Synergistic effect of 2% chlorhexidine combined with proteolytic enzymes on biofilm disruption and killing

TY - JOUR

T1 - Synergistic effect of 2% chlorhexidine combined with proteolytic enzymes on biofilm disruption and killing

AU - Niazi, Sadia

AU - Al-Ali, W. M.

AU - Patel, S

AU - Foschi, F.

AU - Mannocci, F.

PY - 2015/1/3

Y1 - 2015/1/3

N2 - Aim To investigate the dynamics of a disinfection regimen using 1% trypsin and 1% proteinase K in combination with 2% chlorhexidine (with or without ultrasonics) using a nutrient-stressed endodontic multispecies model biofilm. Methodology Nutrient-stressed biofilms (Propionibacterium acnes, Staphylococcus epidermidis, Actinomyces radicidentis, Streptococcus mitis and Enterococcus faecalis OMGS 3202) were grown in prepared root canals of single-rooted teeth. The treatment groups included 1% trypsin and 2% chlorhexidine (CHX), 1% proteinase K and 2% CHX (with and without ultrasonics). 2% CHX was the positive control and untreated group, and sterile saline (with and without ultrasonics) was the negative control. The biofilms were investigated using confocal laser scanning microscopy (CLSM) with live/dead staining and quantitative microbial culture. Results The trypsin and CHX group with ultrasonics was significantly more effective in reducing viable counts and the substratum coverage than those of all other groups (P < 0.05). The viable counts of the proteinase K and CHX group used with (4.26 ± 0.58 log10 cfu mL−1) or without ultrasonics (5.05 ± 1.36 log10 cfu mL−1) were significantly reduced (P < 0.05) as compared with the untreated control (7.67 ± 0.84 log10 cfu mL−1) and saline groups used with (6.57 ± 0.73 log10 cfu mL−1) and without ultrasonics (6.74 ± 0.10 log10 cfu mL−1). The CHX group was less effective in biofilm disruption compared to when used in combination with trypsin and proteinase K. Conclusion The trypsin and CHX group with ultrasonics was significantly more effective at reducing bacterial viable counts and disrupting biofilm.

AB - Aim To investigate the dynamics of a disinfection regimen using 1% trypsin and 1% proteinase K in combination with 2% chlorhexidine (with or without ultrasonics) using a nutrient-stressed endodontic multispecies model biofilm. Methodology Nutrient-stressed biofilms (Propionibacterium acnes, Staphylococcus epidermidis, Actinomyces radicidentis, Streptococcus mitis and Enterococcus faecalis OMGS 3202) were grown in prepared root canals of single-rooted teeth. The treatment groups included 1% trypsin and 2% chlorhexidine (CHX), 1% proteinase K and 2% CHX (with and without ultrasonics). 2% CHX was the positive control and untreated group, and sterile saline (with and without ultrasonics) was the negative control. The biofilms were investigated using confocal laser scanning microscopy (CLSM) with live/dead staining and quantitative microbial culture. Results The trypsin and CHX group with ultrasonics was significantly more effective in reducing viable counts and the substratum coverage than those of all other groups (P < 0.05). The viable counts of the proteinase K and CHX group used with (4.26 ± 0.58 log10 cfu mL−1) or without ultrasonics (5.05 ± 1.36 log10 cfu mL−1) were significantly reduced (P < 0.05) as compared with the untreated control (7.67 ± 0.84 log10 cfu mL−1) and saline groups used with (6.57 ± 0.73 log10 cfu mL−1) and without ultrasonics (6.74 ± 0.10 log10 cfu mL−1). The CHX group was less effective in biofilm disruption compared to when used in combination with trypsin and proteinase K. Conclusion The trypsin and CHX group with ultrasonics was significantly more effective at reducing bacterial viable counts and disrupting biofilm.

KW - Chlorhexidine

KW - Proteinase K

KW - Trypsin

KW - Ultrasonics

UR - http://www.scopus.com/inward/record.url?scp=84920901722&partnerID=8YFLogxK

U2 - 10.1111/iej.12420

DO - 10.1111/iej.12420

M3 - Article

SN - 0143-2885

JO - International Endodontic Journal

JF - International Endodontic Journal

ER -