Orientadores: Brenda Paula Figueiredo de Almeida Gomes, Caio Cezar Randi Ferraz / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba / Made available in DSpace on 2018-08-27T00:47:36Z (GMT). No. of bitstreams: 1 Barbosa-Ribeiro_Marlos1986-_M.pdf: 4792753 bytes, checksum: 592cb57914c07a67f1cf0d83a084cbe7 (MD5) Previous issue date: 2015 / Resumo: O conhecimento da comunidade microbiana e do seu potencial antigênico é importante para o entendimento da patogênese da periodontite apical em dentes endodonticamente tratados. Os objetivos do presente estudo foram: 1) Caracterizar a microbiota associada ao insucesso endodôntico através do teste bioquímico, Nested PCR e sequenciamento parcial do gene 16S rRNA; 2) Quantificar endotoxinas (LPS) por meio do teste Limulus Amebocyte Lysate (LAL) e citocinas pró-inflamatórias IL-1?, IL-1?, TNF-? e PGE2 através do ensaio imunoenzimático (ELISA), correlacionando-as com aspectos clínicos e radiográficos dos pacientes; 3) Avaliar o efeito do preparo químico-mecânico (PQM) e medicação intracanal (MIC) na redução de microrganismos, LPS e de citocinas pró-inflamatórias. Foram coletadas amostras do conteúdo endodôntico de 20 dentes unirradiculares antes (C1), após o PQM (C2), após o uso de EDTA 17% (C3) agitado com ultrassom, e após a MIC (C4). Utilizaram-se materiais estéreis e/ou apirogênicos e técnicas assépticas durante as coletas. Após o processamento laboratorial das amostras, os dados foram tabulados e analisados pelos testes estatísticos Qui-quadrado, Correlação de Spearman e ANOVA (Tukey-Kramer). Os resultados apontaram a presença de uma microbiota mista contendo bactérias Gram positivas e Gram negativas. Quatro diferentes filos foram identificados: Actinobacteria, Firmicutes, Fusobacteria e Proteobacteria. Enterococcus faecalis foi a espécie mais prevalente, identificada fenotipicamente (19/158) e genotipicamente (42/158). O sequenciamento conseguiu identificar 10,12% das amostras em nível de gênero e 89,88% em nível de espécie, enquanto que o teste bioquímico identificou 13,29% e 51,26%, respectivamente. As bactérias mais prevalentes identificadas por Nested PCR foram: Enterococcus faecalis (97,5%), seguido de Porphyromonas gingivalis (88,75%), Fusobacterium nucleatum (56,25%) e Aggregatibacter actinomycetemcomitans (37,5%). O PQM reduziu bactérias em 96,69% (p<0,05), com percentual de redução para Clorexidina (CLX) 2% gel em 99,3% e para NaOCl 6% em 92,1% (p>0,05). O EDTA 17% somente mostrou efeito complementar na redução bacteriana no grupo do NaOCl 6% (p<0,05). Apenas a CLX 2% gel foi efetiva na redução de endotoxinas comparado ao NaOCl 6% e EDTA 17% (P<0,05). O PQM, independentemente da substância química utilizada, foi efetivo na redução dos níveis das citocinas pró-inflamatórias Il-1? (88,14%), Il-1? (89,33%), TNF-? (89,85%) e PGE2 (48,60%) (p<0,05). A MIC não mostrou efeito aditivo na redução de bactérias e citocinas pró-inflamatórias em ambos os grupos (p<0,05); e somente apresentou ação sobre LPS no grupo Ca(OH)2 + CLX 2% gel (p<0,05). Houve correlação positiva ente bactérias, LPS, citocinas pró-inflamatórias e os aspectos clínicos e radiográficos dos pacientes (P<0,05). Conclui-se que o PQM apresentou efeito significante na redução do conteúdo infeccioso de canais radiculares de dentes com insucesso do tratamento endodôntico, enquanto que a MIC não mostrou efeito aditivo significante na redução desses níveis / Abstract: The knowledge of the microbial community and its antigenic potential is important for understanding the pathogenesis of apical periodontitis in endodontically treated teeth. The objectives of this study were: 1) Characterize the microbiota associated to endodontic failure through the biochemical test, Nested PCR and partial sequencing of gene 16S rRNA.; 2) Quantify endotoxin (LPS) by Limulus Amebocyte Lysate test and pro-inflammatory cytokines IL-1?, IL-1?, TNF-? and PGE2 by enzyme-linked immunosorbent assay, correlating them with the patients' clinical and radiographic features; 3) To evaluate the effect of chemo-mechanical preparation (CMP) and intracanal medications (ICM) in reducing microorganisms, LPS and pro-inflammatory cytokines. Samples of endodontic content of 20 single-rooted teeth were collected before (C1), after CMP (C2), after the use of 17% EDTA (C3) agitated with ultrasound, and after ICM (C4). Sterile/apyrogenic materials and a aseptic techniques were used during the samples' collection. After processing the samples, the data were tabulated and analyzed by statistical testes Chi-square, Spearman correlation, and analysis of variance (Tukey-Kramer). The results indicated the presence of a mixed microbiota presenting Gram positive and Gram negative bacteria. Four different phyla were identified: Actinobacteria, Firmicutes, Proteobacteria and Fusobacterium. Enterococcus faecalis was the most prevalent species, identified phenotypically (19/158) and genotypically (42/158). Sequencing was able to identify 10.12% of the samples at the genus level and 89.88% at the species level, whereas the biochemical test identified 13.29% and 51.26%, respectively. The most prevalent bacteria by Nested PCR were: Enterococcus faecalis (97.5%), followed by Porphyromonas gingivalis (88.75%), Fusobacterium nucleatum (56.25%) and Aggregatibacter actinomycetemcomitans (37.5%). CMP reduced bacteria in 96.69% (p<0.05), with a percentage reduction in 99.3% for 2% CLX gel and in 92.1% for 6% NaOCl (p>0.05). EDTA 17% showed only a further effect on bacterial reduction in the 6% NaOCl group (p<0.05). Only 2% CLX gel was effective in reducing endotoxin compared to 6% NaOCl and 17% EDTA (p<0.05). CMP regardless of chemical substance used, was effective in reducing the levels of pro-inflammatory cytokines IL-1? (88.14%), IL-1? (89.33%), TNF-? (89.85%) and PGE2 (48.60%) (p<0.05).The intracanal medication not show additive effect in reducing bacteria and proinflammatory cytokines in both groups (p<0.05); and only presented action against LPS in the Ca(OH)2 + 2% CLX gel group (p<0.05). There was a positive correlation between bacteria, LPS, pro-inflammatory cytokines and clinical and radiographic features (p<0.05). In conclusion, CMP presented a significant effect in reducing the infectious content of root canal of teeth with endodontic failure, while ICM showed no significant additive effect in reducing these levels / Mestrado / Endodontia / Mestre em Clínica Odontológica

Submitted by Renata Lopes (renatasil82@gmail.com) on 2015-12-07T17:01:41Z No. of bitstreams: 1 carolinaoliveiradeandradefurtado.pdf: 2894297 bytes, checksum: f089f62fc6081d6501fc211279a846ba (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2015-12-07T21:41:56Z (GMT) No. of bitstreams: 1 carolinaoliveiradeandradefurtado.pdf: 2894297 bytes, checksum: f089f62fc6081d6501fc211279a846ba (MD5) / Made available in DSpace on 2015-12-07T21:41:56Z (GMT). No. of bitstreams: 1 carolinaoliveiradeandradefurtado.pdf: 2894297 bytes, checksum: f089f62fc6081d6501fc211279a846ba (MD5) Previous issue date: 2015-04-29 / CAPES - Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A clorexidina (CHX) é um agente antimicrobiano com capacidade de retardar a ação das metaloproteinases em tecido dentinário condicionado com ácido fosfórico. Mas, especula-se que os produtos de sua reação podem interferir química e fisicamente sobre os valores imediatos de resistência da união (TBS) dos adesivos autocondicionantes universais. O objetivo foi analisar a influência do tratamento da destina com solução de CHX a 2% previamente a aplicação dos adesivos autocondicionantes e universais sobre TBS. Superfícies oclusais de 20 molares humanos hígidos foram removidas para expor superfície dentinária média. Estes foram divididos em 8 grupos de acordo com o tipo de tratamento submetido: SEself- aplicação do sistema adesivo Clearfil SE Bond de acordo com as instruções do fabricante; SEself + CHX: aplicação prévia da clorexidina por 20 s seguido pela lavagem; SBself: aplicação do adesivo Scotchbond Universal de acordo com as instruções do fabricante no modo autocondicionante; SBself + CHX: aplicação prévia de CHX por 20 s seguido da secagem; SEtotal: condicionamento com ácido fosfórico a 35% por 15 s seguido da lavagem, secagem, primer ácido por 10 s, adesivo e fotoativação deste por 10 s; SEtotal + CHX: sequência técnica semelhante ao anterior, porém com aplicação de CHX após o condicionamento ácido; SBtotal: aplicação do adesivo de acordo com as instruções do fabricante no modo condiciomento ácido total; SBtotal + CHX: após o condicionamento com ácido fósforico, a CHX foi aplicada por 20 s seguido pela secagem e aplicação do adesivo. Blocos em resina composta com 5 mm foram construídos sobre as superfícies hibridizadas, seccionados em palitos de 1 mm2 e armazenados em água deionizada a 37 ºC por 24 horas. Após, os corpos de prova foram submetidos ao teste de microtração com velocidade de 1 mm/min até a fratura. As médias obtidas foram submetidas a ANOVA dois fatores e ao teste Tukey (p = 0.05). No modo autocondicionante, os grupos SEself (39,77 ± 11,56MPa) e SBself (40,84 ± 12,49MPa) não diferiram entre si e foram superiores estatisticamente aos grupos Seself + CHX (22,86 ± 5,18MPa) e Sbself + CHX (27,02 ± 5,58MPa), os quais não apresentam diferença estatística entre si. No modo com condicionamento ácido total, o grupo SBU + CHX apresentou a maior média (37,81 ± 11,69MPa), seguido pelos grupos SBtotal (31,53 ± 9,22MPa) e SEtotal+CHX (28,09 ± 4,2MPa). Já o grupo SEtotal (25,95 ± 5,43MPa) apresentou a menor média e foi inferior estatisticamente aos demais. Conclui-se que a aplicação prévia da CHX sobre a dentina interferiu na efetividade dos valores de resistência da união dos sistemas autocondicionantes e universais à dentina. / Chlorhexidine (CHX) is an antimicrobial agent with ability to slow down the action of metalloproteinases in dentin tissue conditioning with phosphoric acid. But, it is speculated that the products of their reaction may interfere chemically and physically on the immediate values of bond strength (TBS) of self-etching universal adhesives. The objective was to analyze the influence of treatment designed with CHX solution 2% prior to application of self-etch and universal adhesives on TBS. Occlusal surfaces of 20 sound human molars were removed to expose middle dentin surface. These were divided into 8 groups according to the type of treatment submitted: SEself- application of Clearfil SE Bond adhesive system according to the manufacturer's instructions; SEself + CHX: prior use of chlorhexidine for 20 s followed by washing; SBself: applying Scotchbond Universal according to the manufacturer's instructions in self-etching mode; SBself + CHX: previous application of CHX for 20 s followed by drying; SEtotal: phosphoric acid etching to 35% for 15 sec followed by washing, drying, primer acid for 10 seconds, adhesive and curing this for 10 seconds; SEtotal + CHX: Technical sequence similar to the above, but with application of CHX after acid etching; SBtotal: applying the adhesive according to the manufacturer's instructions in order condiciomento Total acid; SBtotal + CHX: after phosphoric acid etching, CHX was applied for 20 s followed by drying and application of the adhesive. Composite resin blocks with 5mm were built on the hybridized surfaces, cut into sticks of 1 mm2 and stored in deionized water at 37 °C for 24 hours. Afterwards, the samples were submitted to microtensile test speed of 1 mm/min until failure. The averages were submitted to two factors ANOVA and Tukey test (p = 0.05). In the self-etching mode, the SEself groups (39.77 ± 11,56MPa) and SBself (40.84 ± 12.49) did not differ statistically and were superior to SEself + CHX groups (22.86 ± 5,18MPa) and SBself + CHX (27.02 ± 5,58MPa), which have no statistical difference between them. On the total etching mode, SBU + CHX group had the highest average (37.81 ± 11,69MPa), followed by SBtotal groups (31.53 ± 9,22MPa) and SEtotal + CHX (28.09 ± 4, 2 MPa). Already SEtotal group (25.95 ± 5.43MPa) had the lowest average and was statistically lower to the other groups. It was concluded that the prior application of CHX on dentine interfered in the effectiveness of bond strength values of self-etching dentin and universal systems.

Submitted by Renata Lopes (renatasil82@gmail.com) on 2015-12-11T13:58:17Z No. of bitstreams: 1 giselicarvalhodepaula.pdf: 1937996 bytes, checksum: 3de1145ff4d14de67b2087792ed59efe (MD5) / Approved for entry into archive by Adriana Oliveira (adriana.oliveira@ufjf.edu.br) on 2015-12-11T15:06:35Z (GMT) No. of bitstreams: 1 giselicarvalhodepaula.pdf: 1937996 bytes, checksum: 3de1145ff4d14de67b2087792ed59efe (MD5) / Made available in DSpace on 2015-12-11T15:06:35Z (GMT). No. of bitstreams: 1 giselicarvalhodepaula.pdf: 1937996 bytes, checksum: 3de1145ff4d14de67b2087792ed59efe (MD5) Previous issue date: 2015-04-28 / Este estudo teve como propósito analisar o efeito da utilização de Digluconato de Clorexidina a 2% como agente de limpeza cavitária antes da aplicação do sistema adesivo convencional na difusão resinosa e no padrão de distribuição da matriz de colágeno na hibridização. Foram realizadas cavidades classe V nas faces vestibulares de vinte dentes pré-molares humanos hígidos que foram divididos em 2 grupos. No Grupo 1: os dentes foram tratados com o sistema adesivo convencional de acordo com as instruções do fabricante e o grupo 2: o Digluconato de Clorexidina 2% foi aplicado na superfície dentinária depois do condicionamento ácido, por 30 segundos e seco com um breve jato de ar. Cada dente foi restaurado com resina composta fotopolimerizável nanoparticulada. Os corpos de prova foram seccionados e as interfaces adesivo/resina foram analisadas por Espectroscopia Raman. As medidas de difusão dos componentes monoméricos e distribuição de colágeno foram avaliadas pelas bandas Raman de 1667 cm-1; 1273 cm-1; 1242 cm-1; 1720 cm-1; 1453 cm-1. O gradiente de desmineralização usado na determinação da região de hibridização foi avaliado pela banda de 960 cm-1 da hidroxiapatita da dentina peritubular. De acordo com os resultados obtidos, a aplicação de Digluconato de Clorexidina favoreceu a reidratação da trama de fibras colágenas da dentina, reexpandindo-as melhorando a qualidade da camada híbrida. / This study aimed to analyze the effect of using Chlorhexidine Digluconate 2% as cavity cleaning agent before applying the conventional adhesive system to resinous dissemination and distribution pattern of the collagen matrix in the hybridization. Class V cavities were performed on the buccal surfaces of twenty premolars healthy human teeth were divided into 2 groups. Group 1: teeth were treated with conventional adhesive systems according to the manufacturers instructions and group 2: Chlorhexidine Digluconate 2% was applied to the dentin surface after etching for 30 seconds and dried with a brief jet air. Each tooth was restored with light-cured composite nanoparticle. The specimens were sectioned and adhesive / resin interfaces were analyzed by Raman Spectroscopy. Diffusion measurements of monomeric components and collagen distribution were evaluated by Raman bands 1667 cm-1; 1273 cm-1; 1242 cm-1; 1720 cm-1; 1453 cm-1. The demineralization gradient used to determine the hybridization region was evaluated by the band of 960 cm-1 hydroxyapatite of peritubular dentin. According to the results obtained, the application of Chlorhexidine Digluconate favored the rehydration of the web of collagen fibers of the dentin, reexpandindo them increasing the hybrid layer.

O sucesso do tratamento endodôntico está vinculado à redução da infecção microbiana dos canais radiculares. Várias substâncias químicas são usadas para esse fim. Entretanto, algumas podem provocar alterações cromáticas na estrutura dental. Objetivo: avaliar a alteração cromática de dentes bovinos, após o uso de substâncias químicas. Método: 120 dentes bovinos divididos em dois grupos, experimentais: G1 foi instrumentado endodonticamente utilizando as substâncias testadas e G2 os fragmentos foram imersos nas substâncias testadas. Os mesmos foram subdivididos em seis subgrupos cada de acordo com as associações das soluções: G1(controle)-soro fisiológico; G2-solução de digluconato de clorexidina a 0,2%+ NaOCL 1%; G3-solução de clorexidina a 0,2%+ NaOCL 2,5%; G4 gel de digluconato de clorexidina a 2% + NaOCL 1%; G5 gel de digluconato de clorexidina a 2%+ NaOCL 2,5% e G6-gel de digluconato de clorexidina a 2% + solução de digluconato de clorexidina a 0,2%. As coroas foram seccionadas a 3,0 mm do colo anatômico e obteve-se 120 fragmentos (4x4x4 mm) para análise por meio de fotorreflectância. A avaliação da alteração cromática foi realizada com o programa Origin 6, após sete, quatorze e vinte e um dias do experimento. Resultados: Em todos os grupos avaliados, houve escurecimento no período de sete dias, exceto no grupo controle (G1), com diferença estatisticamente significante (p<0,05) entre os grupos experimentais e o grupo controle. O escurecimento, exceto no G1, foi decrescente com relação os períodos avaliados. Conclusões: Concluiu-se que as associações das substâncias químicas utilizadas nos canais radiculares e nos fragmentos, promoveram alteração cromática na coroa dental. Sendo que, o gel de clorexidina a 2% apresentou os piores resultados. Entretanto, o grau de escurecimento diminuiu em relação ao tempo experimental. / The success of endodontics treatment its related to reduce bacterial infection from root canal. Many chemical substances are used to this purpose. Although some of them can cause stain in dental structure. Aim: evaluate the chromatic changes of bovine dentals, after using chemical substances. Methods: one hundred and twenty bovine teeth were divided into two groups: G1 the root canal had manual instrumentation and G2 the fragments were immersed in the tested solutions. Both groups were subdivided into six subgroups according to the association between the substances tested of each group : G1(control)-saline solution ; G2- solution digluconate of chlorhexidine 0,2%+ NaOCL 1%; G3- solution digluconate of chlorhexidine 0,2%+ NaOCL 2,5%; G4-gel of digluconate of chlorhexidine 2% + NaOCL 1%; G5- gel of digluconate of chlorhexidine 2%+ sodium hypochlorite 2,5% e G6- gel of digluconate of chlorhexidine 2% + solution digluconate of chlorhexidine 0,2%. The crowns were sectionated approximately 3.0mm from anatomy cervix dental, and 120 fragments (4x4x4 mm) to be analysed by photoreflectancy. The staining was evaluated by Origin 6 program, after seven, fourteen e twenty one days from the data. Results: all groups evaluated,had staining at the period of 7 days, except the control group (G1), with statistics significant difference (p<0,05) between the control group and the others experimentals groups. The staing, except (G1), was in a decrease order related to the evaluated times. Conclusions: It was concluded that the chemical associations used in the root canals and in the fragments produced staining at the dental crown. The chlorhexidine gel 2%presented the worse results, although the staining degree decreased related to experimental time.

The overarching objective of this thesis is to demonstrate a systematic approach for addressing the instability issues associated with low limit degradants by developing quantitative degradation models that incorporate key instability determinants into predictive equations. Chlorhexidine was used as model compound in aqueous solution to demonstrate the application of the predictive models to issues of formulation design and manufacturing. Chorhexidine degrades to p-chloroaniline, a well-established toxicant, by various pH-dependent pathways. In acidic conditions, the direct formation of p-chloroaniline from chlorhexidine is the major pathway whereas the indirect formation of p-chloroaniline via p-chlorophenylurea is the main alkaline pathway. Rate laws and mechanisms for each pathway were presented. Shelf life predictions equations for chlorhexidine formulations were derived based on the kinetics of p-chloroaniline appearance as a function of formulation strength, solution pH, bulk chlorhexidine purity and storage temperature. The pH range for optimal shelf-life was 5.0 to 5.5. Simple extraction procedures used during formulation preparation were identified to improve bulk chlorhexidine purity and thereby extend product shelf-life. Gabapentin degrades directly to gabapentin-lactam in the solid-state. The established limit on gabapentin-lactam in gabapentin pharmaceutical formulations is <0.5% w/w thus gabapentin instability was studied as a model compound for solid state formulation applications. Mechanical stress associated with drug product manufacturing in unit operations such as milling increased the subsequent lactamization rate upon storage due to increased gabapentin crystal disorder. The effect of environment moisture was to decrease the rate of gabapentin-lactam formation due to competitive recovery of gabapentin crystallinity which was accelerated by humidity. A degradation model that combined both physical and chemical instability pathways including autocatalytic branching, spontaneous intra-molecular cyclization and moisture-induced physical transformation steps was shown to be consistent with lactamization kinetics as a function of both environmental (temperature and humidity) and manufacturing-related effects. This kinetic model was used to predict the shelf-life of gabapentin tablets prepared under various exemplary manufacturing conditions thereby demonstrating the ability of the model to link manufacturing variation and shelf-life stability in for solid-state drug formulations.

ABSTRACT Background: The most common species associated with dental caries is Streptococcus mutans. Different Streptococcus mutans adhesion biotypes, SpaP A/B/C and Cnm/Cbm, with ability to predict individual caries development have recently been identified. Aim: The aim of the study was to investigate if there was a difference in growth ability of the Streptococcus mutans adhesion biotypes and their relative sensitivity to biocides such as fluoride and chlorhexidine in vitro. We also aim to compare the potency of biocides in vitro to those concentrations used in the clinic. Methods: Culturing of the Streptococcus mutans biotypes in a planktonic solution with and without fluoride and chlorhexidine. Used concentrations: 3.5-4500 parts per million fluoride and 15-500 parts per million chlorhexidine. Optical density was used to measure growth under the different conditions. Results: The tests with fluoride showed a similar dose dependent inhibition of growth for all 6 biotypes of Streptococcus mutans. The tests with chlorhexidine showed a major inhibition of growth for the concentration 62 parts per million which inhibited growth more than 500 parts per million. All biotypes had a similar proliferation pattern without any biocide present. Conclusion: All tested biotypes of Streptococcus mutans had a similar pattern of sensitivity to the different concentrations of biocides and cultivation conditions used.

Background The use of peritoneal lavage with antiseptic solutions after bowel surgery remains controversial. This study compared peritoneal lavage using chlorhexidine gluconate at low concentrations and normal saline in mice with cecal ligation and perforation. Methods A total of 180 mice were randomized to six groups. Groups A, B, and C received one-time intraperitoneal injections of normal saline, chlorhexidine gluconate 0.05%, and chlorhexidine gluconate 0.025%, respectively. Groups D, E, and F were all subject to cecal ligation and perforation, then underwent partial cecectomy and peritoneal lavage with normal saline only, chlorhexidine gluconate 0.05% followed by normal saline, and chlorhexidine gluconate 0.025% followed by normal saline, respectively. Animals were followed postoperatively then sacrificed and examined at necropsy for occurrence of intra-abdominal abscesses, adhesions, or other pathology. Results A total of 48 mice (26.7%) developed postoperative intra-abdominal abscesses. Group E mice that had chlorhexidine gluconate 0.05% lavage had significantly lower incidence of postoperative intra-abdominal abscesses compared with that of group D mice that had saline lavage only (P = 0.0113). There was no significant difference in occurrence of macroscopic adhesions among mice groups that had or did not have surgery. (P = 1 and P = 0.3728). Microscopic peritoneal fibrosis occurred significantly more among group E mice that had chlorhexidine gluconate 0.05% lavage compared with group D mice that had saline lavage only (P = <0.005). There was no significant difference in postoperative mortality between surgical groups (P = 0.8714). Conclusions Chlorhexidine gluconate 0.05% peritoneal lavage after partial colectomy (cecectomy) in mice reduces postoperative intra-abdominal infection without significant macroscopic adhesion formation.

Indiana University-Purdue University Indianapolis (IUPUI) / Introduction: The resin-dentin interface undergoes degradation by endogenous matrix metalloproteinases (MMPs) after adhesive procedures. Application of several MMP inhibitors such as chlorhexidine (CHX) to the demineralized collagen dentin matrix after acid-etching has been suggested to be a successful approach to prevent degradation of the hybrid layer. Further, nanotubes (HNT) have been used as a reservoir for encapsulation and controlled delivery for several therapeutic drugs with sustained release. Therefore, HNT can be encapsulated with CHX and incorporated into dentin adhesives for the possibility of enhancing the longevity and durability of the hybrid layer. Objective: To evaluate the effect of a CHX-encapsulated nanotube-modified primer/PR and adhesive/ADH on the microtensile resin bond strength (µTBS) to dentin. Materials and Methods: A commercial adhesive and its respective primer were modified by adding CHX-encapsulated nanotubes at two distinct concentrations (10 and 20 wt.%). The experimental adhesives were evaluated by degree of conversion (DC) and viscosity. Meanwhile, only viscosity was determined for the experimental primers. The prepared HNT-encapsulated with CHX (10 and 20 wt.%) powders were incorporated into the primer and/or adhesive according to the groups: ADH (control); HNT (control); 0.2% CHX; PR+CHX10%; PR+CHX20%; ADH+CHX10%; ADH+CHX20%. Human molars were selected and autoclaved; mid-coronal dentin surfaces were exposed for bonding purposes. Dentin surfaces were etched, followed by primer and adhesive application, and restored with a resin composite. After 24 hours, the teeth were sliced into beams for µTBS testing; beams collected for each tooth were equally assigned into two testing condition groups: 24 hours and 6 months. Microtensile bond strength was tested using a universal testing machine, and the types of failure were classified as adhesive, mixed, and cohesive failure. Data from DC and viscosity tests were analyzed using one-way ANOVA. Bond strength data were analyzed by pair-wise comparisons using the Sidak method to control the overall significance level at 5% for each aging time separately. Weibull-distribution survival analysis was used to compare the differences in the microtensile bond strength results among the groups after 24 hours and 6 months. Results and Conclusion: DC analysis revealed no significant differences among adhesive groups. However, ADH group had a significantly lower viscosity than modified adhesive groups, and a significantly higher viscosity than modified primer groups. Test results of stress value (MPa) by each group for each aging time revealed no significant differences among groups after 24 hours. However, after 6-month storage, modified primer groups (PR+CHX10%, PR+CHX20%) and 0.2%CHX group showed a significant difference in µTBS compared to control groups (ADH, HNT) and modified adhesive groups (ADH+CHX10%, ADH+CHX20%) in the same aging time testing (p < 0.05). When comparing the µTBS after 24 hours and 6 months, there were no significant differences among the groups except for the ADH+CHX20% group, for which MPa values were higher after 24 hours than 6 months (p = 0.0487). In conclusion, this study has demonstrated the great potential of modified dental primers with CHX-encapsulated nanotubes in preservation of the resin-dentin bond strength over a 6-month time period. Additionally, modification of dental primers and adhesives was a successful approach that didn’t compromise the characteristics or the mechanical properties of the materials and has a promising long-term effect on resin-dentin bond strength.

Introduktion: Förlust av tänder är idag vanligt förekommande och kan behandlas med hjälp av dentala implantat. För att installation av implantat ska vara möjlig, krävs tillräcklig benvolym där implantat ska installeras. När det föreligger bendefekter i anslutning till det lokala området för implantatinstallationen utgör simultaneous augmentation technique eller enstegsteknik ett behandlingsalternativ för bentransplantat. För att minimera kontamination med orala bakterier av det uppsamlade benet under beninsamlingsmetoder, används idag preoperativ sköljning med klorhexidin som ett steg i behandlingen.Syftet med denna studie är att undersöka möjligheten till ytterligare minimering av bakteriell kontamination vid implantatinstallation, med hjälp borstning av munhålan med klorhexidingel.Metod: 30 patienter deltog i en dubbelblindad, randomiserad studie där 15 patienter utgjorde en kontrollgrupp och 15 andra patienter fick genomgå den införda preoperativa tilläggsåtgärden. Ben- och paperpoint prov togs från samtliga patienter för bakteriell odling. Antalet kontaminerande bakterier uttrycktes som kolonibildande enheter (CFU/ml). En statistisk analys gjordes för att beräkna bakterieantal och kontaminationsgraden i respektive prov. Resultat: Medelvärdet för antal bakterier i benproven från samtliga patienter i kontrollgruppen beräknades till 8 126 CFU/ml respektive 2 946 CFU/ml i testgruppen dock var skillnaden inte signifikant (P = 0,357).Konklusion: Resultatet i denna studie visar ingen statistisk signifikant skillnad mellan patienter som erhållit den preoperativa profylaktiska tilläggsåtgärden, borstning med klorhexidingel, och patienter som inte erhållit detta hygiensupplement. Dessutom kunde ingen slutsats dras gällande effekten av denna tilläggsmetod på virulenta bakteriearterna P. gingivalis, P. Intermedia och A. actinomycetemcomitans. Ett större patientunderlag krävs i framtida randomiserade kontrollerade studier för att utvärdera denna metods effekt. / Introduction: Missing teeth can be replaced by dental implants. To achieve good results using dental implants, it is important that there is sufficient bone volume. In cases with bone defects, simultaneous augmentation technique becomes an alternative for bone augmentation. To minimize the contamination with oral bacteria during the bone collection, preoperative rinsing with chlorhexidine is today commonly used as a step in the treatment.The aim of this study is to examine the additional effect of preoperative brushing with chlorhexidine gel on avoiding bacterial contamination during the installation of dental implants.Method: 30 patients participated in a randomized, double blinded study. 15 patients were included in the control group and 15 patients underwent an additional step in the treatment with a preoperative brushing with chlorhexidine gel. Bone samples and paperpoint samples were collected and analyzed in a laboratory and a statistic analysis was performed to compare the number of bacterial colonies in samples from the two groups (CFU/ml) present and the degree of contamination.Results: The mean bacterial count in bone samples from all patients in the control group was calculated at 8 126 CFU/ml and 2 946 CFU/ml in the test group. CFU/ml was different between the groups (P = 0.357) but the difference was not significant (P <0.05).Conclusion: Brushing with chlorhexidine gel preoperatively showed no significant effects in the bacterial contamination of bone chips. No recommendation for adding this additional step in the standard treatment with dental implants can therefore be made today.

Une antisepsie-désinfection (ATS-D) efficace est fondamentale si l'on considère le manque de traitements antiviraux spécifiques, l'émergence de nouveaux virus et l'accroissement du nombre d'infections nosocomiales virales. A ce jour, une seule norme Européenne, la norme NF EN 14476+A1, propose un cadre pour évaluer l'activité ATS-D antivirale en médecine Humaine et certaines améliorations sont encore nécessaires.Dans ce but, nous avons développé et validé, biologiquement et physico-chimiquement, un protocole pour évaluer l'activité ATS-D antivirale. Ce dernier est basé sur une méthode originale de filtration sur gel faisant appel à des colonnes de Séphadex™ G-25 et G-10 de notre conception comme moyen de neutralisation. Nous avons ainsi évalué, sur le coronavirus Humain 229E (HCoV 229E), les activités ATS-D de deux molécules de référence, la chlorhexidine (CHX) et l'hexamidine (HXM), ainsi que de deux calixarènes : le tetra-para-sulfonato-calix[4]arène (C[4]S) et le 1,3-bis(bithiazolyl)-tetra-para-sulfonato-calix[4]arène (C[4]S-BTZ). Selon la norme Européenne, pour qu'une formulation puisse prétendre à une activité ATS-D antivirale, il faut qu'elle induise une diminution de 4 log10 dans les titres viraux. L'HXM et le C[4]S n'ont montré qu'une très faible activité vis à vis du HCoV 229E. La CHX a montré quant à elle une activité beaucoup plus intéressante bien qu'elle ne puisse néanmoins pas prétendre à une activité ATS sur le HCoV 229E. Enfin, le C[4]S-BTZ a montré une activité comparable, voire meilleure, que la CHX. Son activité s'est en effet avérée plus rapide, rémanente et dénuée de cytotoxicité, contrairement à la CHX / Efficient antisepsis-disinfection is fundamental, considering the lack in antiviral treatments, the emergence of new viruses and the raising of viral nosocomial infections. Only one European Standard (NF EN 14476 + A1) proposes a frame to evaluate antiseptic antiviral activity in Human medicine and some improvements are still needed. We thus developed and validated, biologically and physico-chemically, a virucidal assay based on an original gel filtration method, using “in-house” G-25 and G-10 Sephadex™ columns, as neutralization method. We evaluated, on the Human coronavirus 229E (HCoV 229E), the antiseptic activity of two reference molecules, chlorhexidine (CHX) and hexamidine (HXM), and of two new potent antiviral drugs: the tetra-para-sulfonatocalix[4]arene (C[4]S) and the 1,3-bis(bithiazolyl)-tetra-para-sulfonato calix[4]arene (C[4]S-BTZ). A 4 log10 reduction in viral titers is required, according to the European Standard.HXM and C[4]S showed almost no activity on the HCoV 229E. Considering the CHX, it showed a quite interesting activity, even if it did not reach the threshold to pretend to an antiseptic activity on the HCoV 229E. Finally, The C[4]S-BTZ showed a comparable activity to the CHX, and even better. Thanks to this original method, we could highlight a new interesting molecule, the C[4]S-BTZ, which showed a close activity to the CHX, but faster, residual and exempt of cytotoxicity, whereas chlorhexidine did