Evaluation of the Effect of Enterococcus faecalis Biofilm on the 2% Chlorhexidine Substantivity: An In Vitro Study

J Endod. 2015 Aug;41(8):1364-70. doi: 10.1016/j.joen.2015.04.016. Epub 2015 May 27.

Abstract

Introduction: The aim of this study was to correlate the bacterial viability and the presence of 2% chlorhexidine (CHX) solution on dentin by means of confocal laser scanning microscopy and high-performance liquid chromatography for 48 hours, 7 days, and 30 days.

Methods: One hundred twenty-three extracted human teeth were used. Samples were divided into 4 groups according to the solution (CHX or saline) and the presence of Enterococus faecalis biofilm. Samples were kept in contact with 5 mL of the solution for 5 minutes. Each group was divided into 3 subgroups according to the evaluation period (n = 10). Statistical analysis was performed by using the Kruskal-Wallis test, the Mann-Whitney U test (P < .05), and the Spearman rank correlation coefficient (P < .01).

Results: There was a negative correlation between the percentage of live cells and the amount of remaining CHX (P = .000). CHX significantly reduced the percentage of viable cells compared with saline after 48 hours (P = .007). Differences were maintained in the 7-day evaluation period (P = .001). After 30 days, the CHX group presented an increase of viable cells, thereby becoming similar to saline (P = .623). Simultaneously, the remaining CHX was significantly reduced in the 30-day specimens (P = .000).

Conclusions: The results of this study indicate that 2% CHX solution was detected for 48 hours and 7 days with a low percentage of viable cells. The presence of microorganisms on human dentin did not affect 2% CHX maintenance.

Keywords: Chlorhexidine; Enterococcus faecalis; substantivity.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology*
  • Biofilms / drug effects*
  • Chlorhexidine / pharmacology*
  • Chromatography, High Pressure Liquid
  • Dental Pulp Cavity / drug effects
  • Dental Pulp Cavity / microbiology
  • Dental Pulp Cavity / pathology
  • Dental Pulp Cavity / physiopathology
  • Dentin / drug effects
  • Dentin / microbiology
  • Dentin / pathology
  • Dentin / physiopathology
  • Enterococcus faecalis / drug effects*
  • Enterococcus faecalis / physiology
  • Enterococcus faecalis / ultrastructure
  • Gram-Positive Bacterial Infections / drug therapy*
  • Gram-Positive Bacterial Infections / pathology
  • Gram-Positive Bacterial Infections / physiopathology
  • Humans
  • Microscopy, Confocal
  • Pulpitis / drug therapy*
  • Pulpitis / pathology
  • Pulpitis / physiopathology
  • Random Allocation
  • Time Factors

Substances

  • Anti-Bacterial Agents
  • Chlorhexidine