• 대한치과교정학회지
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• 제27권2호
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• pp.173-180
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• 1997

본 연구는 교정환자를 대상으로 chlorhexidine varnish를 치면에 도포했을 때 치태내 균주의 변화양상을 관찰하여 교정치료환자에 있어 치아우식증예방을 위한 chlorhexidine 사용의 효용성을 평가하고자 하는데 그 목적이 있다. 서울대학교 병원 치과진료부 교정과에 내원한 신환 26명을 대상으로 각 13명씩을 실험군과 대조군으로 구분하여 실험군에는 chlorhexidine varnish를 1주일 간격으로 4희 도포하고 대조군에는 같은 방법으로 placebo varnish를 도포하여 처치 전과 처치 4주후, 처치 8주후의 치태내 균주 변화양상을 간접면역형광현미경법으로 분석하였다. 결과는 다음과 같다. 1. Chlorhexidine varnish 처치에 의해 Streptococcus mutans는 처치 8주후 까지 강력히 억제되었다(p<0.01). 2. Streptococcus sanguis는 chlorhexidine varnish처치 4주후에 일시적으로 증가하였다가(p<0.05) 8주후에 원상으로 회복되었다. 3. Streptococcus mitis, Actinomyces viscosus, Actinomyces naeslundii는 chlorhexidine varnish 처치에 의해 별 다른 변화를 나타내지 않았다.

• 대한소아치과학회지
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• 제25권1호
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• pp.116-126
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• 1998

Numerous chemical agents have been developed to reduce the activity of cariogenic bacteria. Of these, chlorhexidine is acknowledged as the most effective. Gel and mouthrinse have been the traditional method of its application in the mouth. It has been reported that chlorhexidine varnish has prolonged inhibitory effect on the number of streptococcus mutans in saliva and plaque. Recently, chlorhexidine varnish and polyurethane sealant have been developed to promote prolonged anticariogenic effect of chlorhexidine. Products containing 10% chlorhexidine varnish and polyurethane sealant have been developed to prevent caries by reducing the number of streptococcus mutans in the oral cavity. The purpose of this study is to investigate the inhibitory effect of chlorhexidine varnish and polyurethane sealant on streptococcus mutans in the primary dentition. Children with primary dentition containing no active carious lesion were divided into two groups. To the experimental group (n=11), chlorhexidine varnish and polyurethane sealant ($Chlorzoin^{(R)}$, Knowell Therapeutic Technologies, Inc. Canada.) was applied once a week for four weeks according to the manufacturer's instruction. Only oral prophylaxis was performed on the control group(n=7). Caries activity was measured after using $Cariescreen^{(R)}$SM (Knowell Therapeutic Technologies, Inc. Canada,) to incubate streptococcus mutans before and 5, 12, 24 weeks after initial varnish application. The following results were observed.; 1. There was statistically significant decrease in the number of streptococcus mutans in the experimental group for 5 weeks(P<0.01), 12 weeks(P<0.05) after the initial application. but, by 24 weeks significant difference had disappeared. 2. As the inhibitory effect of chlorhexidine varnish and polyurethane sealant application is not everlasting, reapplication at 12-24 weeks should be needed.

• 대한소아치과학회지
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• 제31권4호
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• pp.579-586
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• 2004

본 연구의 목적은 chlorhexidine(Cervitec)과 fluoride(Fluor-protector) 성분을 각각 포함한 varnish를 치아에 적용하였을 때 타액내의 mutans streptococci의 수의 감소에 미치는 효과를 알아보기 위한 것이다. 전북대학교 치과대학생 40명을 대상으로 하여 mutans streptococci 균종 수를 평가하였으며, 이들을 무작위로 네 군으로 나누어 다음과 같이 varnish를 적용하였다; A) varnish를 적용하지 않은 군(n=10), B) chlorhexidine varnish 적용군(n=10), C) fluoride varnish 적용군(n=10), D) chlorhexidine과 fluoride varnish를 모두 적용한 군(n=10). Mutans streptococci 수 측정에는 Orion diagnostica 사의 Dentocult SM을 사용하였다. Varnish를 적용하지 않은 상태에서 1차로 mutans streptococci 수를 측정한 후 각각의 varnish를 적용하였으며, varnish 적용 12주 후 다시 측정하여 기록하였다. 모든 실험군(group B, C, D)에서 12주 후에 측정한 mutans strepococci 수가 감소한 개체가 증가한 개체보다 많았으나 통계적으로 유의한 차이는 보이지 않았다(p>0.05). 실험에 사용된 어떠한 varnish도 적용 12주 후에 타액 내 mutans streptococci 수에 통계적으로 유의할 만한 변화를 주지는 못하는 것으로 나타났다(p>0.05).

• 대한치과교정학회지
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• 제30권3호
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• pp.335-342
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• 2000

본 연구의 목적은 chlorhexidine varnish를 고정식 교정장치 장착 환자의 치면에 도포한 후 나타나는 치태내 균주의 변화 양상을 장기간 관찰하는 것이다. 서울대학교병원 치과진료부 교정과에서 고정치 교정장치로 치료하기로 하였던 환자 100명중에서 32주까지 장기간 추적 (follow-up) 되었던 21명을 최종 연구대상으로 선정하였다. 실험군 (12명) 은 chlorhexidine varnish를 1주일 간격으로 4회 도포한 후 고정식 교정장치를 부착하였고, 대조군 (9명) chlorhexidine varnish 처치를 하지 않고 고정식 교정장치를 부착하였다. 그리고 실험군에서는 20주 째에 chlorhexidine varnish를 1회 처치하였다. 두 군에서 고정식 교정장치 부착 직전과 부착 후 4, 8, 20, 32주의 치태내 균주의 변화 양상을 간접면역 형광 현미경법으로 분석하고 SAS 통계프로그램을 사용하여 다음과 같은 결과를 얻었다. 1. Streptococcus mutans는 실험군에서 전 실험기간동안 통계학적으로 유의성 있게 억제되 었고 (p<0.01), 대조군에서 전 실험기간동안 통계학적으로 유의성 있게 증가하였다 (p<0.05). 2. Streptococcus sanguis, Streptococcus mitis, Actinomyces viscosus, Actinomyces naeslundii는 실험군과 대조군에서 통계학적으로 유의성 있는 변화를 보이지 않았다. 따라서 고정식 교정장치를 사용할 환자에서 chlorhexidine varnish를 처치할 경우 치아 우식의 주 원인균인 Streptococcus mutant를 장기간 선택적으로 억제할 수 있을 것으로 생각된다.

• 대한소아치과학회지
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• 제25권3호
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• pp.513-524
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• 1998

The purpose of this study was to compare the staining ratio on the enamel surface following the use of chlorhexidine mouthwash and the chlorhexidine varnish application. Labial and lingual surfaces of maxillary and mandibular incisors of adults were selected to evaluate the staining ratio. The control group was consisted of 8 individuals, the experimental group 1 and 2 were consisted of 50 each. Prophylaxis with pumice was performed to remove the stain already established on the enamel surface of all groups. The group 1 was asked to use chlorhexidine mouthwash(Hexadent, chlorhexidine gluconate 1ml/100ml) for a minute twice a day. The chlorhexidine $varnish^{(R)}$($Chlorzoin^{(R)}$, consisted of solution 1(10% chlorhexidine acetate) and solution 2(polyurethane sealant)) was applied on the enamel surfaces of the group 2. After 4 weeks of experiment, intraoral photogragh of tooth surfaces were taken in order to record the stained area on the enamel of the control and the experimental groups. Outline of teeth and the stained area in the photographs was traced on the OHP film. Scanner and computer processor were used to calculate stained surface ratio.

• 대한소아치과학회지
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• 제35권1호
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• pp.83-91
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• 2008

치아 우식증은 구강 내 세균, 식이(음식물), 치아 및 타액 등의 숙주 요인이 복합적으로 작용하여 발생한다. 이 중 치아의 탈회에 대한 저항성을 높이거나, 구강 내 세균의 산생성능을 낮춤으로써 치아우식을 예방할 수 있는 대표적인 약제로 불소와 클로르헥시딘이 있다. 이 약제의 구강 내 적용방법으로 치아에 대한 부착력이 뛰어나고 환자의 협조의존도가 비교적 적은 바니쉬 형태가 최근 들어 널리 이용되고 있다. 본 연구는 불소와 클로르헥시딘 바니쉬의 항우식 효과를 생체 내에서 비교 평가하기 위하여, 구강 내 가철성 장치에 우치 시편을 식립하고 불소 바니쉬와 클로르헥시딘 바니쉬를 각각 도포하였다. 치태축적을 유도하여 법랑질 탈회를 통한 우식 유발 환경을 만들고 바니쉬 제제가 구강 내에서 우치 법랑질의 우식 예방에 미치는 효과를 평가하였다. 전자 현미분석 장치와 편광현미경을 사용하여 법랑질 표면의 Ca, P에 대한 정량적 변화를 분석하고 조직학적 관찰을 시행하여 다음과 같은 결론을 얻었다. 1. 인공 우식병소에 대한 편광현미경 관찰 결과, 불소 및 클로르헥시딘 바니쉬 를 도포한 군에서 대조군에 비해 법랑질 병소가 경미하게 나타남을 확인할 수 있었다. 2. 우식을 유발한 경우 Ca와 P의 감소량은 대조군에서 가장 높게 나타났고(P<0.05), 불소 바니쉬군에서는 Ca와 P의 유의한 감소가 나타나지 않았으며 클로르헥시딘 바니쉬군에서는 P만 유의한 감소를 보였다(P<0.05). 이상의 결과로 보아 불소 및 클로르헥시딘 바니쉬 제제의 사용이 항우식 효과를 나타낸 것으로 판단되나, 불소 바니쉬가 좀 더 우수한 효과를 나타낸 것으로 보인다.

• 대한소아치과학회지
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• 제25권4호
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• pp.825-836
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• 1998

The intention of this study was to investigate the preventive effect of chlorhexidine varnish on enamel demineralization. The sample consisted of 57 first premolars scheduled to be extracted for orthodontic purposes. The control group (N=10) was left untreated and the experimental groups were worn with specially designed stainless steel orthodontic bands on premolar for plaque accumulation. The group 1 (N=9) was worn band only, the group 2 (N=19) was applied with chlorhexidine varnish for one time, and the group 3 (N=19) was applied with chlorhexidine varnish for 3 times once a week. After 4 weeks of experimental periods, every specimen were examined by SEM and Vickers hardness test to evaluate and compare the degree of enamel decalcification. The results were as follows: 1. Although SEM revealed various degree of enamel demineralization in every experimental groups, the group 1 showed more severe demineralizations than the group 2 and 3. 2. The mean Vickers Hardness Numbers measured in this study seemed to reveal that there was a statistically significant difference between the control goup and the group 1 (P<0.05), and also a significant difference between the group 1 and the group 2, 3 (P<0.05). And there was no significant difference between the group 2 and the group 3 (p>0.05). 3. The results of VHN did not deemed to show a statistically significant difference between maxillary premolar and mandibular premolar in both group 2 and group 3 (P>0.05).

• Restorative Dentistry and Endodontics
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• 제18권2호
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• pp.341-356
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• 1993

In the prevention of root surface caries, antimicrobial therapy for the control of subgingival and supragingival plaque is seriously considered as a long term suppression of pathogenic microflora. Recently, varnishes containing antimicrobial agents have been developed to control the supragingival microflora. The purpose of this study was to determine the antimicrobial effects of 20% chlorhexidine varnish and 2.6% silane fluoride varnish with sealant. In clinical experiments, 12 subjects were selected from the periodontally treated patient and divided into 3 groups. After a dental prophylaxis, the subjects were treated with single application of placebo varnish (group I), 20% chlorhexidine varnish (group II), and 2.6% silane fluoride varnish (group III). Root surface plaque samples were taken before (baseline) and one, two, four, and 8 weeks after the treatments. Microbiological examinations of root surface plaque were performed with culture study and indirect immunoflorescence (I.I.F.) study, and immunological examination of gingival crevicular fluid antibody titers was performed with ELISA study. The results were as follows: 1. Pathogenic microflora on the root surface including S. mutans, S. sanguis, S. mitis, A. naeslundii, A. viscosus were 24 - 37% on I.I.F. study. 2. S. mutans, S. sanguis, S. mitis, A. naeslundii, A. viscosus of the root surface plaque was significantly reduced from 1 week to 8 weeks after antimicrobial varnish treatment, but showed generally increasing tendency in control group. 3. Gingival crevicular fluid antibody titers were significantly reduced from 1 or 2 weeks to 4 weeks after antimicrobial varnish treatment.

• 대한치과교정학회지
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• 제24권3호
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• pp.659-672
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• 1994

Dental caries is one of the most prevalent dental diseases in Korea and its prevention is very important in orthodontic therapy. For the cleansing action of saliva itself and/or tooth-brushing is lowered in patient with fixed orthodontic appliance, oral hygiene of the patient becomes worse, which provides more favorable environment for micro-organisms. Chlorhexidine, one of the series of bisguanide, has been reported to be strong antimicrobial agent and very effective on Streptococcus mutans. The purpose of this study is to evaluate the possibility of chlorhexidine as a anticariogenic agent in fixed orthodontic therapy. We used the varnish containing chlorhexidine as a main ingredient for the chemical control of salivary S.mutans in patients with fixed appliance therapy We applied the varnish containing chlorhexidine on the labial and interproximal surface of the teeth before bonding and banding teeth of our patients(N=20) and compared to control group patients(N=20). Before the application of chlorhexidine varnish and four times periodically after the completion of fixed appliance set-up, we sampled saliva of both group patients and incuvate S.mutans for 24 hours. In the culture study of sampled saliva, counting the number of S.mutans colonies, we founded as follows : 1. In patients with fixed appliance therapy, the risk of dental caries increase when it compared to that of preorthodontic treatment ; The number of salivary S.mutans increase in Patient's oral cavity. 2. The experimental agent that contain chlorhexidine is effective to reduce the number of salivary S.mutans. 3. For the effect of this agent is not ever-lasting, periodical application is needed, and additional study for economical interval and number of application is needed.

• 대한소아치과학회지
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• 제25권4호
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• pp.797-810
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• 1998

The purpose of this study was to develop a new way of delivery system of chlorhexidine using self-curing acrylic resin. Different preparations of chlorhexidine, such as chlorhexidine varnish($Chlorzoin^{(R)}$) and chlorhexidine diacetate crystalline, were mixed into self-curing acrylic resin with different methods. Every resin plate was made and was immersed in 100ml of distilled water individually, and kept in an incubator at $37^{\circ}C$. Solution(0.8ml) was collected from the each container at every 24 hours, and the amount of released chlorhexidine in the solution was measured in an ultraviolet spectrophotometer at 255nm. Flexural strength of all of the resin plates in the Experiment 2-A and 2-B were measured using Instron at the end of the experimental periods. The results were as follows: 1. It was found that chlorhexidine was released from the experimental groups in the Experiment 1, 2-A, and 2-B. And the release of chlorhexidine from all of the experimental groups showed a pattern of sustained-release preparation. 2. It seemed likely that a condition of "dryness" reduced a release of chlorhexidine from the chlorhexidine varnish. 3. It may be stated that a method of "chlorhexidine diacetate mix" with the polymer be more efficient than a method of "Chlorzoin mix" with the monomer. 4. Although it was evident that a flexural strength of the acrylic resin plates be reduced by a mix of either Chlorzoin or chlorhexidine diacetate crystalline, it seemed likely that the resin plates except Group 4 and 5 in the Experiment 2-B may be usable in the clinical situation.