Suppression of caries-related microorganisms in dentine lesions after short-term chlorhexidine or antibiotic treatment.
This study investigated the efficiency of a chlorhexidine varnish and an antibiotic paste in suppressing the cultivable microflora of deep dentine cavities in a stepwise excavation procedure. Subsequent to enamel preparation and removal of the central biomass, infected dentine was sampled from the cavity floor. Ten cavities each were either covered with the 1% chlorhexidine- and 1% thymol-containing varnish Cervitec (CE), the demeclocycline hydrocortisone-containing ointment Ledermix (LE) or received no treatment as control (CO). A compomer composite was used as intermediate restorative. Cavities were reassessed after 6 weeks and again dentine samples were microbiologically investigated for total viable counts, mutans streptococci and lactobacilli. After 6 weeks a significant reduction of the total viable counts was observed in the LE group (p = 0.011) compared to the control, whereas no differences were found in the CE group (p > 0.05). Mutans streptococci were rarely recovered at baseline and after 6 weeks. Compared to the CO group counts of lactobacilli were significantly reduced in the CE and LE groups (p < 0.05). Lactobacillus species were frequently recovered at baseline and after 6 weeks of observation. Lactobacillus rhamnosus was the predominant species in all samples investigated. Application of CE or LE resulted in reduced counts of lactobacilli after a period of 6 weeks. Although none of the materials completely eliminated the viable microorganisms, the use of LE was more effective than CE in reducing the total anaerobic microorganisms associated with carious dentine.
Department of Operative Dentistry and Periodontology, University of Cologne, Kerpener Strasse 32, DE-50931 Köln, Germany. Michael.Wicht@medizin.uni-koeln.de
Michael J
MJ
Wicht
Rainer
R
Haak
Heidi
H
Schütt-Gerowitt
Susanne
S
Kneist
Michael J
MJ
Noack
D000190:Actinomyces / Q000187:drug effects; D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000627:therapeutic use*; D015169:Colony Count, Microbial; D020770:Compomers; D003707:Demeclocycline / Q000627:therapeutic use*; D003731:Dental Caries / Q000382:microbiology*; D003736:Dental Cavity Lining; D003737:Dental Cavity Preparation / Q000379:methods; D003794:Dental Restoration, Temporary; D003804:Dentin / Q000382:microbiology*; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007778:Lactobacillus / Q000145:classification / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D013295:Streptococcus mutans / Q000187:drug effects; D013943:Thymol / Q000627:therapeutic use*; D014222:Triamcinolone Acetonide / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D020770:Compomers; D004338:Drug Combinations; C079161:chlorhexidine, thymol drug combination; D013943:Thymol; D003707:Demeclocycline; C001527:Ledermix; D014222:Triamcinolone Acetonide; D002710:Chlorhexidine