Anti-biofilm activity of chlorhexidine-releasing elastomerics against dental microcosm biofilms

Abstract

Objective: To evaluate the anti-biofilm activity of chlorhexidine-releasing elastomerics (CRE) developed to prevent biofilm-related diseases in orthodontic patients, using dental microcosm biofilms.

Methods: Elastomerics coated with one of two solutions (CRE 1 and 2) were attached to bovine enamel specimens. Uncoated elastomerics were used for negative (distilled water [DW]) and positive (0.1% chlorhexidine [CHX]) control groups. After saliva inoculation on the surface of the specimen for biofilm formation, DW and CRE groups were treated with DW, and the positive control group was treated with CHX twice a day for 5 min. After 7 days of biofilm formation, colony-forming units (CFUs, total and aciduric bacteria), red/green (R/G) ratio, biofilm thickness, live/dead cell ratio, and bacterial morphology in the biofilms were evaluated. Enamel demineralization was evaluated by fluorescence loss (ΔF).

Results: The CFUs of total and aciduric bacteria and R/G ratios in the CRE groups were significantly lower than those in the DW group with a reduction by 13%, 13%, and 19%, respectively (p < 0.05). The CFUs of total bacteria was significantly lower in the CRE groups than in the 0.1% CHX group (p < 0.05). Among the CRE groups, only CRE 1 exhibited a significantly reduced biofilm thickness of 54% compared to the DW group (p < 0.05) and apparent changes in bacterial morphology. ΔF in the CRE groups was significantly higher by 36% compared to that in the DW group (p < 0.05).

Conclusions: CREs exhibited anti-biofilm and demineralization-inhibiting effect. Particularly, CRE 1 using dichloromethane as the solvent was most effective against biofilms.

Clinical significance: Chlorhexidine-releasing elastomerics exhibited increased anti-biofilm and demineralization-inhibiting effect compared to 0.1% chlorhexidine mouthwash. Therefore, it is possible to prevent biofilm-related diseases simply and effectively by applying chlorhexidine-releasing elastomerics to orthodontic patients.