., Van Winkelhoff A.J., Herrera D., Sanz M. (2003). Clinical effects of a new mouthrinse containing chlorhexidine, cetylpyridinium chloride and zinc-lactate on oral halitosis. A dual-center, double-blind placebo-controlled study. J Clin Periodontol ; 30 (4):300-6.
Fedorowicz Z., Aljufairi H., Nasser M., Outhouse T.L., Pedrazzi V. (2008). Mouthrinses for the treatment of halitosis. Cochrane Database Syst Rev; (4): CD006701.
van den Broek A.M., Feenstra L., de Baat C. (2008). A review of the current literature on management of halitosis. Oral Dis ; 14 (1): 30-9.
Bosy A., Kulkarni G.V., Rosenberg M., McCulloch C.A. (1994).Relationship of oral malodor to periodontitis: evidence ofindependence in discrete subpopulations. J Periodontol; 65: 37-46.
De Boever E.H., Loesche W.J. (1995). Assessing the contributionof anaerobic microflora of the tongue to oral malodor.J AmDent Assoc; 126: 1384-1393.
Thrane P.S., Young A., Jonski G., Rölla G. (2007). A new mouthrinse combining zinc and chlorhexidine in low concentrations provides superior efficacy against halitosis compared to existing formulations: a double-blind clinical study. J Clin Dent ; 18 (3): 82-6.
de Assis D.F., Prado M. do, Simão R.A. (2011) . Evaluation of the interaction between endodontic sealers and den-tin treated with different irrigant solutions. J Endod; 37:1550-2
Ferguson D.B., Marley J.T., Hartwell G.R. (2003). The effect of chlorhexidine gluconate as an endodontic irrigant onthe apical seal: long-term results. J Endod; 29: 91-4.
Tanner J., Dumville J.C., Norman G., Fortnam M. (2016). Surgical hand antisepsis to reduce surgical site infection. Cochrane Database Syst Rev; (1):CD004288.
Cortellini P., Labriola A., Zambelli R., Prato G.P., Nieri M., Tonetti M.S. (2008). Chlorhexidine with an anti discoloration system after periodontal flap surgery: a cross-over, randomized, triple-blind clinical trial. J Clin Periodontol; 35 (7): 614-20.
Caso A., Hung L.K., Beirne O.R. (2005). Prevention of alveolar osteitis with chlorhexidine: a meta-analytic review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod; 99 (2): 155-9.
Minguez-Serra M.P., Salort-Llorca C, Silvestre-Donat FJ (2009). Chlorhexidine in the prevention of dry socket: effectiveness of different dosage forms and regimens. Med Oral Patol Oral Cir Bucal ; 14 (9): e445-9.
Yoon, J. G., Yoon, J., Song, J. Y., Yoon, S. Y., Lim, C. S., Seong, H., Noh, J. Y., Cheong, H. J., & Kim, W. J. (2020). Clinical Significance of a High SARS-CoV-2 Viral Load in the Saliva. Journal of Korean medical science, 35 (20): e195.
Davies T.M., Shaw W.C., Worthington H.V., Addy M., Dummer P., Kingdon A. (1991). The effect of orthodontic treatment on plaque and gingivitis. Am J Orthod Dentofacial Orthop; 99 (2):155-6.
Anderson GB, Bowden J, Morrison EC, Caffesse RG (1997). Clinical effects of chlorhexidine mouthwashes on patients undergoing orthodontic treatment. Am J Orthod Dentofacial Orthop. 1997; 111 (6): 606-12.
Gehlen I., Netuschil L., Berg R., Reich E., Katsaros C. (2000). The influence of a 0.2% chlorhexidine mouthrinse on plaque regrowth in orthodontic patients. A randomized prospective study. Part I: clinical parameters. J Orofac Orthop; 61 (1): 54-62.
Ousehal L., Es-Said R., Hamdoune H., Elquars F., Khadija A. (2011). Evaluation of dental plaque control in patients wearing fixed orthodontic appliances: a clinical study. Int Orthod; 9 (1): 140-55.
Enita N., Dzemidzic V., Tiro A., Hadzic S. (2015). Antimicrobial activity of chlorhexidine in patients with fixed orthodontic appliances. Braz. J. Oral Sci; 10 (2): 79-82.
Claydon N., Smith S., Stiller S., Newcombe RG, Addy M (2002). A comparison of the plaque-inhibitory properties of stannous fluoride and low-concentration chlorhexidine mouthrinses. J Clin Periodontol ; 29 (12): 1072-7.
Hoffmann T., Bruhn G., Richter S. et al (2001). Clinical controlled study on plaque and gingivitis reduction under long-term use of low-dose chlorhexidine solutions in a population exhibiting good oral hygiene. Clin Oral Invest; 5: 89-95.
A.J. Smith, D. Morrison, Douglas Robertson, Michael K. Tang, Z Al-Doori (2003) Efficacy of oral hygiene products against MRSA and MSSA isolates. Journal of Antimicrobial Chemotherapy; 52 (4): 738-739.
Nascimento A.P., Tanomaru J.M., Matoba-Júnior F., Watanabe E., Tanomaru-Filho M., Ito I.Y. (2008). Maximum inhibitory dilution of mouthwashes containing chlorhexidine and polyhexamethylene biguanide against salivary Staphylococcus aureus. J Appl Oral Sci;16 (5): 336-9.
Albuquerque R.F. Jr., Head T.W., Mian H., Rodrigo A., Müller K., Sanches K., Ito I.Y. (2004). Reduction of salivary S. aureus and mutans group streptococci by a preprocedural chlorhexidine rinse and maximal inhibitory dilutions of chlorhexidine and cetylpyridinium. Quintessence Int; 35: 635-40.
Aghazadeh M., Eslami H., Kafil H., Aghazadeh Z., Behroozian A., Motahari P. (2016). A Comparison of antimicrobial effect of the mouthwash containing chlorhexidine, Cetylpyridinium chloride, and zinc lactate (Halita) and chlorhexidine against Pseudomonas aeruginosa and staphylococcus aureus: in vitro study. Scholars Bulletin. 2. 547-553.
Sundqvist G., Figdor D., Sjögren U. (1998). Microbiology analyses of teeth with endodontic treatment and the outcome of conservative retreatment. Oral Surg Oral Med Oral Pathol; 85: 86-93.
Neglia R., Ardizzoni A., Giardino L., Ambu E., Grazi S., Calignano S., et al (2008). Comparative in vitro and ex vivo studies on the bactericidal activity of Tetraclean, a new generation endodontic irrigant, and sodium hypochlorite. New Microbiol; 31: 57-65.
Ardizzoni A., Blasi E., Rimoldi C., Giardino L., Ambu E., Righi E., et al (20090. An in vitro and ex vivo study on two antibiotic-based endodontic irrigants: a challenge to sodium hypochlorite. New Microbiol; 32: 57-66.
Portenier I., Waltimo T.M.T., Ørstavik D., Haapasalo M. (2005). The susceptibility of starved, stationary phase and growing cells of Enterococcus faecalis to endodontic medicaments. J Endod ;31: 380-6.
Souto, Renata & Andrade, Arnaldo & Uzeda, Milton & Colombo, Ana. (2006). Prevalence of “non-oral” bacteria in subgingival biofilm of subjects with chronic periodontitis. Brazilian Journal of Microbiology - Brazilian Journal of Microbiology; 37: 208-215.
Ardila Medina, Carlos Martín, & Villa-Correa, Yesica Alejandra. (2015). Gram-Negative Enteric Rods Associated to Early Implant Failure and Peri-Implantitis: Case Report and Systematic Literature Review. International journal of odontostomatology, 9 (2): 329-336.
Leonhardt A., Dahlén G., Renvert S. (2203). Five-year clinical, microbiological, and radiological outcome following treatment of peri-implantitis in man. J Periodontol;7 4 (10): 1415-22.
Kuo, Hsien-Nan & Mei, Hsiang-I & Liu, Tung-Kuan & Liu, Tse Ying & Lo, Lun-Jou & Lin, Chun-Li. (2017). In Vitro Laser Treatment Platform Construction with Dental Implant Thread Surface on Bacterial Adhesion for Peri-Implantitis. BioMed Research International. 2017: 1-7.
Ellepola A.N., Samaranayake L.P. (2001). Adjunctive use of chlorhexidine in oral candidoses: a review. Oral Dis. 2001 Jan; 7 (1): 11-7.
Suci, P. A., & Tyler, B. J. (2002). Action of chlorhexidine digluconate against yeast and filamentous forms in an early-stage Candida albicans biofilm. Antimicrobial agents and chemotherapy, 46 (11), 3522-3531.
Shino B., Peedikayil F.C., Jaiprakash S.R., Ahmed Bijapur G, Kottayi S., Jose D. (2016). Comparison of Antimicrobial Activity of Chlorhexidine, Coconut Oil, Probiotics, and Ketoconazole on Candida albicans Isolated in Children with Early Childhood Caries: An In Vitro Study. Scientifica; 2016: 1-5.
Ellepola A., N., B., Joseph B., J., Khan Z., U. (2012). Effects of Subtherapeutic Concentrations of Chlorhexidine Gluconate on Germ Tube Formation of Oral Candida. Med Princ Pract; 21:120-124.
Gunsolley J.C. (2006). A meta-analysis of six-month studies of antiplaque and antigingivitis agents. J Am Dent Assoc;137 (12): 1649-57.
Supranoto S.C., Slot D.E., Addy M., Van der Weijden G.A. (2015). The effect of chlorhexidine dentifrice or gel versus chlorhexidine mouthwash on plaque, gingivitis, bleeding and tooth discoloration: a systematic review. Int J Dent Hyg ; 13 (2): 83-92.