Effects of Chlorhexidine on the Microflora on Root Surfaces

Objectives:The aim of the study was to examine the effects of fluoride and chlorhexidine varnishes on the microflora on root surfaces. Methods:33 patients(mean age 54.13 years,SD 8.00)in periodontal maintenance care with at least one tooth with gingival recession in each quadrant were included. A split mouth design was used three test teeth (gr.2-4) and one control tooth (gr. 1).48 hours before baseline, all patients received a professional tooth cleaning.At baseline, plaque samples were taken from test and control teeth, followed by polishing of all teeth.In each patient, plaque samples were taken from buccal surfaces as well as mesial and distal line angles of each tooth.The samples were cultivated on a serie of selective media.The test quadrant was treated with either Duraphat(2,26% fluoride, group 2),Cervitec(1% Chlorhexidine,group 3),or EC40(40% chlorhexidine,group 4);the control quadrant did not receive any additional treatment(group 1).Every three months,the whole procedure was repeated. Clinical(status of caries)and microbiological examinations were performed at baseline and after two years.The total cultivable flora and percentage of Actinomyces(AAC),Mutans streptococci(MS)and Lactobacilli (LB)of total cultivable flora were analyzed.Data analysis was accomplished using Wilcoxon test(SPSS 11.0). Results:No additionally carious root surface lesions were observed during the study period. For each group,the difference of total cultivable flora showed no statistically significant differences between baseline and final examination. However the specific analysis in percentage of AAC, MS, LB of total cultivable flora revealed statistically significant differences.[statistically significant(p<0.001)] AAC (median) % in total cultivable flora Baseline:[20.50(gr.1),19.10(gr.2),11.05(gr.3),13.95(gr.4)] Final:[0.00(gr.1),0.002(gr.2),0.01(gr.3),0.005(gr.4)] MS (median) % in total cultivable flora Baseline:[4.80(gr.1),4.20(gr.2),4.00(gr.3),2.50(gr.4)] Final::[0.09(gr.1),0.02(gr.2),0.23(gr.3),0.15(gr.4)] LB (median) % in total cultivable flora Baseline:[0.25(gr.1),0.15(gr.2),0.10(gr.3),0.10(gr.4)] Final::[0.00(gr.1),0.00(gr.2),0.00(gr.3),0.00(gr.4)] There was statistically significant differences between baseline and final examination for each group. Conclusions: the results suggest, that professional tooth cleaning alone four times a year might be equally effective as the treatment with fluoride (Duraphat) or chlorhexidine (EC 40) to reduce AAC,MS,and LB.