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In vitro sealing ability of two different chlorhexidine varnishes at implant abutment junction

This paper is available in a repository.
This paper is available in a repository.

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Abstract

Background: Peri-implant mucositis is the reversible inflammation of soft tissues around dental implants. If not prevented it may proceed to peri-implantitis which consequently can cause bone resorption around the marginal area. The main cause has been attributed to is bacterial contamination. With regards to two piece implants, the contamination is seen to begin following the second surgical procedure, when implants are exposed to the oral cavity. Chlorhexidine varnishes are mostly used for preventing periodontal diseases and also for peri-implant diseases especially in the first year of function of implants. However the sealing capacity and the impact of the varnishes are not well-documented in the current literature. The in-vitro studies are mostly designed by using titanium discs however observing the sealing capacity of the varnish at implant abutment junction is more valuable. Aim/Hypothesis: The purpose of this study is to evaluate the sealing effect of two varnishes (EC40 and Cervitec) in an oral bio-film in vitro; at the implant abutment junction. Material and methods: In the first phase implants and abutments were sealed with EC40 (Sandarac 35%, Chlorhexidine Diacetate 34%, Ethanol 30%) or Cervitec (Chlorhexidine 1%, Thymol 1%) and abutments were screwed onto the implants and torqued 20 Ncm with a rachet adaptor. Two different types of implants were used (Tekka, Brignais, France and Biohorizon, Birmingham, AL, USA). A mixed culture of Actinomyces Actinomycetencomitans ATCC 33384, Tannerella Forsythia ATCC 43037, Fusobac-terium nucleatum ATCC 25586, Porphyromonas gingivalis, Prevotella intermedia and Streptococcus mutans ATCC 25175 was adjusted to 1 9 108 by McFarland no 0.5 in BHI (Thermo Scientific, UK) broth. Implants sealed with EC4O, Cervitec and control implants were transferred into the mixed culture and incubated anaerobically at 37°C for 72 h. After periods of 7, 14 and 21 days, the sealing capacity and the antimicrobial activity was checked. Statistical analyses were performed using SPSS version 21 (Chicago, IL). Descriptive statistics were shown with frequency and percentages for categorical data. Chi-Square test was used to compare the frequency distribution of the groups. P≤.05 was considered statistically significant. Results: Preliminary results showed no bacterial growth after 7 and 14 days with both Tekka and Biohorizon implants sealed with EC40. On the 21st day, bacterial counts were observed at 2 9 106 and 32 9 106 respectively in Tekka and Biohorizon implants. Cervitec seal displayed high bacterial counts (123 9 106 and 31 9 106) for Biohorizon implants, on the 7th and 14th days. However, following 21 days the bacterial counts decreased both for Biohorizon and Tekka implants. Despite these changes no significant difference was observed between all groups (P < 0.005). Conclusion and clinical implications: Within the limitations of this study, it can be concluded that EC40 exerted prolonged anti-bacterial effect on oral biofilm compared to Cervitec varnish.