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Dinu S, Matichescu A, Buzatu R, Marcovici I, Geamantan-Sirbu A, Semenescu AD, Bratu RC, Bratu DC. Insights into the Cytotoxicity and Irritant Potential of Chlorhexidine Digluconate: An In Vitro and In Ovo Safety Screening. Dent J (Basel) 2024; 12:221. [PMID: 39057008 PMCID: PMC11276539 DOI: 10.3390/dj12070221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/07/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024] Open
Abstract
Chlorhexidine (CHX) represents one of the most commonly used antiseptics in dentistry and other medical-pharmaceutical fields due to its broad-spectrum antimicrobial activity. However, the potential toxic events arising from its common use in practice has become a subject of increasing concern. Thus, the present study was designed to investigate the potential toxicity of CHX digluconate at concentrations covering its antibacterial properties (0.0002-0.2%) in HGF primary gingival fibroblasts, HaCaT immortalized human keratinocytes, and JB6 Cl 41-5a epidermal cells, as well as its irritant action in ovo. Our results indicate that CHX exerted a concentration- and time-dependent cytotoxicity in all cell lines, which was evidenced by the reduction in cell viability, number, and confluence, damaged cell membrane integrity, impaired cell morphology, and specific apoptotic nuclear shape. The highest cytotoxicity was caused by CHX digluconate 0.02% and 0.2%, concentrations, at which an irritant effect on the chorioallantoic membrane was also observed. The novel findings revealed in this research contribute to the overall safety profile of CHX and stand as a basis for further investigations in this regard.
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Affiliation(s)
- Stefania Dinu
- Department of Pedodontics, Faculty of Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy, No. 9, Revolutiei 1989 Bv., 300041 Timisoara, Romania;
- Pediatric Dentistry Research Center, Faculty of Dental Medicine, Victor Babeș University of Medicine and Pharmacy, No. 9, Revolutiei Bv., 300041 Timisoara, Romania
| | - Anamaria Matichescu
- Department of Preventive, Community Dentistry and Oral Health, Translational and Experimental Clinical Research Centre in Oral Health, University of Medicine and Pharmacy “Victor Babeș”, 300040 Timisoara, Romania
- Translational and Experimental Clinical Research Centre in Oral Health, “Victor Babeș” University of Medicine and Pharmacy, 14A Tudor Vladimirescu Ave., 300173 Timișoara, Romania
| | - Roxana Buzatu
- Department of Dental Aesthetics, Faculty of Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Revolutiei Boulevard 9, 300041 Timisoara, Romania;
| | - Iasmina Marcovici
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (I.M.); (A.G.-S.); (A.D.S.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Andreea Geamantan-Sirbu
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (I.M.); (A.G.-S.); (A.D.S.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Alexandra Denisa Semenescu
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (I.M.); (A.G.-S.); (A.D.S.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Remus Christian Bratu
- Faculty of Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy Timișoara, 2 Eftimie Murgu Square, 300041 Timișoara, Romania;
| | - Dana-Cristina Bratu
- Department of Orthodontics II, Faculty of Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy Timișoara, 2 Eftimie Murgu Square, 300041 Timișoara, Romania;
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Baus-Domínguez M, Aguilera FR, Vivancos-Cuadras F, Ferra-Domingo L, Torres-Lagares D, Gutiérrez-Pérez JL, Pereira-Riveros T, Vinuesa T, Serrera-Figallo MÁ. Mucoadhesive Pharmacology: Latest Clinical Technology in Antiseptic Gels. Gels 2023; 10:23. [PMID: 38247746 PMCID: PMC10815608 DOI: 10.3390/gels10010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 12/24/2023] [Accepted: 12/24/2023] [Indexed: 01/23/2024] Open
Abstract
Chlorhexidine (CHX) is one of the most widely used antiseptics in the oral cavity due to its high antimicrobial potential. However, many authors have stated that the effect of CHX in nonsurgical periodontal therapy is hampered by its rapid elimination from the oral environment. The aim of this study was to determine the antibacterial efficacy of a new compound of chlorhexidine 0.20% + cymenol (CYM) 0.10% on a multispecies biofilm. For this, an in vitro study was designed using a multispecies biofilm model of Streptococcus mutans, Fusobacterium nucleatum, Prevotella intermedia, and Porphyromonas gingivalis. Quantification of the microbial viability of the biofilm was performed using 5-cyano-2,3-ditolyl tetrazolium-chloride (CTC) to calculate the percentage of survival, and the biofilms were observed using a a confocal laser scanning microscopy (CLSM). It was observed that the bactericidal activity of the CHX + cymenol bioadhesive gel was superior to that of the CHX bioadhesive gel, in addition to higher penetrability into the biofilm. Therefore, there was greater elimination of bacterial biofilm with the new compound of chlorhexidine 0.2% plus cymenol 0.1% in a bioadhesive gel form compared to the formulation with only chlorhexidine 0.2% in a bioadhesive gel form.
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Affiliation(s)
- María Baus-Domínguez
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, 41009 Sevilla, Spain; (J.-L.G.-P.); (M.-Á.S.-F.)
| | - Felipe-Rodrigo Aguilera
- Unit of Microbiology, Department of Pathology and Experimental Therapeutics, Faculty of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.-R.A.); (T.P.-R.); (T.V.)
- School of Dentistry, Faculty of Medicine, Universidad Austral de Chile, Valdivia 5090000, Chile
| | | | | | - Daniel Torres-Lagares
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, 41009 Sevilla, Spain; (J.-L.G.-P.); (M.-Á.S.-F.)
| | - José-Luis Gutiérrez-Pérez
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, 41009 Sevilla, Spain; (J.-L.G.-P.); (M.-Á.S.-F.)
- Hospital Universitario Virgen del Rociío, Universidad de Sevilla, 41013 Sevilla, Spain
| | - Tanya Pereira-Riveros
- Unit of Microbiology, Department of Pathology and Experimental Therapeutics, Faculty of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.-R.A.); (T.P.-R.); (T.V.)
| | - Teresa Vinuesa
- Unit of Microbiology, Department of Pathology and Experimental Therapeutics, Faculty of Medicine and Health Sciences, University of Barcelona, L’Hospitalet de Llobregat, 08907 Barcelona, Spain; (F.-R.A.); (T.P.-R.); (T.V.)
| | - María-Ángeles Serrera-Figallo
- Departamento de Estomatología, Facultad de Odontología, Universidad de Sevilla, 41009 Sevilla, Spain; (J.-L.G.-P.); (M.-Á.S.-F.)
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Silva JM, Teixeira AB, Reis AC. Silver-based gels for oral and skin infections: antimicrobial effect and physicochemical stability. Future Microbiol 2023; 18:985-996. [PMID: 37750752 DOI: 10.2217/fmb-2023-0034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/27/2023] Open
Abstract
Aim: To systematically evaluate the literature on silver (Ag) gels and their antimicrobial efficacy and physicochemical stability. Materials & methods: A search was performed in PubMed/MEDLINE, LILACS, Web of Science, Scopus, Embase and Google Scholar. Results: Gels were formulated with Ag nanoparticles, Ag oxynitrate and colloidal Ag and showed antimicrobial activity for concentrations ranging from 0.002 to 30%. Gels showed stability of their chemical components, and their physicochemical properties, including viscosity, organoleptic characteristics, homogeneity, pH and spreadability, were suitable for topical application. Conclusion: Ag-based gels show antimicrobial action proportional to concentration, with higher action against Gram-negative bacteria and physicochemical stability for oral and skin infection applications.
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Affiliation(s)
- João Mc Silva
- Department of Dental Materials & Prosthesis, Ribeirão Preto Dental School, University of São Paulo, Avenida do Café s/n, Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Ana Bv Teixeira
- Department of Dental Materials & Prosthesis, Ribeirão Preto Dental School, University of São Paulo, Avenida do Café s/n, Ribeirão Preto, São Paulo, 14040-904, Brazil
| | - Andréa C Reis
- Department of Dental Materials & Prosthesis, Ribeirão Preto Dental School, University of São Paulo, Avenida do Café s/n, Ribeirão Preto, São Paulo, 14040-904, Brazil
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Nisar SS, Irfan F, Hammad H, Abdulla AM, Kamran MA, Barakat A, Niazi F, Baig EA, Qureshi A. Disinfection of caries-affected dentin using potassium titanyl phosphate laser, Rose bengal and Ozonated water on shear bond strength of deciduous teeth. Photodiagnosis Photodyn Ther 2022; 40:103044. [PMID: 35914695 DOI: 10.1016/j.pdpdt.2022.103044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 07/23/2022] [Accepted: 07/28/2022] [Indexed: 12/14/2022]
Abstract
AIM To assess the efficacy of disinfection of caries-effected dentin (CAD) using KTP laser and different decontamination methods using ozonated water (OW), Rose Bengal photosensitizer (RBP), chlorhexidine (CHX), and Er, YAG laser on the shear bond strength (SBS) of adhesive resin bonded to deciduous teeth. MATERIAL AND METHODS A total of 50 extracted and radiographically verified carious primary molars were collected and scrutinized according to ICDAS criteria. Specimens were allocated randomly into five groups (n = 10) as per the type of CAD disinfectants. KTP laser, OW, RBP, CHX (control), and Er, YAG laser. After cavity sanitization, a resin adhesive (prime and bond NT) was smeared on the dentinal exterior followed by incremental composite filling. SBS evaluation was performed by employing specimens in the universal testing machine. The debonded surface was assessed under 40x magnification in a stereomicroscope to ascertain fracture mode. Statistical analysis was done by using the ANOVA and the Post Hoc Tukey multiple comparison tests (p < 0.05). RESULTS The highest SBS was exhibited by group 2 i.e., when OW was employed for CAD disinfection (10.25 ± 0.24 MPa). Whereas, the lowest SBS bond value was unveiled by samples in group 3 when RBP was applied for dentin surface sanitization (7.85 ± 0.59 MPa).CAD disinfection with KTP laser (8.25 ± 0.41 MPa), CHX (8.19 ± 0.73 MPa), and RBP displayed comparable bond values (p > 0.05). CONCLUSION Ozonated water and Er, YAG laser could be employed as cavity disinfectants in primary teeth as they demonstrated better shear bond strength without jeopardizing the adhesive binding capacity of restorative resins bonded to caries-affected dentin.
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Affiliation(s)
- Sidra Sadaf Nisar
- Department of Science of Dental Materials, Dow International Dental College, Karachi, Pakistan.
| | - Fariha Irfan
- Department of Operative Dentistry and Endodontics, Hamdard College of Medicine and Dentistry, Hamdard University, Karachi, Pakistan.
| | - Hina Hammad
- Department of Operative Dentistry and Endodontics, Hamdard College of Medicine and Dentistry, Hamdard University, Karachi, Pakistan
| | - Anshad M Abdulla
- Department of Pedodontics and Orthodontics Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia.
| | - Muhammad Abdullah Kamran
- Department of Pedodontics and Orthodontics Sciences, College of Dentistry, King Khalid University, Abha, Saudi Arabia.
| | - Ali Barakat
- Department of Restorative and Prosthetic Dentistry, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia.
| | - Fayez Niazi
- Department of Restorative and Prosthetic Dentistry, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia.
| | - Eisha Abrar Baig
- Department of Operative Dentistry, Dow International Dental College, Pakistan.
| | - Ambrina Qureshi
- Department of Community and Preventive Dentistry, Dow University of Health Sciences, Karachi, Pakistan.
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Albaqawi AH, Shabib S, Vohra F, abduljabbar T. Efficacy of Chlorhexidine, photosensitizers, green tea extract, and propolis on bond integrity and microleakage of caries-affected dentin. An in-vitro study. Photodiagnosis Photodyn Ther 2022; 39:102998. [DOI: 10.1016/j.pdpdt.2022.102998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 06/28/2022] [Accepted: 07/01/2022] [Indexed: 10/17/2022]
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van de Lagemaat M, Stockbroekx V, Geertsema-Doornbusch GI, Dijk M, Carniello V, Woudstra W, van der Mei HC, Busscher HJ, Ren Y. A Comparison of the Adaptive Response of Staphylococcus aureus vs. Streptococcus mutans and the Development of Chlorhexidine Resistance. Front Microbiol 2022; 13:861890. [PMID: 35694293 PMCID: PMC9186159 DOI: 10.3389/fmicb.2022.861890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 04/11/2022] [Indexed: 11/14/2022] Open
Abstract
Antimicrobials with nonselective antibacterial efficacy such as chlorhexidine can be effective in reducing biofilm, but bear the risk of inducing resistance in specific bacteria. In clinical practice, bacteria such as Staphylococcus aureus have been found resistant to chlorhexidine, but other bacteria, including Streptococcus mutans, have largely remained susceptible to chlorhexidine despite its widespread use in oral healthcare. Here, we aim to forward a possible reason as to why S. aureus can acquire resistance against chlorhexidine, while S. mutans remains susceptible to chlorhexidine. Measurement of surface-enhanced fluorescence indicated that chlorhexidine caused gradual, but irreversible deformation to adhering green fluorescent S. aureus due to irreparable damage to the cell wall. Concurrently, the metabolic activity of adhering staphylococci was higher than of planktonic bacteria, suggesting efflux mechanisms may have been activated upon cell wall deformation, impeding the buildup of a high chlorhexidine concentration in the cytoplasm and therewith stimulating the development of chlorhexidine resistance in S. aureus. Exposure of S. mutans to chlorhexidine caused immediate, but reversible deformation in adhering streptococci, indicative of rapid self-repair of cell wall damage done by chlorhexidine. Due to cell wall self-repair, S. mutans will be unable to effectively reduce the chlorhexidine concentration in the cytoplasm causing solidification of the cytoplasm. In line, no increased metabolic activity was observed in S. mutans during exposure to chlorhexidine. Therewith, self-repair is suicidal and prevents the development of a chlorhexidine-resistant progeny in S. mutans.
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Affiliation(s)
- Marieke van de Lagemaat
- University of Groningen and University Medical Center Groningen, Department of Orthodontics, Groningen, Netherlands
| | - Valerie Stockbroekx
- University of Groningen and University Medical Center Groningen, Department of Orthodontics, Groningen, Netherlands
| | - Gésinda I. Geertsema-Doornbusch
- University of Groningen and University Medical Center Groningen, Department of Biomedical Engineering, Groningen, Netherlands
| | - Melissa Dijk
- University of Groningen and University Medical Center Groningen, Department of Orthodontics, Groningen, Netherlands
| | - Vera Carniello
- University of Groningen and University Medical Center Groningen, Department of Biomedical Engineering, Groningen, Netherlands
| | - Willem Woudstra
- University of Groningen and University Medical Center Groningen, Department of Biomedical Engineering, Groningen, Netherlands
| | - Henny C. van der Mei
- University of Groningen and University Medical Center Groningen, Department of Biomedical Engineering, Groningen, Netherlands
- *Correspondence: Henny C. van der Mei,
| | - Henk J. Busscher
- University of Groningen and University Medical Center Groningen, Department of Biomedical Engineering, Groningen, Netherlands
| | - Yijin Ren
- University of Groningen and University Medical Center Groningen, Department of Orthodontics, Groningen, Netherlands
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