ANTIBACTERIAL EFFECT OF 0.2% CHLORHEXIDINE AND 1% CHITOSAN MOUTHWASH ON BACTERIA DURING ORTHODONTIC MINISCREW USE

ERLINA HASRIATI; HARU SETYO ANGGANI; MARIA PURBIATI; ENDANG WINIATI BACHTIAR

doi:10.22159/ijap.2020.v12s2.OP-07

Authors

ERLINA HASRIATI Orthodontics Residency Program, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
HARU SETYO ANGGANI Department of Orthodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
MARIA PURBIATI Department of Orthodontics, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.
ENDANG WINIATI BACHTIAR Department of Oral Biology, Faculty of Dentistry, Universitas Indonesia, Jakarta, Indonesia.

DOI:

https://doi.org/10.22159/ijap.2020.v12s2.OP-07

Keywords:

Orthodontic miniscrew, Chitosan, Chlorhexidine, Red-complex bacteria, Mouthwash

Abstract

Objective: Inflammation is one of the most common complications observed when using orthodontic miniscrews. Chlorhexidine mouthwash can be
used to prevent and reduce the degree of inflammation, but long-term use of this solution may lead to some side effects. This study sought to evaluate
the peri-miniscrew antibacterial effect of 1% chitosan, a biomaterial with antibacterial properties, relative to 0.2% chlorhexidine mouthwash.
Methods: A randomized, double-blind clinical trial was conducted at the Dental Teaching Hospital and Oral Biology Research Laboratory at the
University of Indonesia from February to June 2019. Thirty subjects (25 females and five males) were randomly assigned to rinse with 1% chitosan
(n=10), 0.2% chlorhexidine digluconate (n=10), and Aquadest (n=10) in addition to their usual oral hygiene procedure for 4 days. Peri-miniscrew
clinical inflammation signs were recorded and peri-miniscrew plaque collected before and after 4 days of rinsing. The total bacterial and red-complex
bacteria count in plaque samples were evaluated by a real-time polymerase chain reaction.
Results: Chitosan and chlorhexidine showed antibacterial activity, reducing total bacterial count around orthodontic miniscrews (p<0.05). The
antibacterial activity of chitosan on total bacteria was not significantly different from that of chlorhexidine (p≥0.05). Regarding the antibacterial
activity of chitosan on red-complex bacteria, the best result seen was a 58% bacteria count reduction in Tannerella denticola.
Conclusion: Chitosan has potential antibacterial activity and could be used in mouthwash to maintain peri-miniscrew hygiene.

Downloads

Download data is not yet available.

References

1. Jasoria G, Shamim W, Rathore S, Kalra A, Manchanda M, Jaggi N.
Miniscrew implants as temporary anchorage devices in orthodontics: A
comprehensive review. J Contemp Dent Pract 2013;14:993-9.
2. Papadopoulos MA, Tarawneh F. Miniscrew implants for temporary
skeletal anchorage in orthodontic treatment. In: Skeletal Anchorage in
Ortodontic Treatment of Class II Malocclusion. New York: Elsevier,
Mosby; 2015. p. 58-65.
3. Kravitz ND, Kusnoto B. Risks and complications of orthodontic
miniscrews. Am J Orthod Dentofac Orthop 2007;131 Suppl 4:43-51.
4. Sato R, Sato T, Takahashi I, Sugawara J, Takahashi N. Profiling of
bacterial flora in crevices around titanium orthodontic anchor plates.
Clin Oral Implants Res 2007;18:21-6.
5. Tallarico M, Canullo L, Caneva M, Özcan M. Microbial colonization
at the implant-abutment interface and its possible influence on
periimplantitis: A systematic review and meta-analysis. J Prosthodont
Res 2017;61:233-41.
6. Balagopal S, Arjunkumar R. Chlorhexidine: The gold standard
antiplaque agent. J Pharm Sci Res 2013;5:270-4.
7. Gürgan CA, Zaim E, Bakirsoy I, Soykan E. Short-term side effects
of 0.2% alcohol-free chlorhexidine mouthrinse used as an adjunct to
non-surgical periodontal treatment: A double-blind clinical study. J
Periodontol 2006;77:370-84.
8. Verlee A, Mincke S, Stevens CV. Recent developments in antibacterial
and antifungal chitosan and its derivatives. Carbohydr Polym
2017;164:268-83.
9. Benhabiles MS, Salah R, Lounici H, Drouiche N, Goosen MF,
Mameri N. Antibacterial activity of chitin, chitosan and its oligomers
prepared from shrimp shell waste. Food Hydrocoll 2012;29:48-56.
10. Ibrahim B, Suptijah P, Zahid A. Efektivitas kitosan mikrokristalin
sebagai alternatif antibakteri alami dalam mouthwash. J Pengolah Has
Perikan Indones 2012;15:119-26.
11. Monga N, Chaurasia S, Kharbanda OP, Duggal R, Rajeswari MR.
A study of interleukin 1-? levels in peri-miniscrew crevicular fluid
(PMCF). Prog Orthod 2014;15:30.
12. Park HS, Jeong SH, Kwon OW. Factors affecting the clinical success of
screw implants used as orthodontic anchorage. Am J Orthod Dentofac
Orthop 2006;130:18-25.
13. Kotsilkov K, Popova C, Boyanova L, Setchanova L, Mitov I.
Comparison of culture method and real-time PCR for detection of
putative periodontopathogenic Bacteria in deep periodontal pockets.
Biotechnol Biotechnol Equip 2015;29:996-1002.
14. Sedgley CM, Nagel AC, Shelburne CE, Clewell DB, Appelbe O,
Molander A. Quantitative real-time PCR detection of oral Enterococcus
faecalis in humans. Arch Oral Biol 2005;50:575-83.
15. Suzuki N, Yoshida A, Nakano Y. Quantitative analysis of multi-species
oral biofilms by taqman real-time PCR. Clin Med Res 2005;3:176-85.
16. Ntolou P, Tagkli A, Pepelassi E. Factors related to the clinical application
of orthodontic mini-implants. J Int Oral Health 2018;10:103-10.
17. Cheng S, Tseng IY, Lee JJ, Kok SH. A prospective study of the risk
factors associated with failure of mini-implants used for orthodontic
anchorage. Int J Oral Maxillofac Implants 2004;19:100-6.
18. Miyawaki S, Koyama I, Inoue M, Mishima K, Sugahara T, Takano-
Yamamoto T. Factors associated with the stability of titanium screws
placed in the posterior region for orthodontic anchorage. Am J Orthod
Dentofac Orthop 2003;124:373-8.
19. Lyczek J, Antoszewska-Smith J. Fundamental factors related to
orthodontic micro-implant stability : Review of the literature. Dent
Med Probl 2017;54:189-93.
20. Osório A, De Freitas A, Gonçalves C. Microbial colonization in
orthodontic mini-implants. Braz Dent J 2012;23:422-7.
21. Daokar SS, Agarwal G. Orthodontic implant failure: A systematic
review. Int J Oral Implantol Clin Res 2016;7:1-6.
22. Livak KJ, Schmittgen TD. Analysis of relative gene expression data
using real-time quantitative PCR and the 2-??CT method. Methods
2001;25:402-8.
23. Apel S, Apel C, Morea C, Tortamano A, Dominguez GC, Conrads G.
Microflora associated with successful and failed orthodontic miniimplants.
Clin Oral Implants Res 2009;20:1186-90.
24. Jaiswal N, Sinha DJ, Singh UP, Singh K, Jandial UA, Goel S.
Evaluation of antibacterial efficacy of chitosan, chlorhexidine, propolis
and sodium hypochlorite on Enterococcus faecalis biofilm: An in vitro
study. J Clin Exp Dent 2017;9:e1066-74.
25. Younes I, Sellimi S, Rinaudo M, Jellouli K, Nasri M. Influence of
acetylation degree and molecular weight of homogeneous chitosans
on antibacterial and antifungal activities. Int J Food Microbiol
2014;185:57-63.