Assessment of dimensional stability of novel VPES impression material at different time intervals with standard disinfectants.

BACKGROUND: Vinyl polyether silicone (VPES) is a novel impression biomaterial made of a combination of vinyl polysiloxane (VPS) and polyether (PE). Thus, it is significant to assess its properties and behaviour under varied disinfectant test conditions. This study aimed to assess the dimensional stability of novel VPES impression material after immersion in standard disinfectants for different time intervals. METHODS: Elastomeric impression material used -medium body regular set (Monophase) [Exa'lence GC America]. A total of 84 Specimens were fabricated using stainless steel die and ring (ADA specification 19). These samples were distributed into a control group (n=12) and a test group (n=72). The test group was divided into 3 groups, based on the type of disinfectant used - Group-A- 2% Glutaraldehyde, Group-B- 0. 5% Sodium hypochlorite and Group-C- 2% Chlorhexidine each test group was further divided into 2 subgroups (n=12/subgroup) based on time intervals for which each sample was immersed in the disinfectants - subgroup-1- 10 mins and Subgroup 2- 30 mins. After the impression material was set, it was removed from the ring and then it was washed in water for 15 seconds. Control group measurements were made immediately on a stereomicroscope and other samples were immersed in the three disinfection solutions for 10 mins and 30 mins to check the dimensional stability by measuring the distance between the lines generated by the stainless steel die on the samples using a stereomicroscope at x40 magnification. RESULTS: The distance measured in the control group was 4397.2078 µm and 4396.1571 µm; for the test group Group-A- 2% Glutaraldehyde was 4396.4075 µm and 4394.5992 µm; Group-B- 0. 5% Sodium hypochlorite was 4394.5453 µm and 4389.4711 µm Group-C- 2% Chlorhexidine was 4395.2953 µm and 4387.1703 µm respectively for 10 mins and 30 mins. Percentage dimensional change was in the range of 0.02 - 0.25 for all the groups for 10 mins and 30 mins. CONCLUSIONS: 2 % Glutaraldehyde is the most suitable disinfectant for VPES elastomeric impression material in terms of dimensional stability and shows minimum dimensional changes as compared to that of 2% Chlorhexidine and 0.5% Sodium hypochlorite.

Study on the disinfection effect of chlorine dioxide disinfectant (ClO2) on dental unit waterlines and its in vitro safety evaluation.

BACKGROUND: Ensuring the safety of dental unit waterlines (DUWLs) has become a pivotal issue in dental care practices, focusing on the health implications for both patients and healthcare providers. The inherent structure and usage conditions of DUWLs contribute to the risk of biofilm formation and bacterial growth, highlighting the need for effective disinfection solutions.The quest for a disinfection method that is both safe for clinical use and effective against pathogens such as Staphylococcus aureus and Escherichia coli in DUWLs underscores the urgency of this research. MATERIALS: Chlorine dioxide disinfectants at concentrations of 5, 20, and 80 mg/L were used to treat biofilms of S. aureus and E. coli cultured in DUWLs. The disinfection effectiveness was assessed through bacterial counts and culturing. Simultaneously, human skin fibroblast cells were treated with the disinfectant to observe changes in cell morphology and cytotoxicity. Additionally, the study included corrosion tests on various metals (carbon steel, brass, stainless steel, aluminum, etc.). RESULTS: Experimental results showed that chlorine dioxide disinfectants at concentrations of 20 mg/L and 80 mg/L significantly reduced the bacterial count of S. aureus and E. coli, indicating effective disinfection. In terms of cytotoxicity, higher concentrations were more harmful to cellular safety, but even at 80 mg/L, the cytotoxicity of chlorine dioxide remained within controllable limits. Corrosion tests revealed that chlorine dioxide disinfectants had a certain corrosive effect on carbon steel and brass, and the degree of corrosion increased with the concentration of the disinfectant. CONCLUSION: After thorough research, we recommend using chlorine dioxide disinfectant at a concentration of 20 mg/L for significantly reducing bacterial biofilms in dental unit waterlines (DUWLs). This concentration also ensures satisfactory cell safety and metal corrosion resistance.

A simplified in vitro model for investigation of the antimicrobial efficacy of various antiseptic agents to prevent peri-implantitis.

The biofilm formation by oral bacteria on the implant surface is one of the most remarkable factors of peri-implant infections, which may eventually lead to bone resorption and loss of the dental implant. Therefore, the elimination of biofilm is an essential step for the successful therapy of implant-related infections. In this work we created a basic in vitro model to evaluate the antibacterial effect of three widely used antiseptics.Commercially pure (CP4) titanium sample discs with sand blasted, acid etched, and polished surface were used. The discs were incubated with mono-cultures of Streptococcus mitis and Streptococcus salivarius. The adhered bacterial biofilms were treated with different antiseptics: chlorhexidine-digluconate (CHX), povidone-iodine (PI), and chlorine dioxide (CD) for 5 min and the control discs with ultrapure water. The antibacterial effect of the antiseptics was tested by colorimetric assay.According to the results, the PI and the CD were statistically the most effective in the elimination of the two test bacteria on both titanium surfaces after 5 min treatment time. The CD showed significant effect only against S. salivarius.Based on our results we conclude that PI and CD may be promising antibacterial agents to disinfecting the peri-implant site in the dental practice.

Importance of disinfection time and procedure with different alginate impression products to reduce dimensional instability.

AIMS: The aim of this study was to determine the best approach to reduce the unfavorable change in the three different dimensions of impressions using disinfection durations of 15 and 30 min; three different disinfection procedures; and alginate impression products as research factors. MATERIALS AND METHODS: CA37, impressional, and cream alginate impressions were used; distortion in the AB, AC, and BC dimensions of impressions using disinfection durations of 15 and 30 min was studied; and no disinfection (ND), conventional disinfection (CD), and sonicator-activated disinfection (SAD) procedures were measured. RESULTS: Regarding AB dimension, the impressional has best performance when CD was applied for both 15 and 30 min. When SAD was applied for 15 min, impressional and cream alginates provide best performance. When CD was applied for 15 min, CA37 and impressional alginates provide best performance. Although ND-applied CA37 alginate after 30 min provides best performance, because of many outlier values, its implication may not be considered as meaningful. Regarding AC dimension, cream alginate has best performance when CD was applied for 15 min. The AC distances in all the alginates are considerably different from the base model after 30 min. Regarding BC dimension, only the CA37 alginate has the best performance when ND was applied for 15 min. All the alginates are considerably different from that of the base model after 30 min. CONCLUSION: Preference of 15-min disinfection can provide favorable results to obtain all impressions with minimally distorted dimensions. CD is an adequate procedure. The studied SAD needs to be developed further. All alginates are comparably successful to obtain impressions with desired distortion degrees.

The Clinical Effectiveness of Calcium Hydroxide in Root Canal Disinfection of Primary Teeth: A Meta-Analysis.

BACKGROUND The aim of this research was to systematically analyze the effectiveness of calcium hydroxide compared to formocresol (FC) and camphor phenol (CP) in root canal disinfection of primary teeth. MATERIAL AND METHODS The meta-analysis was based on the participants, interventions, control, outcome (PICO) study design principle and 16 randomized-controlled clinical trials published from January 2000 to August 2018. The data heterogeneity of each study was assessed by the Q-test. The odds ratio and 95% confidence interval (CI) were calculated based on the heterogeneity results by Revman software. RESULTS Sixteen randomized-controlled clinical trials of 3047 primary teeth were included in this meta-analysis. There were significant differences of clinical effectiveness between calcium hydroxide and FC in root canal disinfection of primary teeth (OR=3.37; 95% CI range: 2.54-4.48, P<0.01) and endodontic inter-appointment emergencies (EIAE) after disinfection for 7 days (OR=0.26; 95% CI range: 0.16-0.42, P<0.01). However, there was no statistical difference of EIAE, after disinfection of primary teeth for 48 hours, between calcium hydroxide and FC (OR=0.62; 95% CI range: 0.34-1.11, P=0.11). There were significant differences of clinical effectiveness between the calcium hydroxide and CP in root canal disinfection of primary teeth (OR=5.50; 95% CI range: 3.36-8.98, P<0.01). CONCLUSIONS This meta-analysis indicated that the effectiveness of calcium hydroxide as root canal disinfectant in primary teeth was more effective than that of FC and CP.

Effectiveness of the ozone application in two-visit indirect pulp therapy of permanent molars with deep carious lesion: a randomized clinical trial.

OBJECTIVES: The aim of this randomized, three-arm parallel, single-blinded clinical trial was to evaluate the clinical and microbiological effectiveness of the ozone application in two-visit indirect pulp therapy. MATERIALS AND METHODS: One hundred five lower first molar teeth with deep caries lesion were included and randomly assigned three groups to apply the two-visit indirect pulp therapy. Treatment procedure was applied without any disinfectant (control), with 60-s 2% chlorhexidine digluconate (CHX) or 60-s ozone application. In four different stages (after initial excavation, ozone/CHX application before the temporary restoration, 4 months later immediately after removing temporary restoration, and final excavation), dentin humidity, consistency, and color properties were recorded to evaluate the clinical characteristics of the tissue, and standard dentin samples were collected for the microbiological analysis of mutans streptococci, lactobacilli, and the total number of colony-forming units. The data were analyzed by using Mann-Whitney U test for multiple comparisons. RESULTS: The remaining dentin became harder, drier, and darker after 4 months in all groups. However, CHX and ozone application were statistically better than the control group (p < 0.05). There was a gradual decrease in the total number of microorganisms in all groups. While cavity disinfectant applications were improved the antibacterial efficacy (control, 79.11%; CHX, 98.39%; ozone, 93.33%), CHX application exhibited a greater significant reduction than both groups (p = 0.000). CONCLUSION: The two-visit indirect pulp therapy yielded successful results for all study groups. However, CHX would be conveniently preferable due to improving the treatment success. CLINICAL RELEVANCE: The two-visit indirect pulp therapy applied with cavity disinfectant is a proper alternative treatment procedure in deep carious lesions, instead of conventional technique.

Do ozonated water and boric acid affect the bond strength to dentin in different adhesive systems?

AIM: The aim of this in vitro study was to compare the effects of the application of three different cavity disinfecting agents to dentin on the micro-shear bond strength (µ-SBS) of one self-etch and two universal adhesive systems. MATERIALS AND METHODS: In total, 120 caries-free human permanent molar teeth were used in this study. Mid-coronal dentin surfaces were revealed by cutting occlusal enamel and a standard smear layer was obtained by using 600-800-1200 grid silicon carbide abrasive papers. Specimens were randomly assigned to four groups according to the disinfectant used: Group 1: Control (no disinfectant); Group 2: 2% chlorhexidine based (Consepsis); Group 3: 10 ppm ozonated water (TeknO3zone); Group 4: 5% boric acid (Handmade). Each group was divided into three subgroups according to the type of adhesive (Clearfil SE Bond, OptiBond XTR, and Tokuyama Universal). Specimens were bonded using either Clearfil SE Bond, OptiBond XTR or Tokuyama Universal, which were employed according to the manufacturer's instructions. Resin composite microcylinders were bonded using Tygon® tubes for µ-SBS testing. After specimens were stored for 24 h, at 37°C in distilled water, µ-SBS test was measured with a universal test machine (LF Plus, Lloyd, Instrument). µ-SBS results were analyzed by one-way analysis of variance (ANOVA) and Tukey's tests. RESULTS: When the mean microshear bond strength values of the control group were compared, the difference between the subgroups was not significant (P < 0.05). When the mean microshear bond strength values of the chx, ozonated water, and boric acid were compared, the difference between Clearfil SE Bond and Tokuyama Universal was significant (P < 0.05) and the difference between the other groups was not significant (P > 0.05). CONCLUSION: Ozonated water and boric acid may be as an alternative to other materials used as cavity disinfectants.

The role of chemical products at low doses in preventing the proliferation of bacteria in dental unit waterlines: the ICX® experience.

In this study we evaluated (1) the efficacy of a protocol that combines hydrogen peroxide (shock treatment) and ICX® tablets (continuous treatment) for the control of microbial contamination in dental unit water lines, and (2) the in vitro antimicrobial activity of ICX® tablets on collection and wild strains isolated from dental chair output waters. To assess the treatment effectiveness, the microbial load in the output water samples of three dental chairs were investigated: one control chair received only shock treatment. In vitro bactericidal activity was tested against Staphylococcus aureus and Pseudomonas aeruginosa. Data obtained from samples collected from chairs treated with ICX® and shock treatment and data from the control chair did not differ significantly on the basis of microbial load. In the in vitro study, the product was unable to kill Gram-negative bacteria. These results show that the continuous introduction of ICX® was not effective in maintaining low counts of the heterotrophic bacteria in the output water of dental devices, and shock treatment may be needed more frequently than monthly.

Cleaning of used rotary nickel-titanium files in an ultrasonic bath by locally intensified acoustic cavitation.

AIM: To compare the pre-sterilization cleaning of rotary Ni-Ti files of different sizes previously used a. ex vivo and b. clinically by a washer-disinfector, a regular ultrasonic bath, and the same ultrasonic bath in combination with a recently developed cavitation intensifying method. METHODOLOGY: Two sets of two hundred rotary Ni-Ti files, one previously used ex vivo and another one used clinically, were collected from the undergraduate and postgraduate clinics of the Academic Centre for Dentistry Amsterdam (ACTA). The instruments were immersed in an enzymatic solution and subsequently cleaned either by a washer-disinfector, a regular ultrasonic bath combined with a glass beaker, the same bath combined with a beaker lined with two cavitation intensifying sheets or with two standard plastic sheets. The positive control consisted of used files that did not undergo any cleaning and the negative control included new unused files. The instruments were then stained to reveal remaining protein material and scored under a stereoscopic microscope. The results were analysed by nonparametric statistical tests (α = 0.05). RESULTS: No significant difference was found between the combination of the ultrasonic bath and the regular glass beaker and the same ultrasonic bath with the beaker lined with the cavitation intensifying sheets. The washer-disinfector left significantly more debris compared to the latter group when clinically used files were evaluated (P ≤ 0.001). The effect of instrument size on cleaning was not consistent. CONCLUSION: None of the tested methods was able to remove all residual protein material from the files; however, it could be noted that this study did not follow the reprocessing protocol provided by the manufacturer.

Mechanical and aesthetics compatibility of Brazilian red propolis micellar nanocomposite as a cavity cleaning agent.

BACKGROUND: Propolis is a natural substance produced by bees and is known to have antimicrobial activity. Our aim was to evaluate the antimicrobial effect of micellar nanocomposites loaded with an ethyl acetate extract of Brazilian red propolis as a cavity cleaning agent and its influence on the color and microtensile bond strength (µTBS) of the dentin/resin interface. METHODS: An ultra-performance liquid chromatography coupled with a diode array detector (UPLC-DAD) assay was used to determine the flavonoids and isoflavones present in an ethyl acetate extract of Brazilian red propolis (EARP) and micellar nanocomposites loaded with EARP (MNRP). The antimicrobial activity of EARP and MNRP was tested against Streptococcus mutans, Lactobacillus acidophilus, and Candida albicans. One of the following experimental treatments was applied to etched dentin (phosphoric acid, 15 s): 5 µL of MNRP (RP3, 0.3%; RP6, 0.6%; or RP1, 1.0% w/v), placebo, and 2% chlorhexidine digluconate. Single Bond adhesive (3 M/ESPE) was applied and a 4-mm-thick resin crown (Z350XT, 3 M/ESPE) was built up. After 24 h, the teeth were sectioned into sticks for the µTBS test and scanning electron microscopy. Spectrophotometry according to the CIE L*a*b* chromatic space was used to evaluate the color. Data were analyzed using one-way ANOVA and the Tukey test or Kruskal-Wallis test and the same test for pairwise comparisons between the means (P < 0.05). RESULTS: The UPLC-DAD assay identified the flavonoids liquiritigenin, pinobanksin, pinocembrin, and isoliquiritigenin and the isoflavonoids daidzein, formononetin, and biochanin A in the EARP and micellar nanocomposites. EARP and MNRP presented antimicrobial activity against the cariogenic bacteria Streptococcus mutans and Lactobacillus acidophilus, and for Candida albicans. ΔE values varied from 2.31 to 3.67 (P = 0.457). The mean µTBS for RP1 was significantly lower than for the other groups (P < 0.001). Dentin treated with RP1 showed the shortest resin tags followed by RP6 and RP3. CONCLUSIONS: The EARP and (MNRP) showed antimicrobial activity for the main agents causing dental caries (Streptococcus mutans and Lactobacillus acidophilus) and for Candida albicans. MNRP at concentrations of 0.3 and 0.6% used as a cavity cleaner do not compromise the aesthetics or µTBS of the dentin/resin interface.

Investigation of Acrylic Resin Disinfection Using Chemicals and Ultrasound.

PURPOSE: Dental prosthetic and orthodontic appliances are transported from the clinic to the laboratory for additions and repairs. These appliances, containing microbes from the oral flora, are a high risk for cross-contamination. The aim of this study was to evaluate the effect of chemical and ultrasound disinfection against two in vitro biofilms and an in vivo formed biofilm grown on unprepared and polished polymethyl methacrylate (PMMA) surfaces. MATERIALS AND METHODS: Rough and polished self-curing PMMA surfaces were infected with strains of both Candida albicans and Streptococcus oralis. After incubation, the samples were treated with different disinfection methods, including ultrasound treatment for both 15 and 30 seconds, and immersion in glutaraldehyde and alcohol-based chemical disinfectants (MD520 and Minuten, respectively). The disinfecting efficacy was assessed by colony forming units (CFU) analysis and by scanning electron microscopy (SEM). Furthermore the adequacy of bacterial elimination of application of 30-second ultrasound and MD520 was assessed on PMMA retrieved from ten volunteers by CFU analyses. ANOVA with p = 0.05 followed by the Tukey post hoc test and the Student t-test was used to analyze the data. RESULTS: The ultrasound treatment for 30 seconds, MD520, and Minuten were the most effective disinfectant methods as they reduced the microbial counts compared to the control (p < 0.05) as shown in the in vitro analyses. S. oralis adhered more to rough acrylic resin surfaces (p < 0.05). Ultrasound treatment was the most effective way to reduce microbial counts on PMMA exposed to oral flora (p = 0.043). CONCLUSION: Ultrasound treatment for 30 seconds was effective against C. albicans, S. oralis, and the oral flora as shown by testing microbial growth on agar plates and SEM.

Comparative Evaluation of the Antimicrobial Efficacy of Three Immersion Chemical Disinfectants on Clinically Derived Poly(Vinyl Siloxane) Impressions.

PURPOSE: To comparatively evaluate the antimicrobial efficacy of freshly prepared electrolyzed oxidizing water (EOW) with that of 2.4% glutaraldehyde (GA) and 1% sodium hypochlorite (SH) on clinically derived poly vinyl siloxane (PVS) impressions. MATERIALS AND METHODS: Four clinically derived PVS impressions each were obtained from 10 subjects. One impression from each subject was randomly kept as control (group I), without disinfection. The remaining three impressions were randomly disinfected by immersion in either 2.4% GA (group II), 1% SH (group III), or freshly prepared EOW (group IV). The samples were subjected to microbial culture individually on brain heart infusion (BHI) agar medium. The organisms isolated were confirmed by visual examination and gram staining. Mean colony forming units (CFU) were counted, log10 reduction obtained and compared. Data were statistically analyzed using one-way ANOVA, followed by multiple comparisons using Tukey-HSD post hoc tests (p < 0.05). RESULTS: Streptococci, Staphylococci, Pseudomonas, Candida, Proteus, Klebsiella, and E. coli were isolated from all impressions including the controls, except those disinfected by EOW. All three disinfectants showed significant reduction in CFU and log10 reduction values as compared to the controls. EOW showed significantly higher reduction in log10 values compared to GA and SH, whereas GA and SH showed similar reductions. EOW, GA, and SH showed kill rates of 100%, 99.60%, and 99.82%, respectively. CONCLUSION: EOW showed significant antimicrobial efficacy as evidenced by reduction in log10 values when used as an immersion disinfectant for PVS impressions when compared with the results obtained using GA and SH. These results need further investigation. CLINICAL IMPLICATIONS: EOW shows high antimicrobial efficacy when used as an immersion disinfectant as compared to GA and SH for clinically derived PVS impressions.

Evaluation of the Efficacy of Different Mixing Techniques and Disinfection on Microbial Colonization of Polyether Impression Materials: A Comparative Study.

AIM: This study aims to determine the role of mixing techniques of polyether impression materials and efficacy of disinfection on microbial colonization of these impression materials. MATERIALS AND METHODS: Polyether impression material was mixed using two methods: First by hand mixing (group I) and second using an automixer (group II) with a total of 100 samples. Four microbial strains were studied, which included Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. After incubation, the bacterial colonies were counted, and then, disinfectant solution was applied. The effect of disinfection solution was evaluated for each specimen. RESULTS: The surface of polyether impression materials mixed with an automixer has less number of voids and overall a smoother surface as compared with the hand-mixed ones. On comparing the disinfection procedures, i.e., specimens without any disinfection and specimens after disinfection, statistically highly significant difference was seen between all the groups. CONCLUSION: We can conclude that impression mixing procedures are important in determining the surface characteristics of the impression and ultimately the colonization of bacteria and also determine the importance of disinfection on microbial colonization. CLINICAL SIGNIFICANCE: This study emphasises the deleterious role of nosocomial infections and specific measures that should be taken regarding the prevention of such diseases. Dental impressions are proved to be a source of such infections and may lead to transmission of such diseases. Thus, proper measures should be taken right from the first step of impression taking to minimizing and preventing such kind of contaminations in clinical practice.

Disinfectant Efficacy of 0.525% Sodium Hypochlorite and Epimax on Alginate Impression Material.

AIM: Species of Streptococcus, Escherichia coli, Staphylococcus, Actinomyces, Pseudomonas, Klebsiella, and Candida are commonly seen in the oral cavity. Impression materials are commonly contaminated with microorganisms. The present study was conducted to assess the disinfection efficacy of Epimax and 0.525% sodium hypochlorite on alginate impression over a period of 10 minutes. MATERIALS AND METHODS: This study was conducted in the Department of Prosthodontics in the year 2015. An alginate impression material was prepared. For each bacteria species, 15 samples were used. Out of 15 samples, 3 were used by 0.525% sodium hypochlorite for disinfection for 5 minutes and 3 others for 10 minutes. Similarly, 3 samples were used by Epimax for 5 minutes and other 3 for 10 minutes. Three samples were used as controls. Each sample was polluted with Candida albicans, Pseudomonas aeruginosa, and Staphylococcus aureus strains. RESULTS: There was no statistical difference in P. aeruginosa and C. albicans after 5 minutes, whereas S. aureus showed significant difference (p < 0.05). Epimax was found to be more effective in removing S. aureus as compared with other disinfectants. Both Epimax and 0.525% sodium hypochlorite did not show significant difference against P. aeruginosa and C. albicans, whereas significant difference was found between both agents against S. aureus (p < 0.05). It was seen that Epimax eliminated S. aureus after 5 minutes and P. aeruginosa after 10 minutes and 99.8% C. albicans after 10 minutes. About 0.525% sodium hypochlorite eliminated 99.1% of C. albicans after 10 minutes, whereas 98.5 and 99% of S. aureus and P. aeruginosa were eliminated after 10 minutes respectively. CONCLUSION: Both Epimax and 0.525% sodium hypochlorite can disinfect the alginate impression material against C. albicans, P. aeruginosa, and S. aureus strains. However, Epimax was found to be more effective against S. aureus as compared with 0.525% sodium hypochlorite. CLINICAL SIGNIFICANCE: Efficacy of disinfection of sodium hypo-chlorite and Epimax on alginate impression.

[Clinical and laboratory grounding of using medication based on the antiseptic troklosene to treat patients with chronic generalized periodontitis of the ii and iii degrees of severity].

OBJECTIVE: Introduction: Periodontal diseases take second place in the world among dental diseases and tend to be ubiquitous regardless of age, sex and place of residence. According to the modern point of view inflammatory periodontal diseases refer to infectious chronic inflammatory diseases, therefore, the normalization of the microflora of the oral cavity is an essential condition for their rational therapy. The aim: To increase the effectiveness of conservative treatment of chronic generalized periodontitis of the II-nd and III-rd severity using the medication based on the antiseptic Troklosene. PATIENTS AND METHODS: Materials and methods: 34 patients of age 45 to 55 years who were diagnosed with chronic generalized periodontitis of the IIInd and IIIrd degree of severity were examined and treated. All patients reported signs of the disease for 3-15 years. Patients of the study group by simple randomization were divided into two subgroups, depending on the therapeutic treatment performed. The I-st subgroup -16 patients treated with the additional use of the medication based on the antiseptic Troklosene, the IInd subgroup - 18 patients who were treated without using this drug. RESULTS: Results: Analyzing the results after the treatment in the patients of the I -st and II -nd subgroup, they noted a decrease in PMA index, Green-Vermillion index, bleeding index. Pathological mobility of teeth decreased to the I degree. The hygienic condition of the oral cavity was characterized in patients of both subgroups after treatment as satisfactory. In patients of the Ist subgroup (with the additional use of the medication based on the antiseptic Troklosene), after the 5th visit there were signs of remission, and in the IInd subgroup (using standard base therapy), after 7 visits, there were signs of clinical remission. With the additional use of the drug based on the antiseptic Troklosene, in contrast to the traditional therapy, a change in the bacterial ratio of microorganisms occurred, which influenced a significant decrease in the total bacterial mass. CONCLUSION: Conclusion: The best results were obtained in the Ist subgroup, where along with the standard base therapy, the supplement of based on the antiseptic Troklosene was used additionally. Introduction to the treatment regimen for patients with chronic generalized periodontitis with II and III severity of the drug based on the antiseptic Troklosene contributed to a stable clinical effect, as evidenced by the dynamics of clinical indicators and the reduction in the number of visits. Also, a change in the bacterial ratio of microorganisms with a significant decrease due to Enterobacterium spp. is noted. To maintain this result, it is recommended to continue the use of the drug based on the antiseptic Troklosene with a frequency of 4 times per day within 7 days after the end of treatment.

Phosphate buffer-stabilized 0.1% chlorine dioxide oral rinse for managing medication-related osteonecrosis of the jaw.

PURPOSE: This is a review of the literature on nonsurgical treatment of non-healing medication related osteonecrosis of the jaw (MRONJ) utilizing a phosphate buffer-stabilized 0.1% chlorine dioxide mouthrinse. METHODS: A literature search in PubMed revealed only six case reports. MRONJ lesion site description, patient's medication history, the healing time, and the MRONJ treatment protocol followed by those authors were recorded. Additional literature review of the scientific mechanism, risks and benefits, safety and efficacy of the phosphate buffer-stabilized 0.1% chlorine dioxide mouthrinse was also performed and discussed. RESULTS: Many of the authors of the published case reports utilized 0.12% chlorhexidine as the initial mouthrinse, but the lesions did not decrease in size. After switching to a phosphate buffer-stabilized 0.1% chlorine dioxide mouthrinse for a duration ranging from 1-12 months, there was complete healing of the MRONJ lesions in all of the cases. The phosphate buffer-stabilized 0.1% chlorine dioxide mouthrinse can be helpful in the management of active MRONJ lesions as well as the prevention of recurrent MRONJ lesions in the susceptible patient population. CLINICAL SIGNIFICANCE: This literature review supports the use of phosphate buffer-stabilized 0.1% chlorine dioxide mouthrinse in the management of MRONJ lesions either as a first line of therapy or after 0.12% chlorhexidine had not been effective.

Effects of chlorine-based and quaternary ammonium-based disinfectants on the wettability of a polyvinyl siloxane impression material.

STATEMENT OF PROBLEM: Polyvinyl siloxane (PVS) impression materials must be cold disinfected before cast pouring to prevent cross-contamination among personnel and patients. However, disinfection may affect the ability of PVS impression materials to provide bubble-free stone surfaces because of the removal of surfactants. PURPOSE: The purpose of this in vitro study was to compare the water contact angles of a PVS impression material treated with either a quaternary ammonium-based (QAB) (DisCide Ultra) or a chlorine-based (CLB) (Dispatch) disinfectant for various exposure times. No disinfection and acetone-immersed (total surfactant removal) specimens were used as positive and negative controls. An additional purpose was to measure changes in the contact angles of the disinfected PVS impression material after applying a topical wetting agent. MATERIAL AND METHODS: Flat and disk-shaped PVS specimens (n=5/test condition) were fabricated and subsequently exposed to disinfectants for different times (1 minute, 5 minutes, 30 minutes, 6 hours, and 24 hours). After disinfection, the contact angle with distilled water was determined over a 3-minute period using dynamic contact analysis. The same contact angle measurements were repeated after a wetting agent was applied to the previously disinfected specimens. Contact angles were statistically compared using 2-way ANOVA. The Sidak post hoc test was used to perform pairwise simple contrast and effect comparisons (α=.05). RESULTS: The contact angle increased directly with disinfectant contact time. For the CLB product, the contact angle after 30-minute disinfection was not significantly different from that of 1 minute disinfection (P>.05). For the QAB product, exceeding 5-minutes of disinfection resulted in a significantly greater contact angle (P<.001). The application of a wetting agent made the disinfected PVS specimens less hydrophobic. CONCLUSIONS: A QAB disinfectant product is more effective at removing surfactant than a CLB disinfectant product. Therefore, a CLB disinfectant provides more working time and control. A wetting agent can reduce the hydrophobicity of a disinfected impression material if the duration of cold disinfection is less than 6 hours.

Comparative Evaluation of Tensile Strength in Die Stone Incorporated with Sodium and Calcium Hypochlorite as Disinfectants: An in vitro Study.

AIM: The aim of this study was to evaluate the tensile strength of die stone incorporated with sodium and calcium hypochlorite as disinfectants. MATERIALS AND METHODS: Two commercially available type IV die stone (Kalrock: Kalabhai Karson Pvt., Ltd and Pearlstone: Asian Chemicals) and two commercially available disinfectant solutions (sodium hypochlorite and calcium hypochlorite: Beachem Laboratory Chemical Private Limited, Chennai and Leo Chem Private Limited, Bengaluru) were used in this study, and the tensile strength was measured using Lloyd's Universal Testing Machine. RESULTS: The results show that incorporating the disinfecting solutions decreases the tensile strength of both products. The effect of decreasing tensile strength on type IV gypsum product is seen more in calcium hypochlorite when compared with sodium hypochlorite disinfecting solution, and the tensile strength of Kalrock specimens is higher than Pearlstone specimens after disinfecting with sodium hypochlorite and calcium hypochlorite solution. The statistical results also show significant results in all the groups when compared with the control group. CONCLUSION: The incorporation of sodium and calcium hypochlorite disinfecting solutions is not an encouraging method for both die materials as it reduces the tensile strength of type IV gypsum product. Tensile strength of Kalstone® die material is superior than Pearlstone® die material after mixing with sodium hypochlorite and calcium hypochlorite. CLINICAL SIGNIFICANCE: According to the recommendations of Americans with Disability Act (ADA) and the Centers for Disease Control and Prevention, disinfecting the whole cast without or minimal changes in physical and mechanical properties was the motto of the study. The tensile strength in type IV gypsum product plays a most important role in retrieval of cast from impression, especially in narrow tooth preparation. This study reveals that incorporating method of disinfecting solutions is not recommended as it reduces the tensile strength.

Laser-based Disinfection of the Root Canal System: An Update.

INTRODUCTION: Microorganisms have been considered to have played a critical role in the initiation and development of pulpo-periapical diseases. Some evidences have shown that mechanical instrumentation may leave considerable portions of canal surfaces undebrided. Therefore, some supplemental methods, such as the use of chemical solutions and/or lasers, have been introduced to further disinfect the complicated canal anatomy and destroy as many microorganisms as possible. The purpose of this review was to address a brief review of characteristics of lasers and their effects to disinfect the root canal in endodontics.

Radiofrequency Glow Discharge as a Mode of Disinfection for Elastomeric Impression Materials.

INTRODUCTION: Prosthodontic practice involves procedures in which impressions of the maxillary and mandibular arches are mandatory. Cross infection is one of the major problems that can occur in regular dental practice. Every dentist should take utmost care to prevent cross infection as oral cavity is the source of variety of microorganisms which can often cause diseases that can be fatal. Although precautions, such as wearing of gloves and mask, sterilization of instruments are given importance, the need for disinfection of impressions is often neglected. Hence, the aim of the study was to assess the disinfection potential of radiofrequency glow discharge (RGD) by microbiological studies. MATERIALS AND METHODS: Disinfection potential of RGD on addition silicone (Reprosil, Dentsply, Milford DE, USA) was assessed. Total sample size was 20. Samples were divided into two groups of 10 each. Group I - control group and group II -RGD-treated group. Main groups were subdivided into subgroups A and B. Data collected were analyzed. RESULTS: The RGD-treated samples were found to be culture sterile which meant that there were no signs of growth of any organisms, thus proving the disinfection potential of RGD. CONCLUSION: From this study, we can conclude that RGD is a very rapid and handy device, which can disinfect saliva contaminated elastomeric impression material surfaces. CLINICAL SIGNIFICANCE: When compared with the difficulties and lack of efficiency encountered in disinfecting impressions by immersion and spray atomization, RGD can be very handy in dental clinics, as it is a very rapid and convenient method for infection control.