Chlorhexidine as a Disinfectant in the Prosthodontic Practice: A Comprehensive Review

Comparative Evaluation of Disinfection Protocols for Dental Impressions in Prosthodontics

BACKGROUND

In prosthodontics, dental impressions are essential for creating precise dental restorations. However, these impressions are susceptible to microbial contamination, which can pose a risk of infection to patients. Consequently, effective disinfection methods are crucial to prevent postoperative infections. This study aims to evaluate the effectiveness of various disinfection techniques for dental impressions used in prosthodontics.

MATERIALS AND METHODS

A total of 148 poured dental impressions were randomized into three disinfection groups: immersed in 0.5% sodium hypochlorite, 2% glutaraldehyde, or 0.2% chlorhexidine solution. The bacterial contamination was evaluated by direct colony-forming unit (CFU) counting, while the dimensional accuracy and surface detail duplication of each resin sample were determined as physical properties. Data were analyzed using SPSS version 23.0 (IBM Corp., Armonk, NY). Either analysis of variance (ANOVA) with the option for post-hoc or non-parametric tests was used to investigate and compare the efficacy of the better disinfection protocols where the p-value was considered significant if less than 0.05.

RESULTS

Glutaraldehyde showed the lowest mean CFU count (2.5 log10 CFUs), followed by sodium hypochlorite (3.2 log10 CFUs) and chlorhexidine (3.5 log10 CFUs). All disinfection protocols were able to significantly reduce microbial contamination when compared with the control group (p < 0.05). The results of the physical property assessment demonstrated acceptable dimensional accuracy in all tested protocols, with slight differences recorded between them regarding the reproduction of surface detail. More specifically, the mean dimensional deviation was in the range between 0.02 and 0.04 mm, while scores for surface detail reproduction ranged from 2 to 4. The ANOVA results revealed significant differences in microbial contamination levels (F(2, 145) = 5.72, p = 0.007) and dimensional accuracy (F(2, 145) = 3.45, p = 0.032) between the various disinfection protocols.

CONCLUSION

This study enlightens the effective sterilization protocol to be adopted in prosthodontics for dental impressions. Glutaraldehyde was most effective in microbial reduction, while sodium hypochlorite and chlorhexidine were equally effective. Therefore, clinicians must be vigilant in assessing the type of microbial flora that can be encountered during prosthodontic procedures while choosing disinfection protocols for patient safety and quality of impressions.

Small molecules modulating RNA splicing: a review of targets and future perspectives

In eukaryotic cells, RNA splicing is crucial for gene expression. Dysregulation of this process can result in incorrect mRNA processing, leading to aberrant gene expression patterns. Such abnormalities are implicated in many inherited diseases and cancers. Historically, antisense oligonucleotides, which bind to specific RNA targets, have been used to correct these splicing abnormalities. Despite their high specificity of action, these oligonucleotides have drawbacks, such as lack of oral bioavailability and the need for chemical modifications to enhance cellular uptake and stability. As a result, recent efforts focused on the development of small organic molecules that can correct abnormal RNA splicing event under disease conditions. This review discusses known and potential targets of these molecules, including RNA structures, trans-acting splicing factors, and the spliceosome - the macromolecular complex responsible for RNA splicing. We also rely on recent advances to discuss therapeutic applications of RNA-targeting small molecules in splicing correction. Overall, this review presents an update on strategies for RNA splicing modulation, emphasizing the therapeutic promise of small molecules.

Knowledge, attitude, and practice of dental health professionals toward dental impression disinfection protocol during the COVID-19 pandemic in Saudi Arabia- a cross-sectional study

BACKGROUND

Despite the updated guidelines on dental impression disinfection protocols during the COVID-19 pandemic, adherence to such procedures has not been studied among dental health professionals in Saudi Arabia. Understanding DHPs' knowledge, attitudes, and practices regarding COVID-19 is crucial in assessing a willingness to adhere to the recommendations provided by health authorities in mitigating the spread of COVID-19 via dental impressions impacting patient safety and infection control measures. Hence, this study aimed to assess dental health professionals' (DHPs) knowledge, attitudes, and practices (KAP) toward dental impression disinfection protocol during the COVID-19 pandemic in Saudi Arabia.

METHODS

A cross-sectional study using an online survey was conducted from 14 December 2022 to 21 March 2023 among practicing dentists, dental assistants (DA), dental laboratory technicians (DT), and dental hygienists in Saudi Arabia. A validated and reliable questionnaire that consisted of 38 items along with demographic variables was prepared to collect the data. Using Google Forms, a questionnaire link was prepared and shared on the social media platforms of DHPs in Saudi Arabia. A descriptive analysis was conducted to report the percentages and frequencies. The mean knowledge, attitude, and practice scores were analyzed using an Independent t-test, ANOVA, and Pearson's correlation tests.

RESULTS

A total of 718 DHPs voluntarily participated in the survey. Most of the DHPs exhibited average knowledge 392 (54.6%), neutral attitudes 393(54.7%), and adequate 549 (76.5%) practice towards dental impression disinfection protocol. The mean knowledge score differed significantly across nationality (p = 0.013), type of DHPs (p < 0.001), qualification (p = 0.045), and experience (p = 0.028) of the study participants. Significant differences in attitude towards impression disinfection were observed in different age groups (p = 0.002), qualifications (p = 0.015), and experiences (p = 0.024) of the DHPs. Similarly, practice varied across different age groups (p = 0.010), nationality (p = 0.013), type of DHPs (p = 0.019), qualification (p = 0.044), experience (p = 0.041), and COVID-19 Infection (p = 0.006). Moreover, a significant positive correlation between knowledge-attitude (r = 0.258, p < 0.01), knowledge-practice (r = 0.283, p < 0.01), and attitude-practice (r = 0.196, p < 0.01) was observed.

CONCLUSION

DHPs considered in this study demonstrated average knowledge and attitudes toward impression disinfection, requiring improvement through continuous dental education and training. However, they displayed acceptable dental impression disinfection practices during the COVID-19 pandemic. It is highly recommended that continuing education programs should mainly reinforce the knowledge of sodium hypochlorite, iodophor, and phenolics and their concentrations to be used as an impression disinfectant. Additionally, it should focus on techniques of disinfecting elastomeric, hydrocolloid, zinc oxide and eugenol, and impression compound materials to mitigate the spread of COVID-19 based on Saudi ministry of health guidelines.

An In Vitro Comparative Evaluation of Conventional and Novel Thymus vulgaris Derived Herbal Disinfectant Solutions against Pathogenic Biofilm on Maxillofacial Silicones and Its Impact on Color Stability

AIM

This study aims to assess the antimicrobial efficacy and impact on color stability of Thymus (T.) vulgaris solution compared to conventional disinfectants on maxillofacial silicones.

MATERIALS AND METHODS

Various solutions were evaluated, including T. vulgaris solutions at 5 and 10%, saline (control), chlorhexidine (4%), and soap water. The substrates were MDX4-4210 silicone elastomers, and the microorganisms tested were Candida (C.) albicans and Staphylococcus (S.) aureus. The viability of microorganisms was determined through an 3-[4,5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) reduction assay, and color stability was measured using a spectrophotometer with X-Rite Europe software. Statistical analysis was performed using the Kruskal-Wallis test, Mann-Whitney U post hoc test, and Wilcoxon Signed Rank test.

RESULTS

Soap water demonstrated superior disinfectant action against both microorganisms, while T. vulgaris solutions at 5 and 10% exhibited comparable antimicrobial efficacy. Chlorhexidine and 10% T. vulgaris solution showed minimal color changes in the silicone material. In contrast, soap water and the 5% T. vulgaris solution resulted in clinically unacceptable color alterations.

CONCLUSION

This study underscores the potential of T. vulgaris as an herbal disinfectant for combating microbial biofilms on maxillofacial silicones, particularly at concentrations of 5 and 10%. The importance of maintaining color stability is emphasized, with Chlorhexidine and the 10% T. vulgaris solution demonstrating effective preservation of esthetics. These findings suggest the viability of considering T. vulgaris as an alternative disinfectant in clinical settings for maxillofacial silicone prostheses.

CLINICAL SIGNIFICANCE

Maxillofacial silicones are vital in restoring aesthetic features for individuals with facial trauma, congenital deformities, or post-surgical interventions. Yet, biofilm-related infections jeopardize their durability and visual integrity. Clinically, T. vulgaris signifies a potential advance in prosthodontic care, offering valuable insights for improving antimicrobial performance and aesthetic durability in maxillofacial prostheses. How to cite this article: Peter M, Kanathila H, Bembalagi M, et al. An In Vitro Comparative Evaluation of Conventional and Novel Thymus vulgaris Derived Herbal Disinfectant Solutions against Pathogenic Biofilm on Maxillofacial Silicones and Its Impact on Color Stability. J Contemp Dent Pract 2023;24(12):967-973.