• The korean journal of orthodontics
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• v.27 no.2
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• pp.173-180
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• 1997

The purpose of this study was to evaluate the effectiveness of chlorhexidine varnish treatment in the prevention of dental caries in orthodontic patients by observing microbial change in dental plaque after varnish treatment. The sample consisted of 26 patients who were classified into an experimental group and a control group, 13 patients each. The experimental group was treated with chlorhexidine varnish once a week for 4 weeks. The control group was treated with placebo varnish using the same procedure, The microbial change was analysed by indirect immunofluorescene technique before treatment and 4 weeks, 8 weeks after treatment. The results were as follows. 1. Streptococcus mutans were strongly suppressed until 8 weeks after chlorhexidine varnish treatment(p<0.01). 2 The proportion of Streptococcus sanguis increased temporarily 4 weeks after chlorhexidine varnish treatment(p<0.05), decreased to original level after 8 weeks. 3. Streptococcus mitts, Actinomyces viscosus, Actinomyces naeslundii did not show significant change after chlorhexidine varnish treatment.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.1
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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.

• Journal of the korean academy of Pediatric Dentistry
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• v.31 no.4
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• pp.579-586
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• 2004

The objective of the present prospective trial was to compare the efficacy of chlorhexidine(Cervitec), Fluoride (Fluorprotector) and combination of chlorhexdine and fluoride varnishes in decreasing the level of salivary mutans streptococci. Forty healthy students of school of dentistry, Chonbuk national university were investigated to evaluate mutans streptococci(MS) counts and randomized into four groups to treat with the experimental varnishes; A) untreated group(n=10), B) chlorhexidine group(n=10), C) fluoride group(n=10), D) chlorhexidine and fluoride group(n=10). Dentocult $SM^{(R)}$ (Orion Diagnostica) strip method was used for measurement of the level of mutans streptococci in saliva. Stimulated saliva were collected at baseline for mutans streptococci counts evaluation (ms1), 12 weeks later the completion of each varnish treatment, mutans streptococci counts were re-evaluated. In varnish group with chlorhexidine, fluoride and combination of chlorhexidine and fluoride, the level of mutans streptococci was lower after 12 weeks than at baseline, but there were no significant differences in saliva(p>0.05), when compared with baseline. After 12 weeks, a remarkable reduction was still found in the subjects with high level of mutans streptococci at baseline, but not different in the low and moderate level of mutans streptococci(p>0.05).

• The korean journal of orthodontics
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• v.30 no.3 s.80
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• pp.335-342
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• 2000

The authors observed the long term effects of chlorhexidine varnish treatment on microbial change of dental plaque in orthodontic patients with fixed appliances. The initial sample was 100 patients who were arranged to be treated with fixed orthodontic appliances. The final sample consisted of 21 patients who could be traced for 32 weeks after application of fixed orthodontic appliances. They were classified into the experimental group (12 patients) and the control group (9 patients). The experimental group was treated with chlorhexidine varnish once a week for 4 weeks before application of fixed orthodontic appliance. The control group was not treated with chlorhexidine varnish before application of fixed orthodontic appliance. The experimental group was treated once more after 20 weeks. The microbial changes of dental plaque were analysed by indirect immunofluorescence technique at pre-treatment, post-treatment 4, 8, 20, and 32 weeks. The results were as follows. 1. In the experimental group, streptococus mutans was significantly suppressed during experimental period. (p<0.01) But, in the control group, streptococcus mutans was significantly increased after placement of fixed orthodontic appliances during experiment period. (p<0.05) 2. Streptococcus sanguis, Streptococcus mitis, Actinomyces viscosus, md Actinomyces naeslundii did not show significant change between the experimental and the control group during experiment period. So, if we treat the orthodontic patients with chlorhexidine varnish before application of fixed appliances, we may suppress the major cariogenic bacteria, Streptococcus mutans, selectively for long period.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.3
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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.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.1
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• pp.83-91
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• 2008

Dental caries which is one of the most common chronic disease complexly developed by the action of oral bacteria, diet, and host factor. Various prevention program enhance resistance of demineralization and reduce the acidogenecity of oral bacteria have been introduced, representative material is fluoride and chlorhexidine. The purpose of the study was to evaluate and compare effectiveness of fluoride varnish and chlorhexidine varnish in vivo. Bovine tooth specimens were implanted in the lower space maintainers and applied with fluoride varnish and chlorhexidine varnish. After seven days in oral environment, metal mesh was covered to make similar condition of plaque accumulation and induce caries. All specimens were analysed by EPMA to evaluate quantitative change of Ca, P and by polarized microscope to identify histological changes. The results were as follows : After initial artificial caries induction in the mouth, there were remarkable enamel caries lesion in the control group under polarized light microscopy. The highest amount of mineral decrease were showed in control group. No statistically significant mineral decrease were showed in fluoride varnish group, while chlorhexidine varnish group showed only significant decrease of P(P<0.05). In conclusion both fluoride varnish and chlorhexidine varnish seemed to be effective for protecting enamel surface from caries activity, although fluoride varnish has more anticariogenic effect than chlorhexidine varnish.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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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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• v.18 no.2
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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.

• The korean journal of orthodontics
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• v.24 no.3 s.46
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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.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.4
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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.