title: Effect of an alcohol-free, 1% chlorhexidine gel as an adjunct to a fluoridated dentifrice using an intraoral crown model.
abstract: OBJECTIVE
  The use of chlorhexidine as a topically applied oral antiseptic is well documented; however, clinical studies examining the effects of chlorhexidine gel on in situ dental caries are limited. This study utilized an in situ caries model and a modified crossover design to examine whether the addition of a biweekly topical, alcohol-free, 1% chlorhexidine digluconate gel to a daily fluoridated dentifrice inhibited artificial caries in dental tissues better than the fluoridated dentifrice alone when compared to a nonfluoridated placebo dentifrice.
  
  
  METHODS
  Thirty patients were recruited based on their need for a mandibular, full crown. Artificial caries lesions were created in extracted human teeth and enamel and root tissue sections 100 mum in thickness were characterized using polarized light microscopy. The sections were fixed in the crown and placed on the prepared tooth. The participants were assigned a placebo toothpaste, a toothpaste with 1,100 ppm F or a 1,100 ppm F toothpaste followed by 1 ml of 1% chlorhexidine gel at day 1 and day 14 (chlorhexidine+). Patients were instructed to brush twice daily for 4 weeks. Following each round, the sections in the crown were replaced with new sections. The sections were recharacterized and the mean changes were compared using ANOVA at alpha = 0.05.
  
  
  RESULTS
  The chlorhexidine + Fdentifrice and the F dentifrice alone significantly reduced lesion area in enamel tissue when compared to the placebo dentifrice. Both treatments also inhibited lesion progression and initiation in root tissue better than control in this model system. Although the chlorhexidine+ group enhanced remineralization and inhibited lesion progression better than the F(-) dentifrice alone for all outcomes measured, the differences were not significant.
  
  
  CONCLUSIONS
  The chlorhexidine, in conjunction with a fluoride dentifrice, was no more effective than the fluoride dentifrice alone. Further study is needed before this 1% alcohol-free chlorhexidine gel should be recommended as an adjunct to a fluoride dentifrice in the treatment of dental caries.
authors.affiliation: Office of Clinical Research, Iowa City, Iowa, USA.
authors.forename: S R
authors.initials: SR
authors.lastname: Timmons
authors.forename: J D
authors.initials: JD
authors.lastname: Harless
authors.forename: M M
authors.initials: MM
authors.lastname: Hogan
authors.forename: G J
authors.initials: GJ
authors.lastname: Eckert
authors.forename: C L
authors.initials: CL
authors.lastname: Marek
authors.forename: D R
authors.initials: DR
authors.lastname: Drake
authors.forename: J S
authors.initials: JS
authors.lastname: Wefel
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002327:Cariostatic Agents / Q000008:administration & dosage*; D002710:Chlorhexidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018592:Cross-Over Studies; D003731:Dental Caries / Q000188:drug therapy*; D003802:Dentifrices; D004359:Drug Therapy, Combination; D005459:Fluorides / Q000008:administration & dosage*; D005782:Gels; D006801:Humans; D016037:Single-Blind Method
chemical_list: D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D003802:Dentifrices; D005782:Gels; C010882:chlorhexidine gluconate; D005459:Fluorides; D002710:Chlorhexidine