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ePaper created 2018-04-10, 12:30:21 | version 1.38.0
industry | Chloramines are physiological compounds that play an essential role in the natural human immune system.4–6 PERISOLV® thus has a pronounced antimicrobial activity1 also against bacteria in biofilms on implant surfaces.7 Its degranulating effect improves the efficiency of tooth root and implant surface cleaning (Figs. 1–7).7–9 Antimicrobial activity The antimicrobial properties of NCA are well stud- ied. NCA causes a significant inactivation of bacteria,10–13 fungi,12, 14, 15 viruses16–18 and protozoa19. Even when exposed to sublethal concentrations of chloramines for pathogenic bacteria, a positive effect is observed. Chlorination of the bacterial cell membrane produces a postantibiotic effect (retardation of growth). As a result, bacterial inactivation is promoted by the body’s immune system.13, 20–22 PERISOLV® shows significant antibacterial activity, which is pronounced even at rather low concentration.2 It has further shown markedly higher inactivation rates than chlorhexidine and hydrogen peroxide for the periodon- tal pathogenic organisms Porphyromonas gingivalis, Prevotella intermedia, Aggregatibacter actinomycetem- comitans and Fusobacterium nucleatum. This superior effectiveness at low concentration is of great relevance for application in the tooth pocket. In this case, especially in periodontally infected pockets, a high sulcular fluid rate prevails, and this can cause rapid dilution of topically applied antiseptics/antibiotics.23 An in vitro study at the University of Bern in Switzer- land has shown that the specific composition of the preparation increases the inactivation efficacy on an es- tablished biofilm compared with standard disinfectants.1 In this study, the antimicrobial activity of PERISOLV®, its components and chlorhexidine was investigated on bac- terial strains associated with periodontal disease. The effect of the antiseptics on individual bacteria and on an established biofilm consisting of six kinds of bacte- ria was examined. PERISOLV® showed a greater inacti- vation rate on the biofilm than the chlorhexidine solution did (Figs. 8–11). The activity of PERISOLV® was found to be different for Gram-positive and Gram-negative bacteria. Gram-nega- tive bacteria were inactivated even at a low PERISOLV® Fig. 8 Fig. 9 Fig. 10 Fig. 11 Fig. 8: Clinical situation of the peri-implant mucositis site. Implant with probing depth ≤ 5 mm and bleeding on probing. Fig. 9: Application of PERISOLV® before the non-surgical therapy. Fig. 10: After an exposure time of 30 seconds, the biofilm was removed non-surgically using an ultrasonic device with a PEEK tip. Fig. 11: Situation six months after therapy. Probing depth of ≤ 4 mm and no bleeding on probing. concentration. This selective inhibition could benefit Gram-positive bacteria, which have a greater associa- tion with periodontal health.24 For example, if these bac- teria are eliminated, their physiological role in the regula- tion of blood pressure could be disturbed.25 Conclusion The adjuvant use of PERISOLV® for the decontami- nation of inflamed periodontal and peri-implant sites is indicated because the slightly alkaline gel softens the extracellular matrix of the biofilm (proteins and polysac- charides), allowing better penetration by the chloramines, which effectively eliminate pathogens. In addition, the immediate inactivation effect of PERISOLV® could prevent bacteria from entering the blood stream during mechanical treatment. All figures: © Vincenzo Iorio-Siciliano about contact Dr Vincenzo Iorio-Siciliano is a professor of periodontology at the University of Catanzaro, Italy, adjunct professor of periodontology and implantology at the University Federico II in Naples, Italy and also works as visiting scientist at the department of periodontology at the University of Bern, Switzerland. REGEDENT AG Zollikerstr. 144 8008 Zurich, Switzerland Tel.: +41 44 7003777 info@regedent.com www.regedent.com 35 1 2018