sodium-hypochlorite and Periodontal-Diseases

The present study aimed to establish the efficacy of sodium hypochlorite mouthwash (NaOCl-MW) compared with a control mouthwash on plaque and clinical parameters of periodontal disease.. MEDLINE-PubMed, Embase and Cochrane-CENTRAL databases were searched for clinical trials on patients with gingivitis or periodontitis that assessed the effect of NaOCl-MW in comparison with a negative or positive control on plaque index (PI), gingival index (GI), and bleeding index (BI) scores and probing pocket depth (PPD). Data were extracted from the eligible studies.. Seven eligible papers were retrieved, which together represented six clinical trials. The studies showed considerable heterogeneity regarding methodological and clinical aspects that did not permit a meta-analysis. Two of the three studies in which NaOCl-MW was compared with a negative control showed that NaOCl-MW significantly reduced PI, GI and BI, and no effect was found on PPD. In three studies, NaOCl-MW was assessed using chlorhexidine mouthwash (CHX-MW) as a positive control; no difference was found for GI and BI. One of the three comparisons showed a statistically significant PI score favouring NaOCl-MW. One study measured PPD and found it to be significant in favour of NaOCl-MW.. Studies with a negative control group provided very weak quality evidence for a very small beneficial effect of NaOCl-MW on PI, GI and BI scores. Studies with a positive control group provided very weak quality evidence that NaOCl-MW had a similar effect as CHX-MW on PI, GI and BI scores. The outcome for PPD was inconclusive.

Topics: Chlorhexidine; Dental Plaque; Gingivitis; Humans; Mouthwashes; Periodontal Diseases; Sodium Hypochlorite

Topics: Anti-Infective Agents, Local; Biofilms; Humans; Periodontal Diseases; Sodium Hypochlorite; Therapeutic Irrigation

The recognition over the past 3 decades of microbial specificity in periodontitis has afforded dental practitioners the ability to prevent and treat the disease with a variety of antimicrobial drugs. These include systemic antibiotics, topical antibiotics and topical antiseptics.. Systemic antibiotic therapy can be essential in eliminating pathogenic bacteria that invade gingival tissue and in helping control periodontal pathogens residing in various domains of the mouth from where they may translocate to periodontal sites. Frequently used periodontal combination antibiotic therapies are metronidazole-amoxicillin (250-375 mg of each 3 x daily for 8 days) and metronidazole-ciprofloxacin (500 mg of each 2 x daily for 8 days). Microbiological analysis helps determine the optimal antibiotic therapy and effectiveness of treatment. Topical antibiotics that are commercially available as controlled release devices suffer from several potential problems, including insufficient spectrum of antimicrobial activity in some periodontal polymicrobial infections, risks of producing an antibiotic resistant microbiota, and high acquisition costs. Topical antiseptics of relevance in periodontal treatment include 10% povidone-iodine placed subgingivally by a syringe for 5 min, and 0.1% sodium hypochlorite solution applied subgingivally by patients using an irrigation device.. The present paper recommends periodontal treatment that includes a battery of professionally and patient-administered antimicrobial agents (properly prescribed systemic antibiotics, povidone-iodine and sodium hypochlorite subgingival irrigants, and chlorhexidine mouthrinse). Available chemotherapeutics can provide effective, safe, practical and affordable means of controlling subgingival colonization of periodontal pathogens and various types of periodontal disease.

Topics: Administration, Topical; Amoxicillin; Anti-Bacterial Agents; Anti-Infective Agents, Local; Ciprofloxacin; Delayed-Action Preparations; Drug Combinations; Humans; Metronidazole; Penicillins; Periodontal Diseases; Periodontitis; Povidone-Iodine; Sodium Hypochlorite; Therapeutic Irrigation; Treatment Outcome

To investigate the clinical and microbiological effects of local disinfection with 0.5% sodium hypochlorite (NaOCl) with or without systemic antimicrobials (amoxicillin and metronidazole, AM) during basic periodontal therapy (BPT).. In a randomized clinical trial (four groups), 110 chronic periodontitis patients received BPT plus local irrigation with saline (BPT + S), local disinfection with NaOCl (BPT + DIS), BPT + DIS + AM or BPT + S + AM. The outcome was analysed at baseline, 3, 6 and 12 months.. There was no difference in clinical attachment level gain at 12 months between the four groups. BPT + DIS showed no additional improvement compared to BPT + S; BPT + DIS + AM showed fewer sites with probing pocket depth (PPD) ≥7 mm versus BPT + S only up to 6 months (p = 0.037). In factorial analyses, additional clinical reduction for PPD (p = 0.023) and number of sites with PPD ≥5 (p = 0.007), ≥6 (p = 0.002) and ≥7 mm (p < 0.001) were found when AM was added to BPT, but not when DIS was applied. In all groups, a comparable decrease in targeted bacteria was found. AM caused adverse events in 22% of the patients.. Local disinfection with NaOCl, also in combination with AM, showed, after 1-year follow-up, no additional clinical and microbiological effects compared to BPT alone.

Topics: Amoxicillin; Anti-Bacterial Agents; Dental Scaling; Disinfection; Follow-Up Studies; Humans; Metronidazole; Periodontal Diseases; Sodium Hypochlorite

The aim of the present study was to assess the antimicrobial activity of a sodium hypochlorite formulation including its components against bacteria associated with periodontal disease.. Sodium hypochlorite formulation (NaOCl gel), its components sodium hypochlorite (NaOCl), and the activating vehicle were compared with 0.1 % chlorhexidine digluconate (CHX) solution. The antimicrobial activity was proven by determination of minimal inhibitory concentrations (MIC), minimal bactericidal concentrations, and killing assays. Furthermore, the influence on formation as well as on a 4-day-old 6-species biofilm was tested.. Except for one strain (Parvimonas micra ATCC 33270 in case of NaOCl gel), the MICs both of the CHX solution and NaOCl gel did not exceed 10 % of the formulations' concentration. In general, MICs of the NaOCl gel were equal as of the CHX solution against Gram-negatives but higher against Gram-positive bacteria. CHX but not NaOCl gel clearly inhibited biofilm formation; however, the activity of NaOCl gel was more remarkable on a 4-day-old biofilm. NaOCl killed bacteria in the biofilm and interfered with the matrix.. The NaOCl gel acts antimicrobial in particular against Gram-negative species associated with periodontitis. Moreover, its component NaOCl hypochlorite is able to alter biofilm matrices.. The NaOCl gel may represent a potential alternative for adjunctive topical antimicrobial treatment in periodontitis.

Topics: Anti-Infective Agents, Local; Biofilms; Chlorhexidine; Gels; In Vitro Techniques; Microbial Sensitivity Tests; Periodontal Diseases; Sodium Hypochlorite; Stem Cells

Some lasers have demonstrated to provide effective disinfection when used as adjunctive device to the conventional treatment. The aim of this in vitro study was to determine the effectiveness of the erbium, chromium:yttrium scandium gallium garnet (Er, Cr:YSGG) laser by measuring its bactericidal effect inside the root canal experimentally colonized with Enterococcus faecalis. The laser was tested at different irradiation times (30 and 60 s) and energy of impulses (75 and 25 mJ). A total of 52 single-rooted extracted human teeth were endodontically prepared with rotary instrumentation. All were sterilized and inoculated with a suspension of E. faecalis (105 bacteria/ml). The teeth were randomized into three treatment (group 1, group 2, and group 3) and one control groups. In all groups, teeth were chemically irrigated with 5.25% sodium hypochlorite and 17% ethylenediaminetetraacetic acid. Groups 1 and 2 were also irradiated at 30 and 60 s, respectively, with an Er, Cr:YSGG laser at 75 mJ. Teeth of group 3 were treated with laser for 60 s at 25 mJ. Samples were processed to detect the presence of E. faecalis. For all groups, a bactericidal effect was observed. The use of laser at 75 mJ with an irradiation time of 30 and 60 s eliminated a percentage of 92.3 and 100% of E. faecalis, respectively. In the control group, a reduction of 92.3% was observed. Lower percentage of reduction (46.1%) was obtained in teeth treated with laser at 25 mJ for 60 s. No statistical differences were observed between the groups (P = 0.543, Fisher's exact test). The results indicated a bactericidal effect of Er, Cr:YSGG laser irradiation at the settings used in this study. The highest bactericidal effect of this laser was observed at 60 s of irradiation time, using an energy pulse of 75 mJ.

Topics: Dental Caries; Dental Pulp Cavity; Disinfectants; Disinfection; Enterococcus faecalis; Erbium; Gram-Positive Bacterial Infections; Humans; Lasers; Lasers, Solid-State; Models, Dental; Periodontal Diseases; Root Canal Therapy; Sodium Hypochlorite; Tooth Root

Topics: Administration, Topical; Anti-Infective Agents, Local; Bacteria; Humans; Mouth; Mouthwashes; Periodontal Diseases; Sodium Hypochlorite

Topics: Citrates; Dental Pulp Diseases; Dentin; Edetic Acid; Humans; Periodontal Diseases; Root Canal Irrigants; Sodium Hypochlorite; Ultrasonic Therapy

Topics: Bacteria; Citrates; Citric Acid; Collagen; Dental Cementum; Dental Scaling; Endotoxins; Humans; Periodontal Diseases; Sodium Hypochlorite; Tooth Root

Root surfaces, exposed by periodontal disease, were studied after treatment with sodium hypochlorite. Observations of the anorganic specimens demonstrated that substantial changes occur in root surfaces incident to periodontal disease. A mineralized surface coating was seen in all areas of the involved root surface, although local regions occurred where the coating was apparently unmineralized. These findings generally confirmed the results of a previous study where the same specimens were studied without hypochlorite treatment. It is concluded that the coating is probably identical to the dental cuticle, and stems from adsorption of components of the gingival inflammatory exudate to the root surface. The coating may also be the carrier matrix for exogenous cytotoxic substances, previously thought to be located in the cementum. The findings may have implications for the way of treating periodontitis-involved root surfaces.

Topics: Calcinosis; Dental Cementum; Dental Enamel; Humans; Microscopy, Electron, Scanning; Periodontal Diseases; Periodontal Pocket; Sodium Hypochlorite; Surface Properties; Tooth Root

Topics: Citrates; Citric Acid; Humans; Periodontal Diseases; Sodium Hypochlorite; Subgingival Curettage

Topics: Citrates; Citric Acid; Dental Scaling; Humans; Oral Hygiene; Periodontal Diseases; Periodontitis; Sodium Hypochlorite; Tooth Root; Toothbrushing

Topics: Blood Proteins; Citrates; Citric Acid; Dental Scaling; Deoxycholic Acid; Edetic Acid; Endotoxins; Humans; Immunosuppressive Agents; Periodontal Diseases; Sodium Hypochlorite; Tooth Root

This study evaluated the effects of chemical and biologic agents on periodontally diseased root surfaces which had been scaled or root planed. The proximal surfaces of 25 teeth were scaled to remove all visible calculus, and the proximal surfaces of another 25 teeth were vigorously root planed to remove all cementum and to achieve a hard, smooth, glass-like surface. Five scaled and five root planed specimens were randomly selected for light microscopic examination to determine the amount of cementum removed. Cementum remained on all scaled surfaces but root planing had removed most of the more coronal cementum. Each of the 40 remaining teeth (20 scaled and 20 root planed) was longitudinally sectioned to obtain an experimental and control specimen. Four scaled and four root planed sections were randomly selected as experimental specimens for a test of each of the following five agents: (1) saturated citric acid for three minutes; (2) 15% EDTA for 5 minutes; (3) sodium hypochlorite for 5 minutes, followed by a 30-second application of 5% citric acid; (4) sodium hypochlorite alone for 5 minutes; and (5) 2% sodium deoxycholate (NAD) for 1 minute, followed by a 1-minute rinse in distilled water, and then a 1-minute application of 5% Cohn's fraction IV1. The control for each experimental specimen was treated with saline. All samples were prepared for SEM and examined at 3,000 X. Areas of particular interest were also examined at 12,000 X. The chemical treatments exposed only individual collagen fibers or irregular fiber bundles on the scaled surfaces. Saturated citric acid, EDTA, and sodium hypochlorite with citric acid neutralization removed debris and exposed openings in the root surfaces. Sodium hypochlorite alone and NaD/Cohn's fraction IV1 were less effective in removing surface debris and had an effect similar to that seen in the saline controls. Application to root planed specimens of saturated citric acid, EDTA, and sodium hypochlorite followed by 30 seconds of citric acid neutralization resulted in surfaces virtually free of debris and with numerous collagen fibers exposed on the surface. EDTA appeared to cause a morphologic change in the collagen fibers. Sodium hypochlorite alone, sodium deoxycholate followed by Cohn's fraction IV1, and physiologic saline were relatively ineffective in surface debridement.

Topics: Adult; Blood Proteins; Citrates; Citric Acid; Dental Scaling; Deoxycholic Acid; Edetic Acid; Endotoxins; Humans; Microscopy, Electron, Scanning; Periodontal Diseases; Pharmacology; Sodium Hypochlorite; Tooth Root

Topics: Adolescent; Aggressive Periodontitis; Bacteria; Child; Dental Plaque; Gingiva; Humans; Periodontal Diseases; Sodium Hypochlorite; Subgingival Curettage

Topics: Anti-Bacterial Agents; Humans; Periodontal Diseases; Periodontal Pocket; Sodium Hypochlorite

Topics: Acetaminophen; Adult; Brompheniramine; Dental Caries; Edema; Female; Humans; Iatrogenic Disease; Oral Hemorrhage; Periapical Tissue; Periodontal Diseases; Pulpectomy; Root Canal Obturation; Root Canal Therapy; Sodium Hypochlorite; Tetracycline; Therapeutic Irrigation

Topics: Caustics; Connective Tissue; Disease; Humans; Periodontal Diseases; Periodontal Pocket; Periodontium; Sodium Hypochlorite

Topics: Chlorine; Humans; Periodontal Diseases; Sodium Hypochlorite