Utjecaj poliheksametilenova bigvanida na mikroorganizme u korijenskom kanalu zuba

Svrha rada: Željela se ispitati djelotvornost 0,2-postotnog poliheksametilenova bigvanida (PHMB) u eliminaciji Enterococcus faecalis, Pseudomonas aeruginosa i Candida albicans te ga usporediti s učinkovitošću 2,5-postotnog natrijeva hipoklorita (NaOCl). Materijali i metode: Na četrdeset osam jednokorijenskih zuba uklonjeni su krune i apikalni dijelovi te su korijenskih kanali instrumentirani Hedström strugaËima do veličine 40. Šesnaest uzoraka inokulirano je bujonskom kulturom E. faecalis (ATCC 51299), P. aeruginosa (ATCC27853) i C. albicans (klinički izolat). Nakon 48-satne inkubacije i ispiranja fiziološkom otopinom uzeti su uzorci dentina iz korijenskih kanala Hedströmovim iglicama veličine 50 i to prije ispiranja 0,2-postotnim PHMB-om i 2,5-postotnim NaOCl-om i nakon toga postupka. Uzorci su zatim preneseni u epruvete s 2 mL sterilne fiziološke otopine i deseterostrukim razrjeđenjem, te su prebačeni na krvni agar nakon 30 sekundi vorteksiranja. Nakon 48-satne inkubacije na 37 ° C prebrojene su bakterijske kolonije po mililitru (CFU/ml). Za statističku analizu korišten je Kruskal-Wallisov test (p <0,05) . Rezultati: Nakon tretmana poliheksametilenovim bigvanidom iz svih je uzoraka uklonjena P. aeruginosa, E. faecalis iz devet od jedanaest, a C. albicans iz sedam od jedanaest uzoraka. NaOCl je bio manje učinkovit od PHMB-a u djelovanju na E. faecalis (p = 0,630) i P. aeruginosa (p = 0,138), a posebice na C. albicans (p = 0,01). Zaključak: Broj E. faecalis i P. aeruginosa učinkovito smanjuju 0,2-postotni PHMB i 2,5-postotni NaOCl. Na C. albicans bolji antimikrobni učinak ima 0,2-postotni PHMB od 2,5-postotnog NaOCl-a. Daljnja istraživanja potrebna su kako bi se ustanovila učinkovitost PHMBa na zreli biofilm i njegova biokompatibilnost.
Objective of work: The objective of this study was to test the effectiveness of 0.2% polyhexamethylen biguanide in the elimination of Enterococcus faecalis, Pseudomonas aeruginosa and Candida albicans and compare it with effectiveness of 2.5% sodium hypochlorite. Materials and Methods: Crown and apical portion of forty- eight single-rooted human teeth was removed and the root canals instrumented with Hedström files up to size 40. Sixteen specimens were inoculated with an overnight broth culture of E.faecalis (ATCC 51299), P.aeruginosa (ATCC27853) and C.albicans (clinical isolate). After 48 h incubation and irrigation with saline, dentine samples were collected from root canal walls with Hedström files size 50 before and after irrigation with 0.2% PHMB and 2.5% NaOCl followed by irrigation with neutralizer and saline. Samples were put into vials containing 2 mL of sterile saline and tenfold dilution, and plated on blood agar after 30 s vortexing. Colony forming units (CFU) were counted after 48 h incubation at 37ºC. For statistical analysis Kruskal-Wallis test (p<0.05) was used. Results: After treatment with PHMB P.aeruginosa was eradicated from all samples, E.faecalis was also reduced and C.albicans was not grown in seven out of eleven samples. NaOCl was less effective than PHMB on E.faecalis (p=0.630) and P.aeruginosa (p=0.138), especially in case of C.albicans (p=0.01). Conclusions: 0.2% PHMB effectively reduced the number of E.faecalis and P.aeruginosa as well as 2.5% NaOCl). On C.albicans 0.2% PHMB showed better antimicrobial effect than 2.5% NaOCl. Further studies will be necessary to determine PHMB’s effectiveness on mature biofilm and its biocompatibility.