Multifunctional Dental Adhesives Formulated with Silane-Coated Magnetic Fe3O4@m-SiO2 Core-Shell Particles to Counteract Adhesive Interfacial Breakdown.

The process of bonding to dentin is complex and dynamic, greatly impacting the longevity of dental restorations. The tooth/dental material interface is degraded by bacterial acids, matrix metalloproteinases (MMPs), and hydrolysis. As a result, bonded dental restorations face reduced longevity due to adhesive interfacial breakdown, leading to leakage, tooth pain, recurrent caries, and costly restoration replacements. To address this issue, we synthesized and characterized a multifunctional magnetic platform, CHX@SiQuac@Fe3O4@m-SiO2, to provide several beneficial functions. The platform comprises Fe3O4 microparticles and chlorhexidine (CHX) encapsulated within mesoporous silica, which was silanized by an antibacterial quaternary ammonium silane (SiQuac). This platform simultaneously targets bacterial inhibition, stability of the hybrid layer, and enhanced filler infiltration by magnetic motion. Comprehensive experiments include X-ray diffraction, FT-IR, VSM, EDS, N2 adsorption-desorption (BET), transmission electron microscopy, scanning electron microscopy, thermogravimetric analysis, and UV-vis spectroscopy. Then, CHX@SiQuac@Fe3O4@m-SiO2 was incorporated into an experimental adhesive resin for dental bonding restorations, followed by immediate and long-term antibacterial assessment, cytotoxicity evaluation, and mechanical and bonding performance. The results confirmed the multifunctional nature of CHX@SiQuac@Fe3O4@m-SiO2. This work outlined a roadmap for (1) designing and tuning an adhesive formulation containing the new platform CHX@SiQuac@Fe3O4@m-SiO2; (2) assessing microtensile bond strength to dentin using a clinically relevant model of simulated hydrostatic pulpal pressure; and (3) investigating the antibacterial outcome performance of the particles when embedded into the formulated adhesives over time. The results showed that at 4 wt % of CHX@SiQuac@Fe3O4@m-SiO2-doped adhesive under the guided magnetic field, the bond strength increased by 28%. CHX@SiQuac@Fe3O4@m-SiO2 enhanced dentin adhesion in the magnetic guide bonding process without altering adhesive properties or causing cytotoxicity. This finding presents a promising method for strengthening the tooth/dental material interface's stability and extending the bonded restorations' lifespan.

Novel anionic surfactant-modified chlorhexidine and its potent antimicrobial properties.

Chlorhexidine dodecyl sulfate (CHX-DS) was synthesized and characterized via single-crystal X-ray diffraction (SC-XRD), 1H nuclear magnetic resonance (NMR) spectroscopy, 1H nuclear Overhauser effect spectroscopy (NOESY), and attenuated total reflectance Fourier-transform infrared spectroscopy (ATR-FTIR). The solid-state structure, comprising a 1 : 2 stoichiometric ratio of chlorhexidine cations [C22H30Cl2N10]2+ to dodecyl sulfate anions [C12H25SO4]-, is the first report of chlorhexidine isolated with a surfactant. CHX-DS exhibits broad-spectrum antibacterial activity and demonstrates superior efficacy for reducing bacteria-generated volatile sulfur compounds (VSCs) as compared to chlorhexidine gluconate (CHG). The minimum inhibitory concentrations (MICs) of CHX-DS were 7.5, 2.5, 2.5, and 10 µM for S. enterica, E. coli, S. aureus, and S. mutans, respectively. Furthermore, MIC assays for E. coli and S. mutans demonstrate that CHX-DS and CHX exhibit a statistically significant efficacy enhancement in 2.5 µM treatment as compared to CHG. CHX-DS was incorporated into SBA-15, a mesoporous silica nanoparticle (MSN) framework, and its release was qualitatively measured via UV-vis in aqueous media, which suggests its potential as an advanced functional material for drug delivery applications.

Silica nanoparticles containing nano-silver and chlorhexidine respond to pH to suppress biofilm acids and modulate biofilms toward a non-cariogenic composition.

OBJECTIVES: Dental caries is caused by acids from biofilms. pH-sensitive nanoparticle carriers could achieve improved targeted effectiveness. The objectives of this study were to develop novel mesoporous silica nanoparticles carrying nanosilver and chlorhexidine (nMS-nAg-Chx), and investigate the inhibition of biofilms as well as the modulation of biofilm to suppress acidogenic and promote benign species for the first time. METHODS: nMS-nAg was synthesized via a modified sol-gel method. Carboxylate group functionalized nMS-nAg (COOH-nMS-nAg) was prepared and Chx was added via electrostatic interaction. Minimal inhibitory concentration (MIC), inhibition zone, and growth curves were evaluated. Streptococcus mutans (S. mutans), Streptococcus gordonii (S. gordonii), and Streptococcus sanguinis (S. sanguinis) formed multispecies biofilms. Metabolic activity, biofilm lactic acid, exopolysaccharides (EPS), and TaqMan real-time polymerase chain reaction (RT-PCR) were tested. Biofilm structures and biomass were observed by scanning electron microscopy (SEM) and live/dead bacteria staining. RESULTS: nMS-nAg-Chx possessed pH-responsive properties, where Chx release increased at lower pH. nMS-nAg-Chx showed good biocompatibility. nMS-nAg-Chx exhibited a strong antibacterial function, reducing biofilm metabolic activity and lactic acid as compared to control (p < 0.05, n = 6). Moreso, biofilm biomass was dramatically suppressed in nMS-nAg-Chx groups. In control group, there was an increasing trend of S. mutans proportion in the multispecies biofilm, with S. mutans reaching 89.1% at 72 h. In sharp contrast, in nMS-nAg-Chx group of 25 µg/mL, the ratio of S. mutans dropped to 43.7% and the proportion of S. gordonii and S. sanguinis increased from 19.8% and 10.9 to 69.8% and 56.3%, correspondingly. CONCLUSION: pH-sensitive nMS-nAg-Chx had potent antibacterial effects and modulated biofilm toward a non-cariogenic tendency, decreasing the cariogenic species nearly halved and increasing the benign species approximately twofold. nMS-nAg-Chx is promising for applications in mouth rinse and endodontic irrigants, and as fillers in resins to prevent caries.

Did in-between rinsing and agitating with distilled water prevents precipitate formation by the interaction between sodium hypochlorite and chlorhexidine canal irrigants?

The interaction of sodium hypochlorite (NaOCl) and chlorhexidine gluconate (CHX) produces an orange-brown precipitate. The present study evaluated the influence of distilled water (H2 O) in different irrigation protocols designed to prevent the formation of precipitate with NaOCl and CHX. Fifty canine teeth were instrumented and split longitudinally. The canal was examined with a stereomicroscope and photographed by canal-thirds. The tooth halves were repositioned and distributed randomly into five groups, according to the final irrigation protocol (n = 10): G1 (control)-Ethylenediaminetetraacetic acid (EDTA) + NaOCl + CHX, conventional irrigation (CI); G2-EDTA + NaOCl + CHX, activated with passive ultrasonic irrigation (PUI); G3-EDTA (PUI) + NaOCl (PUI) + H2 O (CI) + CHX (PUI); G4-EDTA + NaOCl + H2 O + CHX (PUI); G5-EDTA (PUI) + NaOCl (PUI) + H2 O (continuous ultrasonic irrigation [CUI]) + CHX (PUI). The specimens were evaluated with a stereomicroscope and scanning electron microscope (SEM). Energy dispersive x-ray spectroscopy analysis was performed to identify the elemental profile of the irrigated canal walls. The images were scored according to the extensiveness of precipitate. Data were analyzed (Kruskal-Wallis test, α = 5%). Under the stereomicroscope, G1 had significantly higher scores than all the other groups in all canal-thirds (p < .05). All four experimental groups showed similar scores (p > .05). There were no significant differences in precipitate formation among root-thirds in intragroup analysis (p > .05). Upon SEM examination, overall, only G5 had lower scores than G1 (p < .05). Analysis by canal-thirds showed no significant difference among groups and among canal-thirds in the intragroup analysis (p > .05). G1 showed high Cl peaks. In-between irrigation with H2 O activated by CUI is effective in preventing precipitate formation during canal debridement with NaOCl and CHX. RESEARCH HIGHLIGHTS: Continuous ultrasonic irrigation with distilled water was capable to prevent the precipitate formation. The precipitate can be classified as a chemical smear layer.

Microbiological, physicomechanical, and surface evaluation of an experimental self-curing acrylic resin containing halloysite nanotubes doped with chlorhexidine.

OBJECTIVE: The objective was to synthesize halloysite nanotubes loaded with chlorhexidine (HNT/CHX) and evaluate the antimicrobial activity, microhardness, color change, and surface characteristics of an experimental self-curing acrylic resin containing varying concentrations of the synthesized nanomaterial. METHODS: The characterization of HNT/CHX was carried out by calculating incorporation efficiency, morphological and compositional, chemical and thermal evaluations. SAR disks were made containing 0 %, 3 %, 5 %, and 10 % of HNT/CHX. Specimens (n = 3) were immersed in distilled water and spectral measurements were carried out using UV/Vis spectroscopy to evaluate the release of CHX for up to 50 days. The antimicrobial activity of the composite against Candida albicans and Streptococcus mutans was evaluated by disk-diffusion test. Microhardness, color analyses (ΔE), and surface roughness (Ra) (n = 9) were performed before and after 30 days of immersion. Data were analyzed using ANOVA/Bonferroni. {Results.} The incorporation efficiency of CHX into HNT was of 8.15 %. All test groups showed controlled and cumulative CHX release up to 30 or 50 days. Significant antimicrobial activity was verified against both microorganisms (p < 0.001). After the 30-day immersion period, the 10 % HNT/CHX group showed a significant increase in hardness (p < 0.05) and a progressive color change (p < 0.001). At T0, the 5 % and 10 % groups exhibited Ra values similar to the control group (p > 0.05), while at T30, all groups showed similar roughness values (p > 0.05). {Significance.} The modification of a SAR with HNT/CHX provides antimicrobial effect and controlled release of CHX, however, the immediate surface roughness in the 3 % group was compromised when compared to the control group.

Effect of chlorhexidine and benzalkonium chloride on the long-term push-out bond strength of fiber posts.

Background and Aim: Fiber posts are widely used in endodontically treated teeth with extensive loss of coronal structure. The purpose of this study was to investigate immediate and the long-term effects of chlorhexidine (CHX) and benzalkonium chloride (BAC) application, on the push-out bond strength of fiber posts. Material and Methods: Sixty mandibular premolars were decoronated, and root canal treatment was performed. After post space preparation, the specimens were divided into three groups according to the post space-surface pretreatment (n = 20); no surface treatment (control group-Group 1), 2% CHX application (Group 2), and 1% BAC application (Group 3). A self-curing adhesive cement and an etch and rinse adhesive were used for the cementation of posts. Three sections (one cervical, one middle, and one apical) of 1 mm thickness were prepared from each specimen. A push-out test was performed immediately on the half of the specimen sections (n = 10). The other half of the specimen sections were subjected to 20.000 thermal cycles before applying the push-out test (n = 10). The failure mode of each specimen was observed under a stereomicroscope at ×40 magnification. Results: The data were analyzed by one-way analysis of variance (ANOVA), Tukey Honestly significant difference (HSD), and Tamhane tests (P = 0.05). The cervical thirds displayed the highest, and the apical thirds showed the lowest values in all groups (P < 0.05), except the control-aged group (P = 0.554). The aged control groups' values were found to be significantly lower than the aged CHX and BAC groups (P < 0.001). Aging significantly reduced the bond strength values of specimens in control groups (P < 0.001). However, aging did not significantly affect the push-out bond strength values of CHX and BAC groups (P > 0.050). The failure types were adhesive between the post and cement (type 1) in all groups, except control-aged group (type 2). Conclusion: The application of 2% chlorhexidine or 1% BAC may be an essential step that can be taken to preserve the bond strength of fiber posts.

Dual nanocarrier of chlorhexidine and fluconazole: Physicochemical characterization and effects on microcosm biofilms and oral keratinocytes.

OBJECTIVES: This study assembled and characterized a dual nanocarrier of chlorhexidine (CHX) and fluconazole (FLZ), and evaluated its antibiofilm and cytotoxic effects. METHODS: CHX and FLZ were added to iron oxide nanoparticles (IONPs) previously coated by chitosan (CS) and characterized by physical-chemical analyses. Biofilms from human saliva supplemented with Candida species were grown (72 h) on glass discs and treated (24 h) with IONPs-CS carrying CHX (at 39, 78, or 156 µg/mL) and FLZ (at 156, 312, or 624 µg/mL) in three growing associations. IONPs and CS alone, and 156 µg/mL CHX + 624 µg/mL FLZ (CHX156-FLZ624) were tested as controls. Next, microbiological analyses were performed. The viability of human oral keratinocytes (NOKsi lineage) was also determined (MTT reduction assay). Data were submitted to ANOVA or Kruskal-Wallis, followed by Fisher's LSD or Tukey's tests (α=0.05). RESULTS: Nanocarriers with spherical-like shape and diameter around 6 nm were assembled, without compromising the crystalline property and stability of IONPs. Nanocarrier at the highest concentrations was the most effective in reducing colony-forming units of Streptococcus mutans, Lactobacillus spp., Candida albicans, and Candida glabrata. The other carriers and CHX156-FLZ624 showed similar antibiofilm effects, and significantly reduced lactic acid production (p<0.001). Also, a dose-dependent cytotoxic effect against oral keratinocytes was observed for the dual nanocarrier. IONPs-CS-CHX-FLZ and CHX-FLZ significantly reduced keratinocyte viability at CHX and FLZ concentrations ≥7.8 and 31.25 µg/mL, respectively (p<0.05). CONCLUSION: The nanotherapy developed outperformed the effect of the combination CHX-FLZ on microcosm biofilms, without increasing the cytotoxic effect of the antimicrobials administered. CLINICAL SIGNIFICANCE: The dual nanocarrier is a promising topically-applied therapy for the management of oral candidiasis considering that its higher antibiofilm effects allow the use of lower concentrations of antimicrobials than those found in commercial products.

Effect of Chlorhexidine on the Bonding Effect of an Etch-and-Rinse Adhesive to Pretreatment Dentin.

The purpose of this study was to evaluate the effect of 2% chlorhexidine (CHX) on an etch-and rinse adhesive to dentin. Caries-free molars were selected and processed to expose a flat dentin surface. The specimens were bonded with a composite resin by an etch-and-rinse adhesive, which was pretreated with 2% CHX for 0, 15, 30, 45, and 60 seconds. The microtensile bond strength (MTBS) was evaluated before and after thermocycling. No significant differences were observed between groups before thermocycling. The 60-second CHX-pretreated group showed a significantly greater MTBS than the control group after thermocycling. The 2% CHX pretreatment could improve the bonding strength of the etch-and-rinse adhesive and slow down the aging progress of the bonding interface.

Synthesis of Novel Antimicrobial CHX-CaCl2 Coatings on Maxillofacial Fixatures for Infection Prevention.

Maxillofacial surgery placement of fixatures (Leonard Buttons, LB) at close proximity to surgical incisions provides a potential reservoir as a secondary local factor to advanced periodontal disease, with bacterial formation around failed fixatures implicating plaque. To address infection rates, we aimed to surface coat LB and Titanium (Ti) discs using a novel form of chlorhexidine (CHX), CHX-CaCl2 and 0.2% CHX digluconate mouthwash as a comparison. CHX-CaCl2 coated, double-coated and mouthwash coated LB and Ti discs were transferred to 1 mL artificial saliva (AS) at specified time points, and UV-Visible spectroscopy (254 nm) was used to measure CHX release. The zone of inhibition (ZOI) was measured using collected aliquots against bacterial strains. Specimens were characterized using Energy Dispersive X-ray Spectroscopy (EDS), X-ray Diffraction (XRD) and Scanning Electron Microscopy (SEM). SEM displayed copious dendritic crystals on LB/ Ti disc surfaces. Drug release from double-coated CHX-CaCl2 was 14 days (Ti discs) and 6 days (LB) above MIC, compared to the comparison group (20 min). The ZOI for the CHX-CaCl2 coated groups was significantly different within groups (p < 0.05). CHX-CaCl2 surface crystallization is a new drug technology for controlled and sustained CHX release; its antibacterial effectiveness makes this drug an ideal adjunct following clinical and surgical procedures to maintain oral hygiene and prevent surgical site infections.

Interactions Between Calcium Hypochlorite and Irrigants Commonly Used in Endodontic Practice: A Chemical Analysis.

INTRODUCTION: This study aimed to identify possible products resulting from chemical interactions between calcium hypochlorite (Ca[OCl]2) and other irrigants for endodontic use using electrospray ionization quadrupole time-of-flight mass spectrometry. METHODS: The 5.25% Ca(OCl)2 was associated with either 70% ethanol solution, distilled water, saline solution (0.9% sodium chloride), 5% sodium thiosulfate, 10% citric acid, 17% ethylenediaminetetraacetic acid (EDTA), or 2% chlorhexidine (CHX). The reaction ratio was 1:1 and the products obtained were analyzed by electrospray ionization quadrupole time-of-flight mass spectrometry. RESULTS: The interactions between Ca(OCl)2 and CHX generated an orange-brown precipitate, without identification of para-chloroaniline and between Ca(OCl)2 and sodium thiosulfate, a milky-white precipitate. Furthermore, when the oxidizing agent was associated with EDTA and citric acid, chlorine gas was released. As for the other associations, 70% ethanol, distilled water, and saline solution, no precipitation or gas release occurred. CONCLUSIONS: The orange-brown precipitate occurs due to the chlorination of guanidine nitrogens, and the milky-white precipitate is due to the partial neutralization of the oxidizing agent. The release of chlorine gas occurs due to the low pH of the mixture, which results in the rapid formation and decomposition of chlorine. In this context, an intermediate rinsed with distilled water, saline solution, and ethanol between Ca(OCl)2 and CHX, citric acid, and EDTA seems to be appropriate to prevent the formation of by-products when these irrigants need to be used in the canal. Furthermore, if it is necessary to use sodium thiosulfate, a larger volume of the solution must be used compared to that used for the oxidizing solution.

Effect of MMP Inhibitors on the Bond Strength of Fibre Posts After Ageing.

AIM: This in vitro study aimed to evaluate the effect of matrix metalloproteinase (MMP) inhibitors on the bond strength of resin-cemented fibre posts to radicular dentin under an aged-loaded condition. MATERIALS AND METHODS: Radicular dentin was prepared and irrigated by MMP inhibitor solution after root canal obturation in 60 extracted single-rooted teeth based on 6 groups: (1) 2% chlorhexidine (CHX) + loaded; (2) CHX + unloaded; (3) 0.5% benzalkonium chloride (BAC) + loaded; (4) BAC + unloaded; (5) 17% ethylenediaminetetraacetic acid (EDTA) + loaded; and (6) EDTA + unloaded. After final rinsing, all specimens were sliced cross-sectionally and kept in a water bath for 12 months of ageing. Groups 1, 3, and 5 were subjected to cyclic loading. Push-out tests were conducted using a universal testing machine, and failure mode was examined. The data were analysed using 3-way analysis of variance and post hoc tests at α = 0.05. RESULTS: BAC + unloaded demonstrated the highest mean bond strength (3.12 ± 0.18 MPa; P < .001), while the BAC + loaded and CHX + loaded groups showed a significantly lower push-out bond strength than their unloaded counterparts. Mixed adhesive-cohesive failure was the most common failure mode observed. CONCLUSIONS: Without cycling loading, BAC was superior to CHX and EDTA in preserving the bond strength of resin-cemented fibre posts after 12 months of ageing. Loading significantly weakened the effectiveness of BAC and CHX in preserving the bond strength.

Antibacterial and fluorescent clear aligner attachment resin modified with chlorhexidine loaded mesoporous silica nanoparticles and zinc oxide quantum dots.

OBJECTIVES: To develop an antibacterial and fluorescent clear aligner attachment resin via the incorporation of chlorhexidine loaded pore-expanded mesoporous silica nanoparticles (CHX@pMSN) and amino-silane functionalized zinc oxide quantum dots (aZnOQDs), and to evaluate its antibacterial activity, fluorescence capability, esthetic properties, mechanical performance and biocompatibility. METHODS: CHX@pMSN and aZnOQDs were incorporated into the commercial resin composites (Filtek Z350 XT, 3M) at different mass fractions, control group: Filtek; fluorescent attachment resin (FAR): Filtek + 3 wt% aZnOQDs; antibacterial and fluorescent attachment resin (AFAR)-1: Filtek + 3 wt% aZnOQDs + 1 wt% CHX@pMSN; AFAR-2: Filtek + 3 wt% aZnOQDs + 3 wt% CHX@pMSN; AFAR-3: Filtek + 3 wt% aZnOQDs + 5 wt% CHX@pMSN. CHX release, antibacterial activity, fluorescence capability, color change, stain resistance, degree of conversion, depth of cure, polymerization shrinkage, water sorption and solubility, softening in solvent, flexural strength, flexural modulus, shear bond strength, and cytotoxicity were evaluated comprehensively. RESULTS: CHX could be continuously released from the AFAR groups for up to 30 days. CFU, MTT, lactic acid production, SEM and CLSM evaluation showed AFAR-2 and AFAR-3 could effectively inhibit S. mutans biofilms even after 1-month aging. Only AFAR-3 showed clinically perceptible color change and all the experimental groups were not more susceptible to staining. AFAR-1 and AFAR-2 could suppress polymerization shrinkage and enhance the resistance to degradation without compromising other properties, including degree of conversion, water sorption and solubility, flexural strength, flexural modulus, and shear bond strength. Depth of cure of all the four experimental groups was significantly decreased (p < 0.05) but still within the ISO standard. CCK-8 assay and live/dead cell staining denied the cytotoxicity of experimental resins. Fluorescence intensity tests showed that FAR and AFAR-2 could emit strong yellowish fluorescence under the excitation of ultraviolet for up to six months. CONCLUSIONS: AFRA-2 possessed long-term antibiofilm activity, strong fluorescence capability and satisfying biocompatibility without compromising esthetic and mechanical properties. This study proposed a new strategy for reducing bacteria accumulation around the attachment, which is also promising in helping orthodontists to remove the attachment thoroughly and precisely.

Development, characterization and antimicrobial activity of multilayer silica nanoparticles with chlorhexidine incorporated into dental composites.

OBJECTIVE: In this study a dentistry nanocomposite with prolonged antibacterial activity using silica nanoparticles (SNPs) loaded with chlorhexidine (CHX) was developed. METHODS: SNPs were coated with the Layer-by-Layer technique. Dental composites were prepared with organic matrix of BisGMA/TEGDMA and SNPs with or without CHX (0, 10, 20 or 30% w/w). The physicochemical properties of the developed material were evaluated and agar diffusion method was used to test the antibacterial. In addition, the biofilm inhibitory activity of the composites was evaluated against S. mutans. RESULTS: SNPs were rounded with diameters about 50 nm, the organic load increased with increasing deposited layers. Material samples with SNPs loaded with CHX (CHX-SNPs) showed the highest values of post-gel volumetric shrinkage, that ranged from 0.3% to 0.81%. Samples containing CHX-SNPs 30% w/w showed the highest values of flexural strength and modulus of elasticity. Only samples containing SNPs-CHX showed growth inhibition against S. mutans, S. mitis and S. gordonii in a concentration-dependent manner. The composites with CHX-SNPs reduced the biofilm formation of S. mutans biofilm at 24 h and 72 h. SIGNIFICANCE: The nanoparticle studied acted as fillers and did not interfere with the evaluated physicochemical properties while providing antimicrobial activity against streptococci. Therefore, this initial study is a step forward to the synthesis of experimental composites with improved performance using CHX-SNPs.

The Sustained-released Polylactic Co-glycolic Acid Nanoparticles Loaded with Chlorhexidine as Antibacterial Agents Inside the Dental Implant Fixture.

INTRODUCTION: Titanium-based implants are widely used due to their good biocompatibility and high corrosion resistance. Infections after implant placement are the main reason for the failure of implant treatment. Some recent studies have also shown that microbial contamination can occur at the implant-abutment level in implants with healthy or diseased surrounding tissue. The purpose of this study is to investigate the antibacterial effect of slow-release nanoparticles of polylactic co-glycolic acid (PLGA) loaded with chlorhexidine (CHX) inside the implant fixture. MATERIALS AND METHODS: Thirty-six implants in three groups were examined in the bacterial culture environment. In the first group, PLGA/CHX nanoparticles; in the second group, the negative control group (distilled water) and in the third group, the positive control groups (chlorhexidine) were used. The bacterial suspensions, including Escherichia coli ATCC: 25922, Staphylococcus aureus ATCC: 6538 and Enterococcus faecalis ATCC: 29212 were used to investigate the antimicrobial effect of the prepared nanoparticles. RESULTS: The results showed that the use of PLGA/CHX nanoparticles significantly inhibited the growth of all three bacteria. Nanoparticles loaded with chlorhexidine had a significant decrease in the growth rate of all three bacteria compared to chlorhexidine and water. The lowest bacterial growth rate was observed in the Enterococcus faecalis/PLGA nanoparticles group, and the highest bacterial growth rate was observed in the Staphylococcus aureus/H2O group. CONCLUSION: The current study showed that the use of PLGA/CHX nanoparticles could significantly inhibit the growth of all three bacteria. Of course, the current study was conducted in vitro, and to obtain clinical results, we need to conduct a study on human samples. In addition, the results of this study showed that the chemical antimicrobial materials could be used in low concentrations and in a sustained- released manner in cases of dealing with bacterial infections, which can lead to better and targeted performance as well as reduce possible side effects.

Films composed of white angico gum and chitosan containing chlorhexidine as an antimicrobial agent.

Anadenanthera colubrina, popularly known as white angico, is a species extensively cultivated in Brazil, mainly in the cerrado region, including the state of Piauí. This study examines the development of films composed of white angico gum (WAG) and chitosan (CHI) and containing chlorhexidine (CHX), an antimicrobial agent. The solvent casting method was used to prepare films. Different combinations and concentrations of WAG and CHI were used to obtain films with good physicochemical characteristics. Properties such as the in vitro swelling ratio, the disintegration time, folding endurance, and the drug content were determined. The selected formulations were characterised by scanning electron microscopy, Fourier-transform infrared spectroscopy, differential scanning calorimetry, thermogravimetric analysis, and X-ray diffraction, and the CHX release time and antimicrobial activity were evaluated. CHX showed a homogenous distribution in all CHI/WAG film formulations. The optimised films showed good physicochemical properties with 80% CHX release over 26 h, which is considered promising for local treatment of severe lesions in the mouth. Cytotoxicity tests of the films did not show toxicity. The antimicrobial and antifungal effects were very effective against the tested microorganisms.

Twenty-month Performance of a Universal Bonding System on Simulated-challenged Dentin Substrates Pretreated with Chlorhexidine.

OBJECTIVES: Since the use of dentin antiproteolytic agents with universal adhesives (UAs) can potentially degrade the bonding interface, this study evaluated bond strengths with and without chlorhexidine (CHX) on variously altered dentin surfaces for up to 20 months. METHODS: Human molar specimens (n=20) were categorized by substrates as S=sound, E=eroded, and C=carious, and by pretreatment as W=water or CHX. These specimens were subjected to micro-tensile bond strength (µTBS) testing at 24 hours, 6 months, and 20 months, after 30 seconds of pretreatment with CHX or W, followed by self-etching and bonding (Adper Single Bond Universal, 3M ESPE). Modes of failure were assessed using optical microscopy (40×) and scanning electron microscopy (SEM), and the results were analyzed by 3-way ANOVA and Tukey's statistical tests (α=0.05). RESULTS: Substrate (p<0.001), pre-treatment (p=0.0413), and time (p<0.0001) were statistically significant. The sound-dentin group in initial time (W=39.27/CHX=40.55) yielded the higher µTBS values (MPa) in comparison with altered substrates pre-treated with CHX (E-CHX=19.84; C-CHX=18.24) after 20 months, which showed the lowest values. Under SEM analysis, heterogeneous patterns appeared in the hybrid layer of the CHX-treated group, particularly in the altered substrates. CONCLUSIONS: Bond strength to dentin decreased over a period of 20 months using UA with 10-methacryloyloxydecyl-dihydrogen phosphate (MDP) in self-etching mode. Substrates altered by erosion or caries have impaired adhesion and associated clinical use of UA with MDP and CHX should be avoided.

Effect of Chlorhexidine-containing Etch-and-Rinse Adhesives on Dentin Microtensile Bond Strength after Biological Loading.

PURPOSE: This study compared a 2%-CHX dentin pre-treatment with three CHX adhesives (experimentally admixed 0.1% CHX in primer or bonding agent, or industrially added 0.2% CHX in universal adhesive) by evaluating dentin bond strengths after biological loading in a fully automated artificial mouth model. MATERIALS AND METHODS: The occlusal dentin of 50 freshly extracted human third molars was exposed, and the teeth were randomly assigned to 5 groups according to the adhesive protocol (n = 10): 1. control, Scotchbond Multipurpose (3M Oral Care; CTRL); 2. 2% CHX dentin pre-treatment (DENT); 3. 0.1% CHX experimentally admixed into the primer (PRIM); 4. 0.1% CHX experimentally admixed into the bonding agent (BOND); 5. Peak Universal Bond containing 0.2% CHX (Ultradent; PEAK). The teeth were restored with composite resin. Microtensile bond strength testing (bonding area 0.46 mm2 ± 0.04 mm2, crosshead speed 1 mm/min) was performed after 24-h storage in distilled water (baseline) or after 2-day biological loading with S. mutans (demineralization 1 h / remineralization 5 h). The mode of fracture was recorded and exemplary sticks were evaluated under SEM. RESULTS: CTRL exhibited significantly higher µTBS at baseline in comparison to PRIM (p = 0.000), BOND (p = 0.002), and PEAK (p = 0.000). After undergoing the caries model, CTRL demonstrated significantly lower µTBS compared to DENT (p = 0.000), PRIM (p = 0.008), and PEAK (p = 0.000). The same behavior was observed for BOND vs DENT (p = 0.000), PRIM (p = 0.003), and PEAK (p = 0.001). After biological loading, DENT (p = 0.041), PRIM (p = 0.000), and BOND (p = 0.000) exhibited significantly fewer adhesive fractures than CTRL. CONCLUSIONS: CHX addition to the primer protects dentin bond strength from declining after biological loading. Thus, it may offer some clinical advantage in terms of secondary caries inhibition around composite restorations. However, since loss of adhesion at baseline was less when 2% CHX was used as a dentin pre-treatment, it can be suggested as a safer option. so that bonding is not undermined by potential chemical interactions from CHX with the adhesives.

Evaluation of Chitosan-Oleuropein Nanoparticles on the Durability of Dentin Bonding.

Purpose: To evaluate the effects of dentin pretreatment with chitosan-loaded oleuropein nanoparticles (CONPs) on the durability of resin-dentin bonding interfaces. Methods: Eighty freshly extracted non-carious human third molars were randomly divided into four groups (n = 20 each): a de-ionized water (DW) group, a chitosan (CS) group, a chlorhexidine (CHX) group and a CONP group. The dentin in the DW, CS, CHX, and CONP groups were pretreated with de-ionized water, 1.0 mg/L CS solution, 2% chlorhexidine solution, and CONP suspension (prepared with 100 mg/L oleuropein), respectively, followed by the universal adhesive and resin composites. The bonded teeth of each group were randomly divided into two subgroups: an immediate subgroup and an aged subgroup. The bonded teeth of each group were then cut into the bonded beams. We measured their microtensile bond strength (µTBS), observed the characteristics of bonding interface by atomic force microscope, calculated the percentage of silver particles in a selected area for interfacial nanoleakage analysis, and evaluated the endogenous gelatinase activity within the bonding interface for in-situ zymogram analysis. Data were analyzed with two-way ANOVA and LSD multiple comparison test (P < 0.05). Results: Regardless of after 24 h or after thermocycling, CONP exhibited better µTBS (P < 0.05) than the other three groups except that there was not a statistical significance (P > 0.05) in the CONP and CHX groups after 24 h. Besides, the CONP group presented significantly higher modulus of elasticity in the hybrid layers (P < 0.05), lower expression of nanoleakage (P < 0.05), and better inhibitory effect of matrix metalloproteinases than the other three groups before and after thermocycling. Conclusion: Altogether, the CONPs had the potential to act as a dentin primer, which could effectively improve the dentin-resin binding durability.

Evaluation of drug release, monomer conversion and surface properties of resin composites containing chlorhexidine-loaded mesoporous and nonporous hydroxyapatite nanocarriers.

The aim of this study was to evaluate drug release, degree of conversion (DC), and surface properties of resin composites containing chlorhexidine (CHX)-loaded mesoporous (mHAP) and nonporous hydroxyapatite (HAP) nanocarrier. CHX loaded mHAP and HAP, or CHX without nanocarrier was added into the resin composite in 1% and 5% concentrations. After characterization of experimental materials with XRD, EDX, FT-IR, and SEM, the CHX release on the 1st, 7th, 30th, and 120th days were evaluated by UV-vis spectroscopy. DC, surface roughness, and surface hardness of the samples were also evaluated. The data was statistically analyzed. While mHAP groups released significantly higher CHX on the 30th day (p < .05), there was no statistically significant difference between the HAP and mHAP groups on the 120th day (p > .05). DCs of all groups were similar (p > .05). While mHAP and HAP groups containing 5% CHX showed significantly higher roughness than the other groups (p < .05), no statistically significant difference was observed between the other groups (p > .05). The 1% and 5% CHX groups without nanocarrier showed significantly lower surface hardness (p < .05). However, no statistically significant difference was observed between the other groups in terms of surface hardness (p > .05). A controlled CHX release was achieved by mHAP and HAP nanocarriers for 120 days. The nanocarrier addition up to 5% did not negatively affect the DC and the surface hardness which is one of the surface properties of the resin composites. Although the addition of 5% nanocarrier to the resin composite increased the surface roughness, while adding 1% of these nanocarriers did not change.

Catechol-modified chitosan hydrogel containing PLGA microspheres loaded with triclosan and chlorhexidine: a sustained-release antibacterial system for urinary catheters.

Blockage and infection are common in hospitals, especially with long-term indwelling catheters, due to bacterial adhesion, colonization, and other reasons. A drug-sustained-release antibacterial coating for urinary catheters was described in this paper. Chlorhexidine (CHX) and triclosan (TCS) were encapsulated in poly(lactic-co-glycolic acid) microspheres and mixed with a modified chitosan hydrogel deposited on the surface of silicone rubber. The results showed that drugs can be released continuously more than 35 days. Catechol-modified chitosan (Chi-C) hydrogel was successful synthesized according to FT-IR and UV spectrophotometry, as well as 1H NMR. Furthermore, the coating with CHX and TCS presented stable antibacterial ability compared to the other groups. The results of CCK-8 revealed that the coating was cytotoxic-free and had a wide range of applications. The findings could provide a new drug sustained-release system and hydrogel-microsphere assembly for urinary catheters. HighlightsThe microspheres presented a sustained release more than 40 days with a remarkable initial burst release.The microspheres/catechol-modified chitosan (Chi-C)/silicon rubber system emerged stable binding ability in liquid environment more than 14 days.The Chi-C/chlorhexidine (CHX)+triclosan (TCS) microspheres system presented better antimicrobial property for entire experiment period.The coated samples showed no significant difference for relative growth rate (RGR) compared to different groups.