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Chlorhexidine short note – year 2020 subject periodontology (in English)

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Good morning students today we’ll be discussing short notes subject period ontology for the year 2020. we’ll be discussing chlorhexidine today question paper is given here on the screen we’ll be starting with the chlorhexidine chlorhexidine history chlorhexidine was developed by imperial chemical industries in england during 1940s it was marketed as general

Antiseptic in the year 1950. a definitive study for keri’s inhibition by inhibition of dental block was done by low and shared in 1972 structure it is this big night antiseptic a symmetrical molecule consisting of four chlorophenyl ring and two bigonite group connected by central hexamethylene bridge chlorexidine is available in three form digluconate

That is water soluble acetate water soluble hydrochloride salt poorly soluble in water characteristic chlorhexidine is an antimicrobial agent strong base dicatinic at ph level above 3.5 with two positive charges it prevents black accumulation hence it is anti-plaque and anti-gingivitis agent it can be bacteriostatic at the concentration of 0.02 to 0.06 or

Bactericidal at the concentration of 0.2 to 0.12 depending upon the concentration success of chlorexidine efficacy chlorhexidine is bactericidal against gram-positive and gram-negative bacteria and yeast such as those responsible for oral candidiosis substantivity chlorhexidine binds with the hardened soft tissues in the oral cavity and is slowly released

Over time in a concentration that is back divisible the superior anti-plaque effect of chlorhexidine which make it gold standard can be attributed to its substantivity safety chlorhexidine seems to have very low level of toxicity and shows no permanent retention in the body mechanism of action as we have already discussed depending upon the concentration it is

Either bacteriostatic or bactericidal bacteriostatic means at a low concentration it will be altering the osmotic balance of the bacterial cell it promotes release of low molecular weight molecules like potassium and phosphorus but still bacteria will not be killed bacterial that means the bacteria will be killed on the high concentration of chlorhexidine the

Chlorhexidine causes cell death by cytolysis its ability to increase the permeability of bacterial cell membrane resulting in the release of main intercellular component including potassium thereby altering the cell protein structure causing the precipitation or coagulation of cytoplasmic proteins as we have shown this in the diagram this is a chlorexidine

Molecule the positive charge chlorhexidine molecule is attached to the negative charge phosphate group on microbial cell wall once it is attached onto the surface of bacterial cell wall chlorhexidine increase permeability of the cell membrane it increases the permeability of cell membrane various pores are being formed in the cell membrane through which the

Component of the cell will leak out and the cell will die by process of cell lysis action of chlorexidine an influence on particle formation will be there by blocking the acidic group on the salivary glucoprotein thus reducing the protein adsorption on the tooth surface an influence on adsorption of plaque onto the tooth surface by binding to bacteria in

Sublethal amount next influence on the formation of blood so chlorohexine is influencing the pellicle formation it is influencing the absorption of plaque onto the tooth surface as well as formation of plaque by precipitation precipitating the agglutining factor in the saliva and displacing the calcium from the plaque matrix various formulations of chlorexidine

Mouth rinse chlorexidine mouth rinse are available in the form of 0.2 percent and 0.12 percent there is equal efficacy of 0.2 and 0.12 percent rinse when used at appropriate similar dose after rinsing with 10 ml of 0.2 percent aqueous solution of chlorhexidine for one minute approximately 30 of the drug is retained back in the oral cavity pain cushion effect one

Charge end of chlorhexidine molecule bind to the tooth surface and the other remaining available to interact with the bacterial membrane as microbes as microorganism approaches the tooth surface this is known as pin cushion effect ideal regime is twice daily morning and night which will have a substantiveity for 12 hour clinical application as adjunct to oral

Hygiene and professional profile access post oral surgery and in periodontal surgeries or root planning patient with inter maxillary fixation and in patient who are under high risk of carries physically and mentally handicapped chlorhexidine spray can be used medically compromised patient sub gingival irrigation final irrigation before root canal obturation

Management of denture stromatitis hypersensitivity to the decay recurrent oral ulceration patient undergoing orthodontic treatment oral malada for surgical skin preparation and in failure as a local drug delivery system in the form of biodegradable chip that can be used subjunctivally for example perio chip 2.5 milligram of chlorexidine is found to have average

Drug concentration that is greater than 125 microgram per milliliter for 7 to 10 days side effect brown discoloration of the teeth restorative material and as well as yellow discoloration of the tongue so discoloration will be there on the teeth as well as other restorative material unusual or unpleasant taste in the mouth decreased a sensation oral mucosal

Erosion enhance supra general calculus formation and parotid plant swelling limitation teratogenic effect neurosensory deafness which can occur in chlorhexidine is introduced into the middle layer because many drugs are excreted in human milk caution might be indicated when chlorhexidine is administered to nursing women bacterial resistance resistance has not

Been reported even in long-term oral use allergic reactions has been reported with chlorhexidine thank you

Transcribed from video
Chlorhexidine short note – year 2020 subject periodontology (in English) By Dental lectures and papers Dr Kamlesh Singh