Chlorhexidine, Early childhood caries, PCR
Citation Information :
Kalpavriksha AJ, Siddaiah SB, Bilichodmath S, Prabhakara S, Rao HH. Comparative Evaluation of Antibacterial Effect of GIC Containing Chlorhexidine and Miswak on Streptococcus mutans and Streptococcus sobrinus in Early Childhood Caries Children: A PCR Study. Int J Clin Pediatr Dent 2021; 14 (2):229-234.
Background and aim: The therapeutic procedures used in the treatment of caries do not always eliminate all the microorganisms. Persisting cariogenic bacteria can cause recurrent caries and failure of restoration. Incorporation of an antimicrobial agent in the restorative material may be of paramount significance. The purpose of this study was to evaluate and compare the antibacterial effect of glass ionomer cement (GIC) containing CHX and miswak extract on Streptococcus mutans and Streptococcus sobrinus in ECC children using polymerase chain reaction (PCR).
Materials and methods: Forty-five children with ECC in the age-group 3–6 years were selected. The children were randomly allocated into three groups. Supragingival plaque samples (S1) were collected from sound buccal or labial surfaces of primary teeth. Cavity preparation was done and the teeth were restored according to the group to which the child had been allotted. The second plaque sample (S2) was collected 1 month and the final sample after 3 months of restoring all the decayed teeth. All the samples were sent for PCR analysis.
Results: Intergroup analysis was done using Kruskal–Wallis test followed by Mann–Whitney post hoc test showed statistically significant difference in S. mutans and S. sobrinus count between group I (CHX) and group III (control) and group II (miswak) and group III (control) but no statistically significant difference between group I (CHX) and group II (miswak) in S. mutans and S. sobrinus count.
Conclusion: 1% chlorhexidine digluconate and aqueous extract of miswak are equally effective against S. mutans and S. sobrinus. Miswak can be used as an alternative herbal antimicrobial that can be incorporated in anhydrous GIC.
Fejerskov O, Nyvad B, Kidd E. Dental caries. The disease and its clinical management. 3rd ed., West Sussex (UK): Wiley Blackwell; 2015.
Bariker RH, Mandroli PS. An in-vitro evaluation of antibacterial effect of Amalgomer CR and Fuji VII against bacteria causing severe early childhood caries. J Indian Soc Pedod Prev Dent 2016;34(1):23–29. DOI: 10.4103/0970-4388.175506.
Soni H, Vasavada M. Distribution of S. mutans and S. sorbinus in caries active and caries free children by PCR approach. Int J Oral Craniofac Sci 2015;1(1):027–030. DOI: 10.17352/2455-4634.000005.
Çolak H, Dulgergil ÇT, Dalli M, et al. Early childhood caries update: a review of causes, diagnoses, and treatments. J Nat Sci Biol Med 2013;4(1):29–38. DOI: 10.4103/0976-9668.107257.
Singla D, Sharma A, Sachdev V, et al. Distribution of Streptococcus mutans and Streptococcus sobrinus in dental plaque of indian pre-school children using PCR and SB-20M agar medium. J Clin Diagn Res 2016;10(11):60–63. DOI: 10.7860/JCDR/2016/19256.8909.
Choi EJ, Lee SH, Kim YJ. Quantitative real-time polymerase chain reaction for Streptococcus mutans and Streptococcus sobrinus in dental plaque samples and its association with early childhood caries. Int Paediatr Dent 2009;19(2):141–147. DOI: 10.1111/j.1365-263X.2008.00942.x.
Law V, Seow WK, Townsend G. Factors influencing oral colonization of mutans streptococci in young children. Aust Dent J 2007;52(2):93–100. DOI: 10.1111/j.1834-7819.2007.tb00471.x.
Jaidka S, Somani R, Singh DJ, et al. Comparative evaluation of compressive strength, diametral tensile strength and shear bond strength of GIC type IX, chlorhexidine-incorporated GIC and triclosan-incorporated GIC: an in vitro study. J Int Soc Prev Commun Dent 2016;6(Suppl 1):S64–S69. DOI: 10.4103/2231-0762.181188.
Tobias RS, Plant CG, Rippin JW, et al. Pulpal response to an anhydrous glass ionomer luting cement. Endod Dent Traumatol 1989;5(5):242–252. DOI: 10.1111/j.1600-9657.1989.tb00369.x.
Deepalakshmi M, Poorni S, Miglani R, et al. Evaluation of the antibacterial and physical properties of glass ionomer cements containing chlorhexidine and cetrimide: an in-vitro study. Indian J Dent Res 2010;21(4):552–556. DOI: 10.4103/0970-9290.74217.
Mittal S, Soni H, Sharma DK, et al. Comparative evaluation of the antibacterial and physical properties of conventional glass ionomer cement containing chlorhexidine and antibiotics. J Int Soc Prev Community Dent 2015;5(4):268–275. DOI: 10.4103/2231-0762. 161754.
Bellis CA, Addison O, Nobbs AH, et al. Glass ionomer cements with milled, dry chlorhexidine hexametaphosphate filler particles to provide long-term antimicrobial properties with recharge capacity. Dent Mater 2018;34(12):1717–1726. DOI: 10.1016/j.dental.2018.09.003.
Kabil NS, Badran AS, Wassel MO. Effect of the addition of chlorhexidine and miswak extract on the clinical performance and antibacterial properties of conventional glass ionomer: an in vivo study. Int J Paediatr Dent 2016;27(5):380–387. DOI: 10.1111/ipd.12273.
Wassel MO, Khattab MA. Antibacterial activity against Streptococcus mutans and inhibition of bacterial induced enamel demineralization of propolis, miswak, and chitosan nanoparticles based dental varnishes. J Adv Res 2017;8(4):387–392. DOI: 10.1016/j.jare.2017.05.006.
Bawazeer TM, Alsoufi MS, Katowah D, et al. Effect of aqueous extracts of Salvadora persica “Miswak” on the acid eroded enamel surface at nano-mechanical scale. Mater Sci Appl 2016;7(11):754–771.
Kawashita Y, Kitamura M, Saito T. Early childhood caries. Int J Dent 2011;2011:725320. DOI: 10.1155/2011/725320.
Okada M, Soda Y, Hayashi F, et al. PCR detection of Streptococcus mutans and S. sobrinus in dental plaque samples from Japanese pre-school children. J Med Microbiol 2002;;51(5):443–447. DOI: 10.1099/0022-1317-51-5-443.
Banas JA. Virulence properties of Streptococcus mutans. Front Biosci 2004;9(10):1267–1277. DOI: 10.2741/1305.
Conrads G, de Soet JJ, Song L, et al. Comparing the cariogenic species Streptococcus sobrinus and S. mutans on whole genome level. J Oral Microbiol 2014;6(1):26189. DOI: 10.3402/jom.v6.26189.
Duque C, Aida KL, Pereira JA, et al. In vitro and in vivo evaluations of glass-ionomer cement containing chlorhexidine for atraumatic restorative treatment. J Appl Oral Sci 2017;25(5):541–550. DOI: 10.1590/1678-7757-2016-0195.
Turkun LS, Turkun M, Ertug Rul FA, et al. Long-term antibacterial effects and physical properties of a chlorhexidine-containing glass ionomer cement. J Esthet Restor Dent 2008;20(1):29–44. DOI: 10.1111/j.1708-8240.2008.00146.x.
Sajjan P, Laxminarayan N, Kar PP, et al. Chlorhexidine as an antimicrobial agent in dentistry–a review. Oral Health Dent Manag 2016;15(2):93–100.
Kumar SB. Chlorhexidine mouthwash — a review. J Pharm Sci Res 2017;9(9):1450–1452.
Prabhakar AR, Agarwal S, Basappa N. Comparative evaluation of antibacterial effect and physical properties of conventional glass-ionomer cement containing 1% chlorhexidine and 1% xylitol. Int J Oral Health Sci 2014;4(2):63–69. DOI: 10.4103/2231-6027.165103.
Mishra A, Pandey RK, Manickam N. Antibacterial effect and physical properties of chitosan and chlorhexidine-cetrimide-modified glass ionomer cements. J Indian Soc Pedodontics Prev Dent 2017;35(1):28–33. DOI: 10.4103/0970-4388.199224.
Zeng P, Rao A, Wiedmann TS, et al. Solubility properties of chlorhexidine salts. Drug Dev Ind Pharm 2009;35(2):172–176. DOI: 10.1080/03639040802220318.
Marti LM, Mata MD, Ferraz-Santos B, et al. Addition of chlorhexidine gluconate to a glass ionomer cement: a study on mechanical, physical and antibacterial properties. Braz Dent J 2014;25(1):33–37. DOI: 10.1590/0103-6440201302328.
Grönroos L, Mättö J, Saarela M, et al. Chlorhexidine susceptibilities of mutans streptococcal serotypes and ribotypes. Antimicrob Agents Chemother 1995;39(4):894–898. DOI: 10.1128/AAC.39.4.894.
Khalil AK, Qarani SM, Omer AG. In vitro antimicrobial activity of Miswak extracts against some oral pathogenic isolates. Zanco J Med Sci 2010;14(1):71–78.
El-Latif Hesham A, Alrumman SA. Antibacterial activity of miswak Salvadora persica extracts against isolated and genetically identified oral cavity pathogens. Technol Health Care 2016;24(s2):S841–S848. DOI: 10.3233/THC-161214.
Balto H, Al-Sanie I, Al-Beshri S, et al. Effectiveness of Salvadora persica extracts against common oral pathogens. Saudi Dent J 2017;29(1):1–6. DOI: 10.1016/j.sdentj.2016.11.001.
Darout IA, Albandar JM, Skaug N, et al. Salivary microbiota levels in relation to periodontal status, experience of caries and miswak use in Sudanese adults. J Clin Periodontol 2002;29(5):411–420. DOI: 10.1034/j.1600-051x.2002.290505.x.
Abhary M, Al-Hazmi AA. Antibacterial activity of Miswak (Salvadora persica L.) extracts on oral hygiene. J Taibah Univ Sci 2015;10(4):513–520. DOI: 10.1016/j.jtusci.2015.09.007.
Sofrata AH, Claesson RL, Lingström PK, et al. Strong antibacterial effect of miswak against oral microorganisms associated with periodontitis and caries. J Periodontol 2008;79(8):1474–1479. DOI: 10.1902/jop.2008.070506.
Naseem S, Hashmi K, Fasih F, et al. In vitro evaluation of antimicrobial effect of miswak against common oral pathogens. Pak J Med Sci 2014;30(2):398–403. DOI: 10.12669/pjms.302.4284.
El-Tatari A, De Soet JJ, De Gee AJ, et al. Influence of Salvadora persica (miswak) extract on physical and antimicrobial properties of glass ionomer cement. Eur Arch Paediatri Dent 2011;12(1):22–25.