Journal of Oral Implantology December 2013 - (Page 689)

RESEARCH The Bactericidal Effects of an Acidified Sodium ChloriteContaining Oral Moisturizing Gel: A Pilot Study Iwao Kuroyama, DDS, PhD Shigeo Osato, DDS, PhD* Takahiro Ogawa, DDS, PhD The aim of this study was to examine the bactericidal effects and bactericidal time of an acidified sodium chlorite compound gel (ASC-Gel) on bacteria isolated from the peri-implant sulci of 10 patients who received implants 3-27 years previously, and the depth of each peri-implant sulcus was 5 mm or less. Porphyromonas gingivalis (ATCC33277) was used as the control bacterium. Five ASC-Gel preparations were created by adding 3.3%, 5.0%, 7.0%, 9.0%, and 11.0% citric acid (CA) (condition a, b, c, d, and e, respectively) into an oral moisturizing gel containing sodium chlorite. The concentrations of chlorine dioxide (ClO2) generated in ASC-Gel under conditions (a) to (e) were 12.1, 14.1, 17.2, 21.2, and 39.3 ppm, respectively. We examined the bactericidal effects of the 5 ASC-Gel preparations at volumes of 0.5, 1.0, and 2.0 mL, and measured the bactericidal time when 2.0 mL of ASC-Gel was used under condition (e). The bactericidal effects of ASC-Gel became significantly greater with increased concentrations of CA and ClO2 and with increased usage (0.5À2.0 mL) of the gel. All bacteria were killed by using 2.0 mL of ASC-Gel under condition (e). ASC-Gel also needed between 45 and 90 minutes to kill all microbes under condition (e). Within the limits of the present investigation, these results suggest that ASC-Gel is useful as a chemical disinfectant against bacteria in the peri-implant sulcus. Further studies are also required to protect teeth, the surface of hydroxyapatite-coated implants, and the surrounding soft tissues from effects of chemical dissolution such as acid erosion due to the low pH of ASC-Gel. Key Words: bactericidal effect, acidified sodium chlorite (ASC), chlorine dioxide (ClO2), oral moisturizing gel, peri-implant sulcus INTRODUCTION M aintenance of good occlusal loading1,2 and infection control measures3-5 are crucial for the longterm success of implant prostheses.6 For the latter, management of the soft tissue around implants and of the remaining teeth is important.7-10 Treatment protocols that are based on the system of cumulative interceptive supportive therapy have 5 stages: (1) mechanical cleaning, (2) antiseptic therapy, (3) antibiotic therapy, (4) surgical approach, and (5) explantation.11 These protocols have been proDepartment of Histology, The Nippon Dental University School of Life Dentistry at Tokyo, Tokyo, Japan. * Corresponding author, e-mail: osato-s@giga.ocn.ne.jp DOI: 10.1563/AAID-JOI-D-11-00087 posed to improve the condition of patients with peri-implantitis. Chemical cleanings have been reported to be as effective as mechanical cleaning. Citric acid (CA), 3,4 chlorhexidine digluconate (CHX),12,13 and chlorine dioxide (ClO2)14,15 have demonstrated efficacy as antiseptics in postoperative management of peri-implant pathogens. CHX-containing and ClO2-containing mouthrinses have been used in the treatment of oral malodor14,16,17 and chronic atrophic candidiasis,18 and as an antibacterial agent against methicillinresistant Staphylococcus aureus (MRSA).19 Furthermore, a combination of in vitro chemical and mechanical cleaning, involving the use of an acidified ClO2 mouthrinse supplemented with CA and ultrasonic cleaning of the implant fixtures, achieved bacterial elimination in 3 minutes.15 The acidified ClO2 mouthrinse has demonstrated effecJournal of Oral Implantology 689

Table of Contents for the Digital Edition of Journal of Oral Implantology December 2013

Blade-Form Dental Implants: FDA Reclassification as a Class II Dental Implant Device
Effect of Different Storage Media on the Regenerative Potential of Autogenous Bone Grafts: A Histomorphometrical Analysis in Rabbits
Tensile Resistance of Mineralized and Demineralized Rat Bones in Different Regions (Calvarial and Femur)
Microbial Diversity of Peri-Implant Biofilms on Implant Fixed Bar and Telescopic Double Crown Attachments
Evidence-Based Techniques to Assess the Performance of Dental Implants
Influence of Platform and Abutment Angulation on Peri-Implant Bone. A Three- Dimensional Finite Element Stress Analysis
Direct Current Electric Stimulation in Implant Osseointegration: An Experimental Animal Study With Sheep
Prevalence of Sinus Augmentation Associated With Maxillary Posterior Implants
The Bactericidal Effects of an Acidified Sodium Chlorite-Containing Oral Moisturizing Gel: A Pilot Study
Influence of Fine Threads and Platform-Switching on Crestal Bone Stress Around Implant— A Three-Dimensional Finite Element Analysis
An Evaluation of the Resonance Frequency Analysis Device: Examiner Reliability and Repeatability of Readings
Histologic and Histomorphometric Assessment of Implants and Periapical Tissues When Placed in the Sockets of Extracted Teeth, Teeth With Periapical Lesions, and Healed Lesions: A Canine Study
Microbiological Aspects of Human Mandibular Subperiosteal Dental Implants
A Technique for Removal of a Fractured Implant Abutment Screw
Eight-Year Results of Site Retention of Anorganic Bovine Bone and Anorganic Bovine Matrix
A Reactive Lesion (Pyogenic Granuloma) Associated With Dental Implant: A Case Report
Twelve-Year Clinical and Radiological Results of Maxillary and Mandibular Implant- Retained Bar Overdentures Carried out on Oxidized (TiUnite) Replace Select Implants: A Clinical Case
PEEK Dental Implants: A Review of the Literature

Journal of Oral Implantology December 2013