Publication: Klorheksidin vernikleri ve fluoridle kombine kullanımlarının çocuklarda tükürük ve plak florasına etkileri
Abstract
Bu araştırmanın amacı fluorid verniği, klorheksidin verniği, klorheksidin ve fluorid verniğinin kombine kullanımının, çocuklarda tükürük ve arayüz plağındaki mutans streptokoklar üzerindeki etkilerinin karşılaştırılmasıdır. Bu amaçla, 7-12 yaş arası, ağzında açık çürük kavitesi bulunmayan, son bir ay içerisinde antibiyotik kullanmamış, tükürük mutans streptokok düzeyi 2x104 cfu/ ml ve üzeri tespit edilen 40 çocuk araştırma kapsamına alınıp dört gruba ayrıldı. Tüm gruplara diş çürüğü ve bakteriler hakkında bilgi verilip, diş fırçalama ve diş ipi kullanma yöntemleri gösterildi. Rastgele dört gruba ayrılmış çocuklardan birinci gruba fluorid verniği (Fluor Protector), ikinci gruba %1 klorheksidin ve timol içeren klorheksidin verniği (Cervitec) uygulandı. Üçüncü grupta klorheksidin verniğinin üzeri fluorid verniği ile kaplandı. Dördüncü grup kontrol grubu olarak tespit edildi. Vernik uygulamaları, birer hafta ara ile olmak üzere iki kere yapıldı. Bu uygulamalardan sonra hastaların bir saat süre ile yiyip içmeleri, 24 saat diş fırçalamaları ve bir hafta süre ile diş ipi kullanmaları yasaklandı. Uygulamalardan bir ay ve üç ay sonra tükürük ve arayüz plak örnekleri alınıp, mutans streptokok tespiti yapıldı. Tükürük mutans streptokok değerleri incelendiğinde, birinci ay sonunda kontrol grubu da dahil olmak üzere, mutans streptokokların anlamlı bir şekilde baskılandığı tespit edildi. Üçüncü ay sonunda fluorid verniği grubu, klorheksidin verniği grubu ve kontrol grubunda baskılanmanın istatistiksel olarak anlamlı olmadığı tespit edildi. Klorheksidin ve fluorid verniğinin kombine kullanıldığı grupta, üçüncü ay sonunda da mutans streptokokların istatistiksel olarak anlamlı bir şekilde baskılandığı tespit edildi. Plak mutans streptokok değerleri incelendiğinde, üç vernik grubunda da birinci ay ve üçüncü ay sonunda mutans streptokokların anlamlı bir şekilde baskılandığı tespit edildi. Mekanik temizlikle birlikte, üç ayda bir gerek klorheksidin ve fluorid verniklerinin, gerek kombine kullanımın, yüksek çürük riskli gruplarda mutans streptokok düzeyini baskılamada etkili olduğu kanısına varıldı.
THE EFFECTS OF CHLORHEXIDINE AND CHLORHEXIDINE-FLUORIDE VARNISHES ON SALIVA AND DENTAL PLAQUE IN CHILDREN The aim of the study was to evaluate and compare the effects of fluoride varnishes, chlorhexidine varnishes and chlorhexidine-fluoride varnishes on the levels of mutans streptococci (MS) in interdental plaque and saliva. 7-12 years old forthy school-children, without open carious lesions, with high and moderate scores of salivary MS (ý2x104 cfu/ ml) and have not used antibiotics for at least one month were selected and randomised into four groups. Information about dental caries, bacteria and methods of tooth brushing and flossing were given to all groups. First group was treated with fluoride varnish (Fluor Protector), the second group was treated with %1 chlorhexidine and tymol containing chlorhexidine varnish (Cervitec). In the third group chlorhexidine varnish was coated with fluoride varnish and the fourth group was determined as control group. The varnishes were applied two times during a 2-week period. After one month and three months, follow-up samples of saliva and plaque from interdental areas were collected. Eating and drinking was avoided for at least three hours after the varnish application. Patients were also adviced not to use toothbrush for 24 hours and dental floss for one week. Mutans streptococci were supressed in saliva in both varnish groups and control group after one month. After three months the mean count of mutans streptococci had returned to the baseline value in fluoride varnish group, chlorhexidine varnish group and control group. Supression was found only in the third group in which chlorhexidine varnish was coated with fluoride varnish. Mutans streptococi were supressed in the approximal plaque in both groups after one month and three months. With mechanic cleaning procedures, application of chlorhexidine varnishes, fluoride varnishes and chlorhexidine-fluoride varnishes every three months is effective in suppresssion of mutans streptococci in high caries risk groups.
THE EFFECTS OF CHLORHEXIDINE AND CHLORHEXIDINE-FLUORIDE VARNISHES ON SALIVA AND DENTAL PLAQUE IN CHILDREN The aim of the study was to evaluate and compare the effects of fluoride varnishes, chlorhexidine varnishes and chlorhexidine-fluoride varnishes on the levels of mutans streptococci (MS) in interdental plaque and saliva. 7-12 years old forthy school-children, without open carious lesions, with high and moderate scores of salivary MS (ý2x104 cfu/ ml) and have not used antibiotics for at least one month were selected and randomised into four groups. Information about dental caries, bacteria and methods of tooth brushing and flossing were given to all groups. First group was treated with fluoride varnish (Fluor Protector), the second group was treated with %1 chlorhexidine and tymol containing chlorhexidine varnish (Cervitec). In the third group chlorhexidine varnish was coated with fluoride varnish and the fourth group was determined as control group. The varnishes were applied two times during a 2-week period. After one month and three months, follow-up samples of saliva and plaque from interdental areas were collected. Eating and drinking was avoided for at least three hours after the varnish application. Patients were also adviced not to use toothbrush for 24 hours and dental floss for one week. Mutans streptococci were supressed in saliva in both varnish groups and control group after one month. After three months the mean count of mutans streptococci had returned to the baseline value in fluoride varnish group, chlorhexidine varnish group and control group. Supression was found only in the third group in which chlorhexidine varnish was coated with fluoride varnish. Mutans streptococi were supressed in the approximal plaque in both groups after one month and three months. With mechanic cleaning procedures, application of chlorhexidine varnishes, fluoride varnishes and chlorhexidine-fluoride varnishes every three months is effective in suppresssion of mutans streptococci in high caries risk groups.