title: Antibacterial action of Chlorhexidine/thymol containing varnishes in vitro and in vivo.
abstract: OBJECTIVE
  The antibacterial activity of two different formulations of a chlorhexidine/thymol varnish should be elucidated in vitro and in vivo.
  
  
  METHODS
  The agar diffusion assay with Cervitec(®) and CervitecPlus(®) and three reference strains each of streptococci, lactobacilli, actinomyces and periodontal pathogens was performed. In a split-mouth study, 40 volunteers applied the test (CervitecPlus(®), solvent water and ethanol) and control (Cervitec(®), solvent ethyl acetate) varnish at buccal recessions of premolar teeth at baseline as well as after two, four and seven days. Supra- and subgingival plaques were collected 2 weeks before baseline and at the screening appointments. Supragingival plaque was analysed for mutans streptococci and lactobacilli and subgingival samples for Aggregatibacter actinomycetemcomitans, Fusobacterium nucleatum, Porphyromonas gingivalis and Porphyromonas intermedia. Friedman/Wilcoxon tests and U-test were used for statistical analysis (P < 0.05).
  
  
  RESULTS
  Most reference strains were susceptible with inhibition zones (mm) as follows: Cervitec(®)/CervitecPlus(®) streptococci 27 ± 1.7/21.3 ± 2.5, lactobacilli 26 ± 9.2/23.7 ± 4.9, actinomyces 36.3 ± 6.6/27.3 ± 1.5, periodontal pathogens 18.7 ± 7.6/18 ± 1.7. Both varnishes reduced significantly the counts of mutans streptococci and lactobacilli in the patients. However, no significant differences were found between test and control sides at any time. The total counts of periodontal pathogens were low. A tendency to higher counts of A. actinomycetemcomitans at the control side could be shown; the test side did not harbour significantly higher counts.
  
  
  CONCLUSIONS
  Both varnishes may influence the plaque formation and reduce mutans streptococci in supragingival plaque.
authors.affiliation: Centre for Periodontology, Department of Cariology, Endodontology and Periodontology, University Hospital of Leipzig, Leipzig, Germany.
authors.forename: H F R
authors.initials: HF
authors.lastname: Jentsch
authors.forename: F-R
authors.initials: FR
authors.lastname: Eckert
authors.forename: K
authors.initials: K
authors.lastname: Eschrich
authors.forename: S-I
authors.initials: SI
authors.lastname: Stratul
authors.forename: S
authors.initials: S
authors.lastname: Kneist
mesh_terms: D000190:Actinomyces / Q000187:drug effects; D000328:Adult; D016976:Aggregatibacter actinomycetemcomitans / Q000187:drug effects; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D001419:Bacteria / Q000187:drug effects*; D058491:Bacterial Load / Q000187:drug effects; D001641:Bicuspid / Q000382:microbiology; D018441:Biofilms / Q000187:drug effects; D002626:Chemistry, Pharmaceutical; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use*; D003773:Dental Plaque / Q000382:microbiology* / Q000517:prevention & control; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D016967:Fusobacterium nucleatum / Q000187:drug effects; D006801:Humans; D007778:Lactobacillus / Q000187:drug effects; D007780:Lacticaseibacillus casei / Q000187:drug effects; D048191:Lactiplantibacillus plantarum / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D016966:Porphyromonas gingivalis / Q000187:drug effects; D013295:Streptococcus mutans / Q000187:drug effects; D013298:Streptococcus sanguis / Q000187:drug effects; D016986:Streptococcus sobrinus / Q000187:drug effects; D013943:Thymol / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000891:Anti-Infective Agents, Local; D004338:Drug Combinations; C079161:chlorhexidine, thymol drug combination; D013943:Thymol; D002710:Chlorhexidine
keywords: antibacterial activity; chlorhexidine; dental plaque; in vitro; split-mouth study