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1
Purdy, K. R. "Aspects of chlorhexidine degradation." Thesis, University of Bath, 1987. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.376334.
Texte intégralRésumé :
This thesis examines the factors affecting the stability of chlorhexidine salts (principally gluconate) in dilute aqueous solution (0.001 to O.05%w/v). Such studies are pertinent to the use of chlorhexidine as a preservative in aqueous pharmaceutical products. The introduction details the factors affecting the stability of pharmaceuticals in solution. Published work on the physico-chemical properties of chlorhexidine and structurally related compounds is then reviewed together with methods available for the quantitative analysis of chlorhexidine. The experimental section describes the evaluation of a HPLC stability indicating method for the quantitative determination of chlorhexidine in terms of sensitivity, precision, reproducibility and selectivity. Comparison is made between this method and the more conventional colorimetric methods based on the Holbrook technique and 4-chloroaniline determination. The degradation kinetics of dilute aqueous solutions of chlorhexidine gluconate have been examined by a pH-stat.ting technique. Over the range pH 2 to 10, 0.002% w/v chlorhexidine gluconate fohowed a pH of maximum stability around pH 5 (at 90°C) with regions uf specific acid/base catalysis presen~. Modifications attributable to a water catalysed reaction (pH 3.5 to 6.5) and presence of unionised chlorhexidine base (pH> 8.5) were also apparent. Concentration dependency was noted at both alkaline and neutral pH. Linear Arrhenius relationships were observed producing -1 apparent activation energies varying from 69.5 to 96.1 kJ.mol •Degradation rate dependence upon ionic strength was consistent with a negative salt effect in alkaline solution. Variable effects on rate were observed in the presence of buffers and with different types of surfactant. Limited studies indicated chlorhexidine solutions are photochemically stable at netural pH but are not amenable to y-irradiation sterilisation. Quantitative analysis of 4-chloroaniline has shown that this compound is not, as previous literature might suggest, the major degradation product of chlorhexidine. HPLC analysis indicates that up to six degradation products may occur. In the discussion an interpretation of kinetic data is presented. Qualitative information from chromatographic studies is used to support a proposed degradation pathway for chlorhexidine. Finally the kinetic data has been used to assess the stability of chlorhexidine to heat sterilisation processes and on long term storage.
2
Cavier, Isabelle. "La chlorhexidine : métabolisme et toxicologie expérimentale." Paris 5, 1992. http://www.theses.fr/1992PA05P081.
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3
Knöpfli, Roland Urs. "Quality-specific taste impairment following the application of chlorhexidine digluconate mouthrinses = Qualitätsspezifische Geschmacksveränderungen nach Mundspülungen mit Chlorhexidin-Digluconat /." [S.l : s.n.], 1987. http://www.ub.unibe.ch/content/bibliotheken_sammlungen/sondersammlungen/dissen_bestellformular/index_ger.html.
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4
Wood, Natalie Jane. "Chlorhexidine-based antimicrobial coatings for titanium dental implants." Thesis, University of Bristol, 2015. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.683729.
Texte intégralRésumé :
Dental implants are a popular solution to missing teeth; they are predominantly formed from titanium due to its biocompatibility, corrosion resistance and high rate of osseointegration. While micro-roughening of the surfaces has been shown to increase osteoblast adhesion and proliferation, it has also been shown to increase the adhesion of bacteria and therefore the likelihood of implant infection and implant failure. Chlorhexidine is a broad spectrum antimicrobial agent used extensively in healthcare, particularly in oral care products such as mouthwash. It has previously been shown to adhere to titanium, forming a saturated surface layer within 60 s; these surfaces exhibited an antimicrobial efficacy against the oral bacterium Streptococcus gordonii. However, this effect was shown to be short-lived as the coated surfaces released their entire chlorhexidine payload within c.a. 2 days' immersion in water. The development of two surface coatings, based on nanoparticle and coacervate technology, is described in this thesis. The aim was to increase the surface retention of chlorhexidine on a titanium surface to provide antimicrobial functionality. An antimicrobial nanoparticle has been developed by combining chlorhexidine with hexametaphosphate. These particles form micron-sized surface aggregates on titanium substrates upon exposure to the nanoparticle suspension. The nanoparticle-coated titanium substrates elute soluble chlorhexidine for 230 days and exhibit an effective antimicrobial action against the oral primary coloniser S. gordonii and oral pathogen Porphyromonas gingivalis. An antimicrobial coacervate has been created through the combination of chlorhexidine and carboxymethyl dextran. When this suspension was drop-cast onto a titanium surface, a confluent film was formed; these film-coated surfaces exhibited an antimicrobial efficacy against S. gordonii. The film was released from the surface after immersion in water for 1 hour. Finally, by applying both coatings, a dual-action antimicrobial surface has been developed
5
Crosby, C. T. "Chlorhexidine and the prevention of surgical site infection." Thesis, Aston University, 2009. http://publications.aston.ac.uk/21096/.
Texte intégralRésumé :
Surgical site infections (SSI) are a prevalent health care-associated infection (HAl). Prior to the mid-19th century, surgical sites commonly developed postoperative wound complications. It was in the 1860's, after Joseph Lister introduced carbolic acid and the principles of antisepsis that postoperative wound infection significantly decreased. Today, patient preoperative skin preparation with an antiseptic agent prior to surgery is a standard of practice. Povidone-iodine and chlorhexidine gluconate are currently the most commonly used antimicrobial agents used to prep the patient's skin. In this current study, the epidemiology, diagnosis, surveillance and prevention of SSI with chlorhexidine were investigated. The antimicrobial activity of chlorhexidine was assessed. In in-vitro and in-vivo studies the antimicrobial efficacy of 2% (w/v) chlorhexidine gluconate (CHG) in 70% isopropyl alcohol (IPA) and 10% povidoneiodine (PVP-I) in the presence of 0.9% normal saline or blood were examined. The 2% CHG in 70% IPA solutions antimicrobial activity was not diminished in the presence of 0.9% normal saline or blood. In comparison, the traditional patient preoperative skin preparation, 10% PVP-I antimicrobial activity was not diminished in the presence of 0.9% normal saline, but was diminished in the presence of blood. In an in-vivo human volunteer study the potential for reduction of the antimicrobial efficacy of aqueous patient preoperative skin preparations compromised by mechanical removal of wet product from the application site (blot) was assessed. In this evaluation, 2% CHG and 10% povidone-iodine (PVP-I) were blotted from the patient's skin after application to the test site. The blotting, or mechanical removal, of the wet antiseptic from the application site did not produce a significant difference in product efficacy. In a clinical trial to compare 2% CHG in 70% IPA and PVP-! scrub and paint patient preoperative skin preparation for the prevention of SSI, there were 849 patients randomly assigned to the study groups (409 in the chlorhexidine-alcohol and 440 in the povidone-iodine group) in the intention-to-treat analysis. The overall surgical site infection was significantly lower in the 2% CHG in 70% IPA group than in the PVP-I group (9.5% versus 16.1 %, p=0.004; relative risk, 0.59 with 95% confidence interval of 0.41 to 0.85). Preoperative cleansing of the patient's skin with chlorhexidine-alcohol is superior to povidone-iodine in preventing surgical site infection after clean-contaminated surgery.
6
Reda, Bashar [Verfasser]. "Chlorhexidine retention in the oral cavity and the effects of chlorhexidine and octenidine mouth rinsing on the dental biofilm / Bashar Reda." Saarbrücken : Saarländische Universitäts- und Landesbibliothek, 2020. http://d-nb.info/1232240079/34.
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7
Kamarudin, Yasmin. "In vitro study of chlorhexidine hexametaphosphate nanoparticles to produce a sustained chlorhexidine release environment to reduce white spot lesions in orthodontic patients." Thesis, University of Bristol, 2017. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.738317.
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8
Karpanen, Tarja. "Studies on skin antisepsis and enhanced penetration of chlorhexidine." Thesis, Aston University, 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.493879.
Texte intégralRésumé :
Effective skin antisepsis prior to incision of the skin, for example, during surgery, is essential in preventing subsequent infection. However, infections associated with invasive procedures remain a significant cause of morbidity and mortality and impose additional costs upon the Health Service. Current evidence-based guidelines recommend that 2% (w/v) chlorhexidme digluconate (CHG), preferably in 70% (v/v) isopropyl alcohol (IPA), is used for skin antisepsis prior to incision of the skin. However, many antiseptics poorly permeate the skin and microorganisms residing in the deeper layers and around hair follicles, may survive the procedure and cause infection.
9
Kärpänen, Tarja J. "Studies of skin antisepsis and enhanced penetration of chlorhexidine." Thesis, Aston University, 2008. http://publications.aston.ac.uk/15332/.
Texte intégralRésumé :
Current evidence-based guidelines recommend that 2% (w/v) chlorhexidine digluconate (CHG), preferentially in 70% (v/v) isopropyl alcohol (IIPA), is used for skin antisepsis prior to incision of the skin. In this current study, the antimicrobial efficacy of CHG, six essential oils [tea tree oil (TTO), thymol, eucalyptus oil (EO), juniper oil, lavender oil and citronella] and novel benzylidenecarboxamidrazone and thiosemicarbazone compounds were determined against a panel of microorganisms commonly associated with skin infection (Staphylococcus epidermidis, S. aureus, meticillin-resistant S. aureus, Propionibacterium acnes, Acinetobacter spp., Pseudomonas aeruginosa and Candida albicans) The results demonstrated synergistic activity of CHG in combination with EO against biofilm cultures of S. epidermidis, with significantly reduced concentrations of CHG and EO required to inhibit biofilm growth compared to CHG or EO alone. Skin permeation of CHG was subsequently investigated using an in vitro human skin model (Franz cell) and the penetration profile was determined by serial sectioning of the full thickness human skin. Two percent (w/v) CHG in aqueous solution and in 70% (v/v) IPA demonstrated poor skin permeation; however, the skin permeation was significantly enhanced in combination with 5% - 50% (v/v) EO. Detectable levels of CHG did not permeate through full thickness skin in 24 h. Skin permeation of 2% (w/v) CHG in 70% (v/v) IPA in the presence of 10% (v/v) EO was subsequently studied. The results demonstrated a significantly enhanced skin penetration of CHG after a 2 min application, with CHG detected at significant levels to a depth of 600 m with CHG in combination with EO and IPA compared to 100 m with IPA alone. Combination antisepsis comprising CHG and EO may be beneficial for skin antisepsis prior to invasive procedures to reduce the number of microorganisms on and within the skin due to enhanced skin penetration of CHG and improved efficacy against S. epidermidis in a biofilm mode of growth.
10
Duquette, Janine Lee-Anne. "Preoperative Chlorhexidine Skin Preparation for Patients Undergoing Vascular Surgery." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4136.
Texte intégralRésumé :
In response to improving quality patient care, combined with the growing rates of surgical site infections (SSIs) in vascular patients, the need to explore current practice trends with current evidence has been identified. SSIs affect quality patient care and compromise patient safety. Empirical evidence has recommended the use of a chlorhexidine wash preoperatively to reduce SSIs. Despite this recommended practice, vascular patients were not receiving it in their routine plan of care within a hospital organization in southern Ontario. Guided by Lewin's theory of planned change, this project explored how the planning of a chlorhexidine preoperative surgical skin preparation protocol impacted progress toward improved care of vascular patients. The project was designed as a quality improvement project examining approximately 110 vascular surgical procedures over a 1-month period and staff surveys that were provided to staff in the preoperative (n = 88), same day surgery (n = 68), and inpatient (n = 47) units. These data were analyzed and demonstrated a reduction in vascular SSIs from 4.9% pre-implementation to 2.8% 1-month post-implementation. Major themes generated from the staff surveys demonstrated the nursing staff had a good understanding of the content that was presented in the in-service provided. These findings have implications for social change by highlighting the benefits of incorporating evidence in to practice and further informing the preoperative practice in other surgical specialties.
11
Trébaol, Annai͏̈ck. "Etude préléminaire "in vitro" de l'activité antiseptique de la chlorhéxidine sous forme liposomale en vue d'une utilisation en odonto-stomatologie." Paris 5, 1993. http://www.theses.fr/1993PA05P267.
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12
Li, Wen, and 李雯. "The effect of chlorhexidine (CHX) with or without an anti-discoloration system (ADS) on the development of experimentalgingivitis in man." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2012. http://hub.hku.hk/bib/B48395183.
Texte intégralRésumé :
Background: Chlorhexidine (CHX) is the most effective antiseptic mouthwash known and yet, side effects such as tooth discolorations and bitter taste exist. A new product of CHX with an anti-discoloration system (ADS) was supposed to minimize these side effects while maintaining the antiseptic effects. The aim of this clinical trial was to evaluate the effectiveness of the CHX with and without an ADS on stains, plaque accumulation and gingivitis development.
Material and Methods This double blinded RCCT included 26 healthy dental students. After a preparatory period (3 weeks) of professional prophylaxis and optimal tooth brushing, the participants were randomly assigned to one of three groups: Group P (Placebo), Group T1 (0.12% CHX without ADS) and Group T2 (0.12% CHX with ADS). During 3 weeks of abolished oral hygiene, the participants were asked to rinse with a mouthwash twice daily. Allocation was concealed until after the baseline examination. The clinical parameters were assessed on Days 0, 7, 14 and 21 and included the Discoloration Index (DI), the Plaque Index (PII) and Gingival Index (GI).
Results All 26 participants completed the study with good compliance. At baseline, there were no significant differences for any parameters between any of the groups. Throughout the study, there were no significant differences in mean DI, PII or GI between group T2 and group P. However, significant differences in mean DI between group T2 and group T1 on Day 14 (0.19±0.15 vs. 0.87±0.56, p=0.007) and on Day 21 (0.21±0.17 vs. 1.13±0.59, p=0.001) were noted. Also, the mean PII between group T2 and group T1 on Day 7 (0.89±0.40 vs. 0.13±0.09, p<0.001), Day 14 (1.32±0.46 vs. 0.25±0.12, p<0.001) and on Day 21 (1.45±0.39 vs. 0.25±0.19, p<0.001) differed significantly. Likewise, significant differences were found in mean GI between group T2 and group T1 on Day 14 (0.71±0.39 vs. 0.14±0.10, p=0.002) and on Day 21 (1.12±0.41 vs. 0.18±0.19, p<0.001).
Conclusions CHX with ADS appeared to be effective in preventing stain on teeth. However, the efficacy of preventing plaque accumulation and gingivitis development was greatly hampered by the addition of ADS. In fact, CHX mouthwash with ADS showed no superior effect over placebo on maintenance of oral hygiene or prevention of gingivitis.<br>published_or_final_version<br>Dental Surgery<br>Master<br>Master of Dental Surgery
13
Wang, Ching Shan Teixeira Fabricio B. "Clinical efficiency of 2% chlorhexidine gel in reducing intracanal bacteria." Chapel Hill, N.C. : University of North Carolina at Chapel Hill, 2007. http://dc.lib.unc.edu/u?/etd,947.
Texte intégralRésumé :
Thesis (M.S.)--University of North Carolina at Chapel Hill, 2007.<br>Title from electronic title page (viewed Dec. 18, 2007). "... in partial fulfillment of the requirements for the degree of Master of Science in the School of Dentistry (Endodontics)." Discipline: Endodontics; Department/School: Dentistry.
14
Ismaeel, N. A.-A. "Resistance of Providencia stuartii to chlorhexidine and other antibacterial agents." Thesis, Cardiff University, 1987. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.376556.
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15
McElhatton, A. "Development and evaluation of novel chlorhexidine formulations for oral healthcare." Thesis, Queen's University Belfast, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.246430.
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16
Ghods, Manijeh. "Sensitivity of staphylococcus epidermidis to chlorhexidine and associated resistance properties." Thesis, Aston University, 2003. http://publications.aston.ac.uk/12347/.
Texte intégralRésumé :
Staphylococcus epidermidis are common Gram-positive bacteria and are responsible for a number of life-threatening nosocomial infections. Treatment of S. epidermidis infection is problematic because the organism is usually resistant to many antibiotics. The high degree of resistance of this organism to a range of antibiotics and disinfectants is widely known. The aims of this thesis were to investigate and evaluate the susceptibility of isolates of S. epidermidis from various infections to chlorhexidine (CHX) and to other disinfectants such as benzalkonium chloride (BKC), triclosan (TLN) and povidone-iodine (PI). In addition, the mechanisms of resistance of S. epidermidis to chlorhexidine (the original isolates and strains adapted to chlorhexidine by serial passage) were examined and co-resistance to clinically relevant antibiotics investigated. In 3 of the 11 S. epidermidis strains passaged in increasing concentrations of chlorhexidine, resistance to the disinfectant arose (16-fold). These strains were examined further, each showing stable chlorhexidine resistance. Co-resistance to other disinfectants such as BKC, TLN and PI and changes in cell surface hydrophobicity were observed. Increases in resistance were accompanied by an increase in the proportion of neutral lipids and phospholipids in the cell membrane. This increase was most marked in diphosphatidylglycerol. These observations suggest that some strains of S. epidermidis can become resistant to chlorhexidine and related disinfectants/antiseptics by continual exposure. The mechanisms of resistance appear to be related to changes in membrane lipid compositions.
17
Taylor, Barbara Anne. "The effect of subgingival irrigation with chlorhexidine in the treatment of adult periodontitis." Thesis, The University of Sydney, 1989. http://hdl.handle.net/2123/4791.
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18
Yan, Jing. "In-vitro evaluation of a lyophilised nasal dosage system containing chlorhexidine." Thesis, University of Strathclyde, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.502306.
Texte intégralRésumé :
The aim of this research project was to examine the in-vitro properties of a nasal insert formed from a lyophilised viscous hydroxyproylmethylcellulose (HPMC) gel solution designed to deliver chlorhexidine intranasally to prevent MRSA colonisation. In-vitro drug release tests indicated that the chlorhexidine release rate is influenced by the molecular weight and concentration of HPMC and the presence of mannitol. Increasing the HPMC molecular weight and concentration made it more difficult for the drug to release from the matrix and reduced the release rate; as there could be more HPMC molecules in unit volume which means more polymer matrix. Adding mannitol resulted in faster release of chlorhexidine, as mannitol dissolves in water and creates niore pathways for the drug to diffuse through. In-vitro dynamic adhesion tests were carried out on an agar/mucin plate which was designed to mimic the movement of the formulation over the nasal mucosa. Results indicated that increasing the HPMC molecular weight and concentration increased adhesion to this synthetic mucosal surface.
19
Patel, H. K. "The micellar properties of mixtures of alkyltrimethylammonium bromides and chlorhexidine digluconate." Thesis, University of Manchester, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.233332.
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20
Francisconi, dos Rios Luciana Fávaro, Marcela Pagani Calabria, Leslie Casas-Apayco, Heitor Marques Honório, Marcela Rocha De Oliveira Carrilho, José Carlos Pereira, and Linda Wang. "Chlorhexidine does not improve but preserves bond strength to eroded dentin." American Journal of Dentistry, 2015. http://hdl.handle.net/10757/607304.
Texte intégralRésumé :
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.<br>PURPOSE: To evaluate the effect of aqueous solutions of chlorhexidine digluconate (CHX) in different concentrations on bond strength to eroded dentin up to 6 months, using normal dentin as a control. METHODS: Exposed flat dentin of extracted third molars was only ground with 600-grit SiC paper/1 minute (normal dentin - N), or subsequently eroded by a regular-cola soft-drink (eroded dentin - E). N and E were acid-etched, washed, dried and rehydrated with 1.5 μL, respectively, of distillated water (control - NC / EC); of 0.004% CHX (N0.004% / E0.004%); or of 2% CHX (N2% / E2%). Adper Single Bond 2 was applied in all specimens and resin composite buildups were constructed with Filtek Z350. Specimens were sectioned in beams, which were tested (μTBS) immediately or after 6 months of aging. RESULTS: Microtensile bond strength to eroded dentin was always significantly lower than that to normal dentin. Application of tested CHX solutions did not exert a significant effect immediately; however, after aging, the 2% CHX prevented abrupt bond strength loss both to eroded and normal dentin.<br>Revisión por pares
21
Snyders, Olivia Gayle. "Chlorhexidine in the prevention of ventilator associated pneumonia : a systematic review." Thesis, Stellenbosch : Stellenbosch University, 2011. http://hdl.handle.net/10019.1/17943.
Texte intégralRésumé :
Thesis (MCur)--Stellenbosch University, 2011.<br>ENGLISH ABSTRACT: Ventilator-Associated Pneumonia (VAP) is a hospital acquired infection, not present or
incubating at the time of admission and developing in patients during the process of care within
the hospital setting. Between nine and twenty-seven percent of patients who are mechanically
ventilated will develop ventilator-associated pneumonia. Mortality rates for ventilated patients
who develop ventilator-associated pneumonia are estimated to be between 33-50%. The Institute
for Healthcare Improvements (IHI) in 2006 recommended the use of ‘care bundles’ to reduce
VAP but no statistically significant decline has been noted.
Despite the completion of an extensive literature search for purposes of this review, no statistical
data on nosocomial infections or nosocomial pneumonia relevant to South Africa was found.
Mechanical ventilation, a support therapy used in approximately one third of patients,
significantly increases the patient’s risk of developing this nosocomial pneumonia. Critically ill
patients are by virtue of their critical illness more prone to the development of infections,
especially ventilator-associated pneumonia. Consistent evidence suggests that oropharyngeal
colonization can be associated with the development of VAP. Studies focusing on standard oral
care, with or without the concurrent use of chlorhexidine, have not provided sufficient evidence
for the use of chlorhexidine in VAP prevention. Chlorhexidine is an antiseptic agent, which
when tested, proved to reduce total respiratory tract infections by up to 69% (DeRiso et al,
1996:1558).
Objective: The aim of this study was to systematically appraise and review evidence on the
effectiveness of chlorhexidine in reducing the incidence of ventilator-associated pneumonia in
adult patients. The secondary aim was to systematically summarize evidence on the use of
chlorhexidine in reducing mortality.
Methodology: An extensive literature search of studies published in English was undertaken.
Electronic databases searched were CENTRAL, CINAHL, EMBASE and MEDLINE. Reference
lists of articles, textbooks and conference summaries were examined. Literature searches were conducted using Medical Subject Headings (MeSH). These included: Ventilator-associated
pneumonia, chlorhexidine, VAP and oral care. Eight randomized controlled trials, investigating
the efficacy of Chlorhexidine in ventilator-associated pneumonia prevention in adults met the
inclusion criteria. The effect measure of choice was Risk ratio with 95% confidence intervals for
dichotomous data using the random effects (Mantel-Haenszel) model; (p=value of 0.05).
Heterogeneity was assessed using the Cochrane Q statistic and I².
Results: Eight randomized controlled trials met the inclusion criteria for this review. Pooled risk
ratio for the incidence of ventilator-associated pneumonia was 0.64 (95% CI; 0.44-0.91; p
=0.18). Treatment with chlorhexidine decreased the risk of ventilator-associated pneumonia by
36%. There was no evidence of Chlorhexidine reducing mortality.
Conclusions: Chlorhexidine is a cost effective safe treatment in the prevention of VAP. The use
of 2% chlorhexidine may be more effective in reducing the incidence of VAP. No studies were
found conducted in developing countries. More rigorously designed trials using 2%
chlorhexidine are recommended.<br>AFRIKAANSE OPSOMMING: Agtergrond
Ventilator-Geassosieerde Longontsteking (VAP) is 'n hospitaal verkry infeksie, nie teenwoordig
met toelating nie. Ventilator-geassosieerde longontsteking word ontwikkel in pasiënte tydens die
proses van sorg in die hospitaal. Tussen nege en sewe en twintig persent van pasiënte wat
meganies geventileer word kry ventilator-geassosieerde pneumonie. Sterftesyfers vir
geventileerde pasiënte wat ventilator-geassosieerde pneumonie ontwikkel is na raming tussen 33-
50%. Die Institute for Healthcare Improvements (IHI) het in 2006 die gebruik van 'sorg bundels'
aanbeveel om VAP te verminder, maar geen statisties beduidende daling is aangeteken nie.
Ten spyte van 'n uitgebreide literatuur soek, is geen statistiese data op nosokomiale infeksies of
nosokomiale longontsteking toepaslik tot Suid-Afrika gevind nie. Meganiese ventilasie, 'n
ondersteuningsterapie wat gebruik word in ongeveer een derde van die pasiënte, verhoog
aansienlik die pasiënt se risiko vir die ontwikkeling van hierdie nosokomiale longontsteking.
Kritiek siek pasiënte is op gronde van hul kritieke toestand meer geneig tot die ontwikkeling van
infeksies, veral ventilator-geassosieerde pneumonie. Konsekwente bewyse dui daarop dat
orofaringeale kolonisasie kan met die ontwikkeling van VAP geassosieer word. Studies wat
fokus op standaard mond sorg, met of sonder die gelyktydige gebruik van chlorhexidine, het nie
voldoende bewyse vir die gebruik van chlorhexidine in VAP voorkoming nie. Chlorhexidine is 'n
antiseptiese agent, wat wanneer in een verewekansigde gekontroleerde studies (VGS) getoets
was die totale respiratoriese kanaal infeksies verminder deur tot 69%.
Doel: Die doel van hierdie sistematiese literatuuroorsig was om stelselmatig te evalueer en
bewyse oor die effektiwiteit van chlorhexidine in die vermindering en voorkoms van ventilatorgeassosieerde
pneumonie in volwasse pasiënte te hersien. Die sekondêre doel was om
stelselmatig bewyse op te som op die gebruik van chlorhexidine in die vermindering van sterfte.
Metodiek: 'n Uitgebreide literatuursoektog van studies wat in Engels gepubliseer is was
onderneem. CENTRAL, CINAHL, EMBASE en MEDLINE was deursoek. Naslaanlyste van
artikels, handboeke en konferensie opsommings is ondersoek. Die literatuur soektog is uitgevoer
met behulp van Medical Subject Headings (MeSH). Dit sluit in: ventilator-geassosieerde pneumonie, chlorhexidine, VAP en mond sorg. Agt verewekansigde gekontroleerde studies
(VGS), wat die doeltreffendheid van Chlorhexidine in ventilator-geassosieerde pneumonie
voorkoming in volwassenes ondersoek, was ingesluit vir hierdie studie. Die effek mate van keuse
was risiko ratio (RR) met 95% vertrouensintervalle met behulp van die ewekansige effekte
(Mantel-Haenszel) model; (p = 0.05). Heterogeniteit is bepaal deur gebruik te maak van die
Cochrane Q- statistiek en I².
Hoof resultate: Agt verewekansigde gekontroleerde studies (VGS) het die insluiting kriteria vir
hierdie oorsig gepas. Gepoelde risiko ratio vir die voorkoms van ventilator-geassosieerde
pneumonie: Risiko Ratio (RR) was 0.64 (95% CI; 0.44-0.91; p=0.18).
Gevolgtrekkings: Behandeling met chlorhexidine het die risiko van ventilator-geassosieerde
pneumonie met 36% gedaal. Daar was geen bewyse van Chlorhexidine op die vermindering van
mortaliteit nie. Chlorhexidine is 'n koste-effektiewe veilige behandeling in die voorkoming van
VAP. Die gebruik van 2% chlorhexidine kan moontlik meer effektief wees in die vermindering
van die voorkoms van VAP. Meer streng ontwerp studies met 2% chlorhexidine word aanbeveel.
22
Macdonald, Emma Louise. "Laboratory studies into the development and control of extrinsic chlorhexidine stain." Thesis, University of Bristol, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.685431.
Texte intégralRésumé :
Extrinsic staining of teeth is a common aesthetic problem for which toothpaste manufacturers strive to produce effective products to chemically and/or physically control the problem. Clinical studies proving efficacy are rare and reliance on tests in vitro are more common. The aim of these studies was to develop two in vitro models which could be used to screen and compare agents and formulations for dietary stain control. The first model utilised immobilised hydroxyapatite (RA) with tea as the chromogen. Using residual tea optical density to assess extrinsic staining proved unreliable. Tea extraction and direct measurement from wells however was shown to be reliable in demonstrating the efficacy of known active chemical agents and differentiating between toothpastes. The second model used roughened Perspex to simultaneously assess toothpastes and their ingredients for chemical and or mechanical stain removal. In line with the RA model, results differentiated between toothpastes and other agents for chemical stain removal. Chemical/mechanical stain removal in the model also showed differences for toothpastes, abrasives and detergents but abrasivity levels did not show the expected linear correlation: the toothbrush itself appeared to be the dominant factor in the model. The final experiment attempted to determine whether chromogen/pellicle interaction was specific or non-specific. Results showed no evidence of specificity indeed data suggested that chromogens may merely be absorbed into the pellicle and held physically rather than by chemical interactions. Since some of the data from both models was consistent with other published laboratory and clinical studies it is cautiously concluded that the models may prove rapid, simple and useful screening methods for anti-staining agents and products. Only the availability of more clinical data to support claims for numerous products, however, will allow the models to be retrospectively validated.
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Grady, Helena Joy. "Development and characterisation of chlorhexidine-hexametaphosphate nanoparticles for antimicrobial central venous catheters." Thesis, University of Bristol, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.715825.
Texte intégral
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Francisconi, dos Rios Luciana Fávaro, Leslie Casas-Apayco, Marcela Pagani Calabria, Paulo Afonso Silveria Francisconi, Ana Flávia Sanches Borges, and Linda Wang. "Role of chlorhexidine in bond strength to artificially eroded dentin over time." Quintessence Publishing Group, 2015. http://hdl.handle.net/10757/607257.
Texte intégralRésumé :
El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.<br>PURPOSE: To assess the long-term effect of a 2% aqueous chlorhexidine (CHX) solution on bond strength to artificially eroded dentin compared to sound dentin. MATERIALS AND METHODS: Flat mid-coronal dentin surfaces of extracted third molars (n = 28) were subjected only to grinding with a 600-grit SiC paper for 1 min (sound dentin S, n = 14) or additionally to erosive pH cycling with a cola-based soft-drink (eroded dentin E, n = 14). After acid etching, rinsing, and air drying, S and E were rehydrated with 1.5 μl of 2% CHX (S2%, n = 7; E2%, n = 7) or of distilled water (control SC, n = 7; EC, n = 7). Composite buildups were incrementally constructed with Filtek Z350 following Adper Single Bond 2 application. Specimens were sectioned into beams, which were subjected to microtensile testing immediately or after 6 or 12 months of aging. Fractured surfaces were observed under a digital microscope (50X magnification). Microtensile bond strength (μTBS) (MPa) was analyzed by three-way ANOVA and Tukey's tests (α = 0.05) and failure mode by the Kruskal-Wallis test (α = 0.05). RESULTS: Compared to sound dentin, eroded dentin was consistently related to lower μTBS. Immediately and after 12-month aging, the effect of CHX was insignificant, but it was significant after 6-month aging, when it conserved the bond strength to both eroded and sound dentin. The percentage of adhesive and mixed failures were equivalent, and significantly more frequent than cohesive failures, whether in dentin or in composite. CONCLUSION: The 2% CHX effect on bond strength conservation to both eroded and sound dentin was not found to be persistent.<br>Revisión por pares
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Abdalrahman, Basheer Mohamed. "The antimicrobial efficacy of three chlorhexidine mouth rinses: an in-vitro analysis." Thesis, University of the Western Cape, 2014. http://hdl.handle.net/11394/3843.
Texte intégralRésumé :
>Magister Scientiae - MSc<br>Different chlorhexidine (CHX) preparations and formulations are available in local markets. Some preparations contain anti-discoloration systems (ADS), additional antimicrobials like cetylpyridinium chloride (CPC), or alcohol. The aim of this study was to compare the antimicrobial efficacies of 3 different CHX preparations (Corsodyl®, Curasept® and GUM®
Paroex®)
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Ahmed, Sara Ali Mohamed. "The effect of percentage combination of probiotics and chlorhexidine on C. albicans." University of the Western Cape, 2019. http://hdl.handle.net/11394/7220.
Texte intégralRésumé :
Magister Scientiae Dentium - MSc(Dent)<br>Background:
Candida is a normal commensal of the oral cavity; these microorganisms can be isolated in 20% to 80% of healthy individuals. Oral candidiasis (OC) is the most common fungal infection related to the oral cavity caused by the most common opportunistic fungus (C. albicans). The management of oral candidiasis involves removal or reduction of predisposing factors together with the administration of an antimitotic agent either in topical or systemic form with or without chlorhexidine (CHX). The increasing number of people who are immunosuppressed and the development of antimicrobial resistance, has necessitated there is a need to explore others treatment to fight this infectious disease. This led to the exploration and use of beneficial microorganisms (probiotics) as an alternative prophylactic & therapeutic mode of treatment against Candida infections.
Aim:
To evaluate the effect of percentage combination of chlorhexidine (CHX) and probiotics on (PB) C. albicans growth.
Method:
The study was conducted in the Department of Oral Medicine and Periodontology and the Oral and Dental Research Laboratory (ODRL) at the Faculty of Dentistry, University of the Western Cape, Tygerberg campus. This in-vitro laboratory study was based on the established principle of spread plate technique followed by colony counting on selective media and non-selective media. Chlorhexidine (CHX) and probiotics (PB) were combined at different concentrations (XCHXyPB) (percentage combination), the added sum of which equals to 100 % (the percentage is achieved by multiplication of volumes (V*V)), to evaluate their effect on C. albicans. The treatments were incubated at 37°C for 30 minutes and 24 hours. Serial dilution was carried out on a micro-titer plate based on McFarland standards. A fixed volume (100 μL)
of the solution was transferred into plates (selective and non-selective media). Deionized water served as a control (negative).
Results:
100 μL CHX with 0 μL PB (100 CHX 0 PB) had a mean value of (0) at both 30 minutes and 24 hours. While 25 μL CHX with 75 μL PB (25 CHX 75 PB) the mean value (9.4) at 30 minutes and (9.5) at 24 hours. 0 μL CHX with 100 μL PB (0 CHX 100 PB) the mean value was (9.6) at 30 minutes while at 24 hours the mean value was (9.9). The control (0 CHX 0 PB) showed at 30 minutes and at 24 hours slightly similar reading (mean) as for the 0 μL CHX with 100 μL PB (0 CHX 100 PB). The largest difference was between the control (0 μL CHX with 0 μL PB) (0 CHX 0 PB) versus 100 μL of CHX with 0 μL PB (100 CHX 0 PB) (9.692), p <0.001. The smallest difference was between control (0 μL CHX with 0 μL PB) (0 CHX 0 PB) versus 0 μL CHX with 100 μL PB (0 CHX 100 PB).
Conclusion:
Chlorhexidine (CHX) and probiotics (PB) could be used at different combination concentration, provided that the CHX ratio is lower than the PB. Depending on the combination used, the number of colonies were slightly different. CHX (100 CHX) showed the lowest number of colonies (zero), while probiotics (0 CHX 100 PB) showed the highest number of colonies. Combination 25 CHX 75 PB showed reduction in CFU/mL. This means that CHX destroyed the organism which have already been established in literature, in comparison to probiotics which reduces the number of organisms (strain specific effect). These two effects are required when treating Candida infection, the treatment goal when treating Candida infection is to eradicate the organism but not completely, because if we completely eradicate the organism it will cause an unbalance in the normal flora of the oral cavity. Therefore, it is recommended that probiotics be administered to patients after being treated with CHX to avoid an imbalance in the normal flora. . Should these combinations be used simultaneously or subsequently is a question that requires further elucidation by research.
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Hénaff, Charline. "Formulation à l'état amorphe : cas de la chlorhexidine et de la riboflavine." Electronic Thesis or Diss., Université de Lille (2022-....), 2023. https://pepite-depot.univ-lille.fr/ToutIDP/EDSMRE/2023/2023ULILR073.pdf.
Texte intégralRésumé :
La faible solubilité de certains médicaments en milieu aqueux est un obstacle majeur pour le développement de traitements médicamenteux innovants. Ce projet de thèse est dédié à l'optimisation de l'efficacité thérapeutique de deux principes actifs modèles dont les formes cristallines sont très peu solubles : la chlorhexidine (base libre) et la riboflavine (base libre). L'objectif est d'améliorer la solubilité de ces principes actifs en les formulant à l'état amorphe sous formes de dispersions moléculaires dans une matrice de polymère. Cela a nécessité une caractérisation préalable fine des propriétés physiques des principes actifs cristallins stables, de leurs formes polymorphiques métastables, et de leurs formes amorphes obtenues directement à l'état solide par broyage mécanique. De plus, leurs cinétiques de dissolution respectives ont été déterminées. Par ailleurs, la possibilité de réaliser des dispersions moléculaires avec chaque principe actif dans des matrices polymères (PVPK12 et Lycoat RS720) à l'état solide par broyage mécanique a été démontrée et leurs cinétiques de libération respectives ont été déterminées. Ces cinétiques ont été comparées à celles d'un mélange physique dans le lequel le principe actif est cristallin et à celles d'un mélange physique dans lequel le principe actif est amorphe. De cette manière il a été possible à la fois de déterminer l'influence de l'état physique du principe actif et d'évaluer l'avantage de former une dispersion moléculaire amorphe du principe actif dans la matrice de polymère. Les caractérisations physiques sont effectuées en utilisation les techniques suivantes : ATG, RX, DSC et les performances de dissolution sont évaluées en utilisant différentes techniques expérimentales telles que : la dissolution des poudres, la dissolution intrinsèque et la dissolution de comprimés<br>Poor aqueous drug solubility is a major hurdle for the development of innovative medical treatments. This thesis project is dedicated to optimizing the therapeutic efficacy of two model drugs whose crystalline forms exhibit a very low solubility: chlorhexidine (free base) and riboflavin (free base). The aim is to improve the solubility of these drugs by formulating them in an amorphous state as molecular dispersions in a polymer matrix. To that extend, detailed characterization of the physical properties of the stable crystalline drugs, their metastable polymorphic forms, and their amorphous forms obtained directly in the solid state by mechanical milling were required. Moreover, an evaluation of their respective dissolution kinetics was performed. In addition, the possibility of producing molecular dispersions of each drug in polymeric matrices (PVPK12 and Lycoat RS720) in the solid state by mechanical milling was demonstrated, and their release kinetics determined. These dissolution kinetics were compared with those of a physical mixture in which the drug is crystalline and of a physical mixture in which the drug is amorphous, in order to determine both the influence of the drug's physical state and to assess the advantage of having the amorphous drug molecularly dispersed in the polymer. The physical characterizations are performed using TGA, XRD, DSC and SEM and the dissolution performances are evaluated using different experimental set-ups including: powder dissolution, intrinsic dissolution and tablet dissolution
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Sy, Kadiatou. "Potentiel thérapeutique de médications intracanalaires dans les lésions endo-parodontales." Electronic Thesis or Diss., Université de Lille (2022-....), 2022. http://www.theses.fr/2022ULILS047.
Texte intégralRésumé :
Les lésions endo-parodontales (LEP) sont des situations cliniques complexes où coexistent, au niveau d'une même dent, une pathologie parodontale et une pathologie pulpaire. Leur traitement implique en général une approche combinée endodontique et parodontal et leur pronostic est souvent incertain. Les médications intracanalaires (MIC) à base d'hydroxyde de calcium (Ca[OH]2), pour compléter la désinfection canalaire, auraient un effet positif sur la cicatrisation parodontale dans les LEP mais les mécanismes qui expliquent cet effet sont encore mal compris.La première partie de cette étude expérimentale est consacrée à l'optimisation d'une MIC à base de Ca(OH)2 par addition de différents agents antimicrobiens (cuivre, zinc, argent et chlorhexidine [CHX]) et à la caractérisation détaillée des formulations obtenues. Parmi les molécules testés, seule la chlorhexidine (CHX) (0,5%, 1% et 2%) a significativement amélioré, in vitro, l'activité antimicrobienne de la pâte de Ca(OH)2 sur les microorganismes cibles, sans en altérer les propriétés mécaniques et physico chimiques.La deuxième partie du travail rapporte l'étude ex vivo du potentiel de diffusion de composés actifs contenus dans la MIC à travers la racine dentaire et l'étude in vitro de l'effet d'extraits de MIC sur la viabilité et la réponse de trois populations de cellules parodontales (fibroblastes du ligament alvéolo-dentaire, cémentoblastes et ostéoblastes). Une diffusion d'ions (Ca2+, OH-) et de CHX, plus importante via l'apex, a pu être mise en évidence, avec des profils de libération variables au cours du temps et selon la dose de CHX de départ. In vitro, les extraits de Ca(OH)2 dilués (avec ou sans CHX) semblent bien tolérées par les cellules parodontales et réduire la production de médiateurs inflammatoires sans effet significatif cependant sur le potentiel de minéralisation des cellules<br>Endo-periodontal lesions (EPL) are difficult clinical situations where periodontal and pulpal pathologies occur in the same tooth. Their treatment usually involves a combined endodontic and periodontal approach, and their prognosis is often uncertain. Intracanal calcium hydroxide (Ca[OH]2) medications (ICM), to complete root canal disinfection, have been reported to have a positive effect on periodontal healing in EPL, but the specific mechanisms involved in the process are still unclear.The first part of this experimental study is devoted to the optimization of a Ca(OH)2-based MIC by addition of different antimicrobial agents (copper, zinc, silver and chlorhexidine [CHX]) and to the precise characterization of the resulting formulations. Among the tested molecules, only chlorhexidine (CHX) (0.5%, 1% and 2%) significantly improved, in vitro, the antimicrobial activity of the Ca(OH)2 paste on the target microorganisms, without altering its mechanical and physicochemical properties.The second part of the work reports the ex vivo study of the diffusion potential of active compounds contained in the ICM through the dental root and the in vitro study of the effect of ICM extracts on the viability and response of three populations of periodontal cells (fibroblasts of the periodontal ligament, cementoblasts and osteoblasts). A stronger diffusion of ions (Ca2+, OH-) and CHX via the apex could be demonstrated, with variable release profiles over time and according to the initial CHX dose. In vitro, diluted Ca(OH)2 extracts (with or without CHX) seem to be well tolerated by periodontal cells and to reduce the production of inflammatory mediators without significant effect on the mineralization potential of the cells
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Rodrigues, Ivana Ferreira Gomes. "Avaliação clinica do uso de um dispositivo de liberação lenta de clorexidina (Periochip) na terapia periodontal de suporte." [s.n.], 2005. http://repositorio.unicamp.br/jspui/handle/REPOSIP/289997.
Texte intégralRésumé :
Orientadores: Sergio de Toledo, Antonio Wilson Sallum<br>Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba<br>Made available in DSpace on 2018-08-04T03:45:17Z (GMT). No. of bitstreams: 1
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Previous issue date: 2005<br>Resumo: O objetivo deste estudo foi avaliar clinicamente a utilização de um dispositivo de liberação lenta de clorexidina (PerioChip®) em pacientes engajados na Terapia Periodontal de Suporte (TPS) que ainda apresentavam áreas com sangramento à sondagem e profundidade de sondagem > 5mm e < 8mm em dentes anteriores. Foram utilizados 42 pacientes com boa saúde geral, sendo 21 pacientes no grupo teste (PerioChip®) e 21 no grupo controle (raspagem e alisamento radicular) distribuídos aleatoriamente. Os parâmetros Índice de Placa (IP), Índice Gengival (IG), Sangramento à Sondagem (SS), Profundidade de Sondagem (PS), Recessão Gengival (RG) e Nível de Inserção Clínica (NIC) foram avaliados nos períodos inicial, 6, 12 e 24 semanas. Ao término das 24 semanas, a profundidade de sondagem reduziu 2,64 + 0,02mm no grupo teste e 2,12 + 0,02mm no grupo controle (p > 0,05); o ganho de inserção clínica foi de 2,19 + 0,87mm no grupo teste e 2,07 + 1,53mm no grupo controle (p > 0,05); ambos os tratamentos mostraram diferenças intragrupo estatisticamente significantes. Com as limitações do presente estudo, pode-se concluir que os tratamentos avaliados foram igualmente efetivos em proporcionar ganho de inserção clínica em pacientes na terapia de suporte periodontal. Entretanto, considerando as bolsas periodontais profundas, o dispositivo de liberação lenta de clorexidina foi mais eficiente do que a raspagem e alisamento radicular quanto à redução na profundidade de sondagem<br>Abstract: The aim of this study was to clinically evaluated the use of PerioChip® in sites showing bleeding on probing and pocket depth ranging from 5mm to 8mm (anterior teeth) in maintenance patients. Forty two patients that consented to participate in the study were randomly assigned to two groups test, treated with PerioChip® and control, treated by scaling and root planing. Patients were assessed for plaque index (PI), gingival index (GI), bleeding on probing (BOP), pocket depth (PD), clinical attachment level (CAL) and gingival recession (GR) at baseline, 6, 12 and 24 weeks. After 24 weeks, a reduction of 2,64 + 0,02mm and 2,12 + 0,02mm in PD was observed for the test and control group (p > 0,05), respectively. The observed gain in CAL was 2,19 + 0,87mm and 2,07 + 1,53mm for the test and control group (p > 0,05), respectively. In both treatments, the intragroup comparisons showed statistically significant differences in the parameters evaluated. Within the limits of this study, it can be concluded that both treatments were equally effective in the reestablishment of periodontal health in inflamed sites of maintenance patients. However, considering the deep periodontal pocket, the PerioChip® was more efficient than the scaling and root planing as for the reduction in the probing depth<br>Mestrado<br>Periodontia<br>Mestre em Clínica Odontológica
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Gaumé, Marie Lagarce Frédéric. "Formulation et étude de stabilité d'un collyre à la chlorhexidine pour le traitement de la kératite amibienne." [S.l.] : [s.n.], 2005. http://theses.univ-nantes.fr/thesemed/PHgaume.pdf.
Texte intégral
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Kiklis, Zoe. "Chemical Dental Plaque Control: Chlorhexidine Tooth Staining and Efficacy of Common Whitening Procedures." Scholarship @ Claremont, 2014. http://scholarship.claremont.edu/scripps_theses/336.
Texte intégralRésumé :
Chlorhexidine mouth rinses remove dental plaque from teeth, preventing dental caries, dental decay, and more serious systemic infections. Tooth discoloration due to extrinsic staining is the most prominent side effect of regular chlorhexidine use. Decreasing the concentration of chlorhexidine reduces staining area and severity. Staining can also be prevented and treated by tooth bleaching, a common cosmetic dental procedure that diminishes extrinsic staining by oxidizing chromagens adsorbed onto the tooth surface. In the proposed trial, common bleaching agents will be investigated for their efficacies in preventing chlorhexidine staining. Results of the trial could further the development of a chlorhexidine mouth rinse that is suitable for long term use.
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Mei, Lei, and 梅蕾. "Actions of chlorhexidine and silver diamine fluoride on cariogenic biofilm and root caries." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B44900776.
Texte intégral
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FÃlix, Luan Cartaxo. "Two methods of oral hygiene with chlorhexidine in preventing of ventilator-associated pneumonia." Universidade Federal do CearÃ, 2016. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=16740.
Texte intégralRésumé :
Ventilator-associated pneumonia (VAP) is a lung infection that affects patients under mechanical ventilation (MV). The main pathophysiological mechanism of VAP is the aspiration of bacterial pathogens of the oral cavity and pharynx. The reduction of bacterial colonization in the oral cavity is one of the preventive measures for this infection, therefore, this study aimed to evaluate the efficacy of two techniques of oral hygiene in preventing VAP. A prospective, randomized clinical trial was conducted with patients hospitalized in the ICU of Hospital Geral Dr. Waldemar AlcÃntara (HGWA). The volunteers were divided into two groups: the method performed as hospital routine that used gauze soaked in 0.12% chlorhexidine digluconate every 8 hours (Gauze Group), and another method that was performed with a manual toothbrush imbibed in the same solution every 8 hours (Toothbrush Group). A minimum sample of 23 patients per group was estimated to yield a sample with 90% power and 95% confidence (paired t test). The primary outcome was the occurrence of VAP. This infection was investigated until the end of MV. Secondary outcomes were: [1] assessment of oral health (visible plaque, lingual plate and possible alterations intraoral and perioral normality) and [2] presence / absence of respiratory microorganisms in dental and lingual plate. These secondary outcomes were evaluated in two phases: in the first 24 hours of MV and 72 hours after the first evaluation. The two techniques showed low incidence of ventilator-associated pneumonia (VAP) and there was no statistically significant difference between the two oral hygiene methods in preventing this infection. K. pneumoniae and P. aeruginosa were the bacterial species most often isolated. There was no statistically significant difference between the two oral hygiene methods when comparing the efficacy in reducing the incidence of respiratory microorganisms. In the 2nd assessment, less visible plaque index was observed in the group that used the toothbrush.<br>Pneumonia associada à ventilaÃÃo mecÃnica (PAV) à uma infecÃÃo pulmonar que afeta pacientes submetidos à ventilaÃÃo mecÃnica (VM). O principal mecanismo fisiopatolÃgico da PAV à a aspiraÃÃo de patÃgenos bacterianos da cavidade oral e da faringe. Como a reduÃÃo da colonizaÃÃo bacteriana na cavidade oral à uma das medidas tÃcnicas de higiene oral na prevenÃÃo da PAV, o presente estudo teve como objetivo avaliar a eficÃcia de duas tÃcnicas de higiene oral na prevenÃÃo da PAV. Foi realizado um ensaio clÃnico prospectivo e randomizado, com pacientes internados nas Unidades de Terapia Intensiva do Hospital Geral Dr. Waldemar AlcÃntara. Os voluntÃrios foram alocados em dois grupos: Grupo Gaze (n=28), higiene bucal utilizada como padrÃo no Hospital, sendo esta realizada com gaze embebida em digluconato de clorexidina 0,12%; Grupo Escova (n=30), higiene bucal com escova dental manual embebida na mesma soluÃÃo. Uma amostra mÃnima de 23 pacientes, por grupo, foi estimada para se obter uma amostra com 90% de poder e 95% de confianÃa (teste t pareado). O desfecho primÃrio foi a ocorrÃncia de PAV, sendo esta infecÃÃo investigada atà o tÃrmino da VM. Os desfechos secundÃrios foram: [1] avaliaÃÃo da saÃde bucal (placa visÃvel, placa lingual e eventuais alteraÃÃes da normalidade intraoral e perioral) e [2] presenÃa/ausÃncia de microrganismos respiratÃrios na placa dental e lingual. Estes desfechos secundÃrios foram avaliados em dois momentos: nas primeiras 24 horas de VM e 72 horas apÃs a primeira avaliaÃÃo. As duas tÃcnicas apresentaram baixa incidÃncia de PAV, e nÃo houve diferenÃa estatisticamente significativa entre os dois mÃtodos de higiene oral na prevenÃÃo desta infecÃÃo. K. pneumoniae e P. aeruginosa foram as espÃcies bacterianas mais frequentemente isoladas. NÃo houve diferenÃa estatisticamente significativa entre os dois mÃtodos de higiene oral, quando comparando a eficÃcia na reduÃÃo da incidÃncia de microrganismos respiratÃria. Na 2 avaliaÃÃo, um menor Ãndice de placa visÃvel foi observado no grupo que utilizou a escova dental.
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Hendry, Emma. "Studies on enhanced surface disinfection and skin antisepsis using chlorhexidine and eucalyptus oil." Thesis, Aston University, 2011. http://publications.aston.ac.uk/15813/.
Texte intégralRésumé :
Healthcare associated infections may arise from many sources, including patient?s own skin flora and the clinical environment, and inflict a significant burden within the health service. Adequate and effective skin antisepsis and surface disinfection are therefore essential factors in infection control. Current EPIC guidelines recommend 2 % chlorhexidine (CHG) in 70 % isopropyl alcohol (IPA) for skin antisepsis however poor penetration has been reported. Eucalyptus oil (EO) is a known permeation enhancer, producing synergistic antimicrobial activity when combined with CHG. In this current study, the antimicrobial efficacy of EO and its main constituent 1,8-cineole were assessed against a panel of clinically relevant microorganisms, alone and in combination with CHG. The superior antimicrobial efficacy of EO compared with 1,8-cineole, and synergistic effects with CHG against planktonic and biofilm cultures, confirmed its suitability for use in subsequent studies within this thesis. Impregnation of EO, CHG and IPA onto prototype hard surface disinfectant wipes demonstrated significantly improved efficacy compared with CHG/IPA wipes, with clear reductions in the time required to eliminate biofilms. Optimisation of the EO/CHG/IPA formulation resulted in the development of Euclean® wipes, with simulated-use and time kill studies confirming their ability to remove microbial surface contamination, prevent cross contamination and eliminate biofilms within 10 minutes. The employment of isothermal calorimetry provided additional information on the type and rate of antimicrobial activity possessed by Euclean® wipes. A clinical audit of the Euclean® wipes at Birmingham Children?s Hospital, Birmingham, U.K. revealed divided staff opinion, with the highest cited advantage and disadvantage concerning the odour. Finally, skin penetration and cell toxicity studies of EO/CHG biopatches and Euclean® solution developed during this study, revealed no permeation into human skin following biopatch application, and no significant toxicity. These current studies enhance the knowledge regarding EO and its potential applications.
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Lascol, Manon. "Gélification ionique de la pectine pour l’encapsulation d’antiseptiques buccaux : études physico-chimiques et formulation." Thesis, Lyon, 2016. http://www.theses.fr/2016LYSE1317.
Texte intégralRésumé :
L'objectif de cette thèse a été de développer une forme galénique pour l'administration locale d'antiseptiques dans le traitement de lésions buccales. De par la présence de la salive et des mécanismes de déglutition et de mastication, le temps de séjour des principes actifs dans la cavité buccale est court ce qui conduit à une faible efficacité thérapeutique locale. Ainsi, l'encapsulation de principes actifs dans des microparticules mucoadhésives à base de pectine a été envisagée. Deux antiseptiques couramment utilisés dans le traitement des lésions buccales ont été retenus : la chlorhexidine (CX) et l'hexétidine (HX). Le procédé utilisé pour l'encapsulation de l'HX consiste en la gélification ionique de pectine contenue dans la phase aqueuse d'une émulsion double L/H/L par l'ajout de Ca2+. L'influence des paramètres de procédé et de formulation sur l'efficacité d'encapsulation de l'actif a été étudiée à l'aide d'un plan d'expériences. Dans le cas de la CX, les essais préliminaires ont mis en évidence des interactions entre l'actif et la pectine conduisant à la gélification du polymère sans utilisation d'ions Ca2+. Des études physicochimiques ont donc été réalisées afin d'investiguer ces interactions et de comparer le mécanisme de gélification observé à celui de la gélification ionique de la pectine par les ions Ca2+. Des mécanismes de gélification similaires ont été observés pour ces deux cations divalents avec de plus fortes interactions entre la pectine et la CX. Puis des microparticules de pectine et CX ont été développées par prilling sans ajout d'ions. L'influence de l'ajout de Zn2+ dans la formulation sur les propriétés des microparticules a finalement été étudiée<br>The aim of this project was to develop a dosage form for antiseptics local administration in order to treat buccal injuries. Due to the presence of saliva in association with swallowing and chewing, actives substances have a short retention time in the buccal cavity and thus a low therapeutic efficacy. To resolve this problem, the encapsulation of active agents in pectin mucoadhesive microparticles was studied. For this purpose, two widely used antiseptics have been selected: chlorhexidine and hexetidine. Hexetidine encapsulation was obtained by performing calcium-induced ionic gelation of the pectin aqueous solution involved in a double emulsion L/H/L. The influence of both process and formulation parameters on encapsulation efficiency were studied by using an experimental design. In the case of chlorhexidine, preliminary experiments highlighted interactions between the active substance and pectin leading to polymer gelation without the use of additional Ca2+ dications. Hence, pectin/chlorhexidine interactions were investigated by several physico-chemical studies and the corresponding gelation mechanism was compared to that of the well-known pectin ionic gelation induced by Ca2+ ions. Similar binding processes were observed for both divalent ions, though stronger interactions were observed with chlorhexidine. Pectin/chlorhexidine microparticles were then developed by prilling (vibrational jet technique) without additional Ca2+ ions. Finally, the influence of zinc dications addition in the formulation on the microparticle properties (size, encapsulation efficiency, drug release kinetics) was evaluated
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Lima, Ramille AraÃjo. "âO uso da clorexidina intracanal em molares decÃduos com necrose pulpar â estudo clÃnico e microbiolÃgicoâ." Universidade Federal do CearÃ, 2009. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=4008.
Texte intégralRésumé :
FundaÃÃo de Amparo à Pesquisa do Estado do CearÃ<br>O sucesso do tratamento endodÃntico depende de muitos fatores, sendo a reduÃÃo ou eliminaÃÃo da infecÃÃo bacteriana o mais importante desses fatores. Portanto, o uso de substÃncias capazes de agir nesses microorganismos e em seus subprodutos torna-se uma etapa importantÃssima no tratamento. O objetivo deste ensaio clÃnico âsplit-mouthâ foi comparar a eficÃcia da clorexidina gel 1% e do hidrÃxido de cÃlcio associado ao paramonoclorofenol canforado (Callen PMCCÂ), como medicaÃÃo intracanal, e do tratamento executado em sessÃo Ãnica (grupo controle), contra Estreptococos do grupo mutans (EGM) e bactÃrias anaerÃbias presentes no interior dos canais radiculares de molares decÃduos com necrose pulpar. Um total de 21 crianÃas (37 dentes) participou do estudo. Amostras iniciais (prÃ-tratamento) e finais (apÃs a permanÃncia das substÃncias por 14 dias no interior dos canais) foram coletadas para anÃlise microbiolÃgica e incubadas em placas de Mitis Salivarius Bacitracina, em aerofilia, para a observaÃÃo dos nÃveis de EGM, assim como em placas de Brucella Ãgar, em anaerobiose, para verificaÃÃo de bactÃrias anaerÃbias. Os nÃveis de sucesso da pulpectomia apÃs um perÃodo de acompanhamento de atà 12 meses foram analisados baseados em parÃmetros clÃnicos e radiogrÃficos. A clorexidina gel a 1% reduziu significantemente os nÃveis de EGM (p= 0,010, teste de Wilcoxon) e o Callen PMCC reduziu significantemente os nÃveis de bactÃrias anaerÃbias (p=0,002, teste de Wilcoxon). Observou-se diferenÃa significativa na comparaÃÃo da reduÃÃo dos nÃveis de EGM obtidos pelo grupo da clorexidina e pelo controle (p=0,032, Mann-Whitney). A taxa de sucesso do tratamento foi de 81,71% no grupo do Callen PMCCÂ, 78,57% para o grupo da clorexidina gel 1% e 77,77% no grupo controle. Concluiu-se que a clorexidina gel a 1%, assim como o hidrÃxido de cÃlcio associado ao paramonoclorofenol canforado, possui eficÃcia limitada na reduÃÃo de bactÃrias dos canais radiculares decÃduos infectados. Os presentes resultados sugerem que uma possÃvel associaÃÃo entre as medicaÃÃes testadas em estudos futuros pode eliminar de maneira mais eficaz estas bactÃrias.<br>The success of endodontic treatment depends on many factors, and the reduction or elimination of bacterial infection is the most important one. Therefore, the use of substances that act against these microorganisms and their products becomes an important stage in treatment. The aim of this in vivo split-mouth study was to compare the efficacy of a 1% chlorhexidine gel, calcium hydroxide/camphorated paramonochlorophenol (Callen PMCCÂ) as intracanal medications, and a Control group (1-visit endodontic treatment) against mutans streptococci (EGM) and anaerobic bacteria found in primary molars with necrotic pulps. A total of 21 children (37 teeth) participated in this study. Initial (pre-treatment) and final (14 days post-treatment) intra-canal samples were collected for microbiological analysis and were incubated in Mitis Salivarius Bacitracin plates under microaerophilic conditions for EGM counting; as well as in Brucella-agar plates, anaerobically, to allow growth of anaerobic bacteria. The success rate of the pulpectomies after a 12 months follow-up were also evaluated based on clinical and radiographic parameters. Chlorhexidine gel significantly reduced EGM levels (p=0,010, Wilcoxon test), whereas Callen PMCC significantly reduced anaerobic bacteria levels (p=0,002). Significant difference was observed when comparing EGM reduction levels between the Chlorhexidine and Control groups (p=0,032, Mann-Whitney test). The success rate was 81,71% in the Callen PMCC group, 78.57% in the Chlorhexidine group and 77.77% in the control group. We concluded that 1% chlorhexidine gel, as well as calcium hydroxide/camphorated paramonochlorophenol, has limited efficacy in the reduction of bacteria from deciduous infected root canals. The present results suggest that a possible association between these two medications in future studies may eliminate more efficiently these bacteria.
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Lessa, Fernanda Campos. "Citotoxicidade direta e transdentinária da clorexidina sobre células odontoblastóides MDPC-23 e análise de sua atividade antimicrobiana in vitro /." Araraquara : [s.n.], 2008. http://hdl.handle.net/11449/104257.
Texte intégralRésumé :
Orientador: Carlos Alberto de Souza Costa<br>Banca: Elisa Maria Aparecida Giro<br>Banca: Denise Madalena Palomari Spolidorio<br>Banca: Maria Cristina Borsatto<br>Banca: Mario Fernando de Góes<br>Resumo: O objetivo da presente pesquisa foi avaliar o efeito citotóxico direto e transdentinário de diferentes concentrações de clorexidina (CHX), bem como sua atividade antibacteriana. Para isto, concentrações de 0,06%; 0,12%; 0,2%; 1% e 2% de CHX foram aplicadas sobre células odontoblastóides MDPC-23 em cultura (teste direto). Além disto, as concentrações de CHX também foram aplicadas sobre a superfície oclusal de discos de dentina de 0,5mm ou 0,2mm de espessura, os quais apresentavam células MDPC-23 cultivadas sobre sua superfície pulpar (teste indireto). O metabolismo e morfologia celular foram avaliados pelo teste de MTT e pela análise em MEV, respectivamente. O potencial antibacteriano da CHX foi avaliado sobre S.mutans com e sem interposição de discos de dentina. Os dados numéricos obtidos dos experimentos realizados foram submetidos à análise estatística. A redução do metabolismo celular provocado pela CHX mostrou-se dose e tempo dependentes. Foi demonstrado ainda que quanto menor a espessura do disco de dentina e maior a concentração da CHX, mais intensos são os efeitos tóxicos deste agente químico sobre as células pulpares em cultura, e mais efetiva é a atividade antibacteriana da CHX sobre S.mutans. Foi possível concluir que o intenso efeito tóxico direto observado para a CHX é notavelmente reduzido pela interposição de barreiras de dentina, cuja espessura interfere no metabolismo das células pulpares MDPC-23. Além disso, a CHX difunde através dos túbulos dentinários exercendo efeito antibacteriano contra S.mutans.<br>Abstract: The aim of this in vitro study was to evaluate the direct and transdentinal cytotoxicity of different concentrations of chlorhexidine (CHX) and its antibacterial activity. The following concentrations of CHX: 0.06%; 0.12%; 0.2%; 1%; and 2% were applied directly on odontoblast-cell line MDPC-23 or on the occlusal surface of dentin discs (0.5mm or 0.2mm thick) which presented pulp cells seeded on their pulpal surface. Cell metabolic activity and morphology were evaluated by MTT assay and SEM, respectively. The influence of dentin thickness on the antibacterial activity of CHX against S. mutans was also assessed. The data were submitted to the statistical analysis of Mann-Whitney. Reduction in the cell metabolism from 42% to 78% was observed according to the concentration of CHX and its period of application on the cells. Therefore, the direct cytotoxicity of CHX is dose and time dependent. It was also observed that the most intense toxic effects occurred as thicker was the dentin disc and as higher was the concentration of CHX. Antibacterial activity against S. mutans was observed to the highest concentration of CHX. It was concluded that the intense cytotoxicity of all concentrations of CHX applied directly on the MDPC-23 cells is notably reduced by the presence of dentin discs interposed between this chemical agent and the cultured cells. In addition, the transdentinal diffusion of CHX causes antibacterial activity against S. mutans.<br>Doutor
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AraÃjo, Maria do Socorro Ramalho Guanabara. "Clinical evaluation of chlorhexidine incorporation in two-step self-etching adhesive: a pilot study." Universidade Federal do CearÃ, 2012. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=17704.
Texte intégralRésumé :
CoordenaÃÃo de AperfeÃoamento de Pessoal de NÃvel Superior<br>This study evaluated the effect of the incorporation of chlorhexidine into primer of one self-etching adhesive system on the clinical performance of composite restorations placed in non-carious cervical lesions (NCCLs) at baseline and after 6 and 12 months. Sixty-five restorations were placed in 22 subjects being treated for NCCLs. The restorations were randomly placed in two groups: G1 (CSE): Clearfil SE Bond system applied following manufacturerâs instructions and G2 (CSE/CHX): as described in G1 but using the Clearfil Primer containing a concentration of 1% chlorhexidine digluconate. Filtek Z-250 composite resin was used as the restorative material for all restorations. Two clinicians evaluated the restorations blindly at baseline, 6 months and 12 months after restorationâs placement using a modified United States Public Health Service (USPHS) criteria. No statistically significant difference between the two groups was observed for all criteria evaluated.<br>Este estudo avaliou o efeito da incorporaÃÃo de Clorexidina no primer de um sistema adesivo autocondicionante, no desempenho clÃnico de restauraÃÃes de resina composta, realizadas em lesÃes cervicais nÃo-cariosas (LCNC), imediatamente, apÃs sua confecÃÃo e apÃs 6 e 12 meses. Sessenta e cinco restauraÃÃes foram realizadas em 22 pacientes com LCNCs. Os dentes foram distribuidos aleatoriamente em 2 grupos: G1 (CSE): o sistema adesivo Clearfil SE foi aplicado na superfÃcie das lesÃes segundo as indicaÃÃes do fabricante; G2 (CSE/CHX): o Primer do Clearfil SE contendo 1% de Digluconato de Clorexidina foi aplicado como descrito para o G1. Todos os preparos foram restaurados com a resina micro-hÃbrida Z 250. Dois clÃnicos avaliaram as restauraÃÃes logo apÃs a execuÃÃo (baseline), 6 e 12 meses, usando os critÃrios modificados do ServiÃo de SaÃde PÃblica dos Estados Unidos (USPHS). NÃo houve diferenÃa estatisticamente significativa entre os dois grupos para qualquer dos critÃrios avaliados.
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Barthet, Pierre. "Réponse clinique et bactériologique a l'implantation d'une éponge collagène-chlorhexidine dans les poches parodontales." Toulouse 3, 1992. http://www.theses.fr/1992TOU30064.
Texte intégralRésumé :
De nombreux systemes a liberation lente d'antibacteriens ont ete experimentes in situ dans les poches parodontales. Nous avons realise une etude pour etudier les effets cliniques et bacteriologiques d'une eponge collagene-chlorhexidine. Seize patients atteints de parodontite de l'adulte sont choisis pour cette etude. 3 sites par patient (un actif, un placebo, un temoin) sont selectionnes (profondeur de poche > 6 mm). Les parametres suivants sont enregistres aux jours 0, 30 et 90 (indice de plaque, indice gingival, profondeur de sondage, niveau d'attache, flore totale et repartition des flores). Les resultats cliniques presentent une amelioration des parametres dans les 3 groupes, meilleurs dans le groupe actif de j30 a j90. Les resultats bacteriologiques presentent une evolution comparable dans les 3 groupes, reduction de la flore anaerobie a j30, retour a l'etat initial a j90, et reduction de la flore totale surtout dans le groupe actif
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Tutumlu, Christian, and André Lund. "Inhibition of different strains of Streptococcus mutans at different concentrations of Fluoride and Chlorhexidine." Thesis, Umeå universitet, Tandläkarutbildning, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-178759.
Texte intégralRésumé :
ABSTRACT Background: The most common species associated with dental caries is Streptococcus mutans. Different Streptococcus mutans adhesion biotypes, SpaP A/B/C and Cnm/Cbm, with ability to predict individual caries development have recently been identified. Aim: The aim of the study was to investigate if there was a difference in growth ability of the Streptococcus mutans adhesion biotypes and their relative sensitivity to biocides such as fluoride and chlorhexidine in vitro. We also aim to compare the potency of biocides in vitro to those concentrations used in the clinic. Methods: Culturing of the Streptococcus mutans biotypes in a planktonic solution with and without fluoride and chlorhexidine. Used concentrations: 3.5-4500 parts per million fluoride and 15-500 parts per million chlorhexidine. Optical density was used to measure growth under the different conditions. Results: The tests with fluoride showed a similar dose dependent inhibition of growth for all 6 biotypes of Streptococcus mutans. The tests with chlorhexidine showed a major inhibition of growth for the concentration 62 parts per million which inhibited growth more than 500 parts per million. All biotypes had a similar proliferation pattern without any biocide present. Conclusion: All tested biotypes of Streptococcus mutans had a similar pattern of sensitivity to the different concentrations of biocides and cultivation conditions used.
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Duckworth, Peter Francis. "Chlorhexidine-phosphate salts in wound care : the development and testing of antimicrobial functionalised materials." Thesis, University of Bristol, 2017. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.738245.
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Jarrar, Ahmed Ali. "Comparison of an essential oil mouth rinse and chlorhexidine on 4-day interproximal plaque regrowth." Thesis, University of the Western Cape, 2006. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_1346_1210745930.
Texte intégralRésumé :
<p>Dental plaque is the most important etiological factor of periodontal diseases. Mechanical plaque control is the most effective way in preventing periodontal diseases. Chemical plaque control methods (such as mouthrinses) have been recommended to be used because of some drawbacks in the mechanical methods in some areas of the dentition (such as interproximal areas). But are these mouthrinses really effective in those areas? The aim of this study was to compare the effectiveness of Essential Oils mouthrinse (Listerine) on plaque formation in interproximal areas with Chlorhexidine and Sterile water.</p>
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Imai, Pauline H. "The effects of flossing with a chlorhexidine solution on interproximal gingivitis : a randomized controlled trial." Thesis, University of British Columbia, 2007. http://hdl.handle.net/2429/32854.
Texte intégralRésumé :
Background: Gingivitis, which is an inflammatory response of the gingival tissues to
bacterial plaque, can be treated by brushing and flossing or using chlorhexidine (CHX).
Objective: To determine whether floss presoaked in CHX would improve oral health
relative to floss presoaked in placebo solution.
Materials and methods: A 3 month, double-blinded, parallel, randomized control trial
was conducted on 27 adults with a minimum of 10 bleeding sites, who were randomly
assigned to dental floss with 0.12% CHX or a placebo solution (QS). Scaling, rubber cup
prophylaxis, and flossing instructions were performed at Week -1. Subjects were
assessed for probing depth (PD) with bleeding on probing (BOP), gingival index (GI),
plaque index (PI), and stain index (SI) at Weeks 0, 6, and 12. Flossing compliance was
monitored by self-reports and yards of dental floss used. Student t-tests, ANCOVA and
Wilcoxon Signed-Rank were conducted.
Results: Self-reported median flossing compliance was 100% for CHX and 93% for QS.
A statistically significant reduction for PD in the CHX group at Week 6 (p = 0.029) and
specifically, for the gingivitis sites at Week 6 (p = 0.006) and Week 12 (p = 0.005).
Reductions in BOP were statistically significant for CHX group with moderate gingivitis
(p = 0.0078). The CHX group had a statistically significant reduction in BOP in all areas
of the oral cavity with the largest reductions occurring in the anterior areas (p = 0.011).
All GI scores were statistically significant from Weeks 0 to 12 (p < 0.0001). Although
not statistically significant, PI appeared to be constant for CHX group and increasing for
QS group. The two groups did not differ significantly for SI.
Conclusion: CHX applied via dental floss significantly reduced probing depths in
shallow sulci and bleeding in subjects with moderate gingivitis. Further studies are
suggested to determine the effects of CHX with different interdental aids, higher
concentrations of CHX, and subjects with moderate to severe gingivitis.
Funding: CFDHRE and BCDHA
Key words: gingivitis, chlorhexidine, dental floss, RCT, bleeding on probing, gingival
and plaque indices.<br>Dentistry, Faculty of<br>Graduate
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Rogers, Stephen Christopher. "Delmopinol-induced matrix removal facilitates photodynamic therapy and chlorhexidine methods for disinfecting mixed oral biofilms." Thesis, State University of New York at Buffalo, 2014. http://pqdtopen.proquest.com/#viewpdf?dispub=1561655.
Texte intégralRésumé :
<p> It is often observed that the slimy matrixes of various bacterial-formed biofilms can limit their disinfection. This investigation demonstrated that disinfection effectiveness by either photodynamic therapy (PDT) or chlorhexidine irrigation is significantly improved by collapse of that matrix using the non-bactericidal reagent delmopinol as part of the treatment sequence. Cyclic shear-producing conditions were used to grow 4-day, whole salivary and growth media biofilms on glow-discharge-treated polystyrene (N=46) and mini-germanium internal reflection prisms to serve in a periodontal crypt model of disinfection by either methylene-blue-mediated PDT or by chlorhexidine irrigation. Assays for bacterial viability, with and without treatments, were performed by alamarBlue<sup>®</sup> fluorescent methods, statistically applied (ANOVA, Tukey's HSD). Multiple Attenuated Internal Reflection Infrared (MAIR-IR) assays confirmed selective removal of the predominantly polysaccharide matrix materials by the delmopinol treatment, but not by equivalent water or chlorhexidine methods. Confocal-IR microscopy showed that the delmopinol reagent, alone, caused about one-third of each wet biofilm to be removed, while bacterial re-growth was confirmed by alamarBlue<sup>®</sup> assay. Chlorhexidine and PDT suppression of bacterial activity without regrowth was significantly improved with the added delmopinol treatment, and is likely to provide similarly beneficial results in the effective disinfection of diverse biofilms in many settings.</p>
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Mohd, Razi M. R. "Effects of polyacrylic acid on brushite bone cement setting, mechanical properties, degradation and chlorhexidine release." Thesis, University College London (University of London), 2012. http://discovery.ucl.ac.uk/1361005/.
Texte intégralRésumé :
In the field of Paediatric Dentistry, brushite cement has potential as an endodontic medicament and bone substitute material. Clinical applications however are limited due to their inherent properties, such as rapid setting time and poor mechanical properties. Antimicrobial e.g. chlorhexidine (CHX) could be incorporated into the cement for localised drug release. Aim and objectives: The aim of this study was to assess if partial replacement of citric acid (CA) by polyacrylic acid (PAA) can improve the properties of conventional brushite cements. The objectives were to assess the effects of varying PAA and CHX concentrations in brushite cements on their setting kinetics, final composition, microstructure of the cement, mechanical properties, degradation and CHX release profile. Materials and Methods: The cements consisted of equimolar β- tricalcium phosphate and monocalcium phosphate monohydrate (β-TCP/MCPM) and 6 or 11% (w/w) CHX. The liquid phase consisted of aqueous 800 mM CA and PAA solution at different ratios. Compositions with no CHX and/or PAA were used as control cements. Setting kinetics and final composition were determined using FTIR and Raman spectroscopy respectively. Brushite microstructure was examined using scanning electron microscopy. The cements were tested for microhardness and biaxial flexural strength (BFS). CHX release was quantified with UV spectroscopy and degradation by mass loss. Results: The setting times for compositions with PAA were delayed by up to 12 hours. FTIR indicated formation of dicalcium citrate and polyacrylate complexes could delay brushite formation. High CHX content inhibited the acid retarding effects and complex formation. Raman mapping demonstrated discrete regions of brushite and CHX in all set cements. Microscopically, PAA addition resulted in denser and less porous structure. The BFS ranged from 5.8 ± 1.3 MPa to 11.1 ± 1.2 MPa. CHX incorporation resulted in reduced BFS and modulus whilst PAA addition increased it. The average mass change was significantly different between compositions with and with no chlorhexidine; 12% and 0.2% respectively at the end of study period. The daily degradation rate ranged from 0.1 ± 0.03 wt% to 0.6 ± 0.15 wt%. PAA presence reduced CHX release from more than 90% to less than 20% over 4 weeks. Conclusion: PAA substantially slowed the setting reaction and chlorhexidine release characteristics, altered the final brushite crystal microstructure, increased mechanical properties but did not affect the degradation kinetics.
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Chaiyakunapruk, Nathorn. "Meta-analysis and cost-effectiveness analyses of chlorhexidine gluconate and povidone iodine use for the prevention of catheter-related bloodstream infection /." Thesis, Connect to this title online; UW restricted, 2001. http://hdl.handle.net/1773/7946.
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Atbayga, Abdalla Mohammed Ali. "In vitro anti-bacterial activity of titanium oxide nano-composites containing benzalkonium chloride and chlorhexidine gluconate." Thesis, Cape Peninsula University of Technology, 2013. http://hdl.handle.net/20.500.11838/1460.
Texte intégralRésumé :
Thesis submitted in fulfilment of the requirements for the degree Master of Technology: Biomedical Technology
In the Faculty of Health and Wellness Sciences
At Cape Peninsula University of Technology
2013<br>Newly developed and commercial dental resins which are commonly used nowadays have to be tested for their antimicrobial susceptibility. The purpose of this in vitro study was to investigate the antimicrobial activity of a titanium oxide (TiO2) nano-composite which was prepared with different antibacterial substances and used as restoratives in dentistry to combat certain selected bacteria that are considered the principle causes of some tooth diseases, for example, tooth decay and to prevent unsuccessful dental restoration.
The TiO2 nano-composite was prepared and divided into four groups: The first group was an untreated TiO2 nano-composite. The second group was silane-treated TiO2 nano-composite. The third group was treated TiO2 nano-composite which was combined with chlorhexidine gluconate (CHxG). The fourth group was treated TiO2 nano-composite which was combined with benzalkonium chloride (BzCl).
Five of the selected bacteria were grown overnight in Petri dishes. Four of them, namely, Escherichia coli (E. coli) ATCC 11775, Staphylococcus aureus (S. aureus) ATCC 12600, Enterococcus faecalis (E. faecalis) ATCC 29212, and Pseudomonas aeruginosa (P. aeruginosa) ATCC 10145, were grown on Müller-Hinton Agar (MHA). Streptococcus mutans (S. mutans) ATCC 25175 was grown on Brain Heart Infusion (BHI) agar. All these bacteria were tested against the TiO2 nano-composite, and incubated for 24 hours at 37°C, except S. mutans, which was incubated separately and exposed to CO2. It was placed into a CO2 water-jacketed incubator in an atmosphere of 5% CO2 for 24 hours at 37°C.
The obtained results showed that neither of the groups of TiO2 nano-composites, (untreated TiO2 nano-composite and treated TiO2 nano-composite) exhibited antimicrobial activity against the pathogens. Only preparations of TiO2 nano-composites at a concentration of 3 %m/m of both CHxG and BzCl showed antimicrobial activity against S. aureus. Antimicrobial activity against S. mutans, E. coli, P. aeruginosa, E. faecalis and S. aureus, were only realized at a concentration of 10 %m/m for both CHxG and BzCl..
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Estrabaud, Yves. "Étude de l'activité de la chlorhexidine en irrigations sous-gingivales sur la maladie parodontale chez l'homme." Nantes, 1992. http://www.theses.fr/1992NANT03OD.
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MARCILLY, ALAIN. "Influence du fluorure de sodium et de la chlorhexidine sur les fermentations mixtes de streptococcus mutans." Lyon 1, 1990. http://www.theses.fr/1990LYO1DE01.
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Ludes, Bertrand. "Toxicité de la chlorhexidine sur le tissu pulmonaire : étude chez le cobaye et chez le rat." Université Louis Pasteur (Strasbourg) (1971-2008), 1985. http://www.theses.fr/1985STR1M145.
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