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DOI: 10.1055/s-0031-1278698
© Georg Thieme Verlag Stuttgart · New York
Plaquekontrolle mit Chlorhexidin – Spüllösungen, Gele, Lacke, Chips
Plaque Control by Chlorhexidine – Mouthrinses, Gels, Varnishes, ChipsPublication History
Publication Date:
02 May 2011 (online)
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Plaquekontrolle ist conditio sine qua non zur Prävention von Karies, Gingivitis und Parodontitis. Die Plaquekontrolle erfolgt grundsätzlich mechanisch, rein chemisch oder kombiniert mechanisch und chemisch. Chlorhexidin hat sich seit Jahrzehnten als „Goldstandard“ zur chemischen bzw. mechanisch-chemischen Plaquekontrolle in Form von Spüllösungen, Gelen und Lacken erwiesen. Aus Sicht der Sensibilität kariogener und parodontopathogener Keime in vitro sind beide Keimgruppen im Wirkspektrum des Chlorhexidins eingeschlossen. Die Rekolonisierung von Aktinomyzeten und Streptokokken in der supragingivalen Plaque dürfte empfindlich gestört werden und unter den gramnegativen Bakterien insbesondere die von Porphyromonas gingivalis in der subgingivalen Plaque. Auch Staphylococcus aureus (Implantate) und Candida albicans (Prothesenstomatitis) erwiesen sich als sensibel gegenüber Chlorhexidin. Mit dem PerioChip® werden insbesondere Gramnegative und S. aureus erfasst. Gele sind Mundspüllösungen in ihrer Wirkung überlegen und 0,1 %ige und 0,2 %ige Mundspüllösungen gleichwertig.
Control of biofilms is fundamental to prevent caries, gingivitis and periodontitis. Dental biofilms were usually controlled inadequately by mechanical means. Therefore, agents that prevent the formation of biofilms, disrupt biofilms or modify the biofilm biochemistry and ecology were developed. Chlorhexidine is the most thoroughly studied and the most efficacious antibiofilm and antigingivitis agent, and represents a gold standard against which the potency of other antibiofilm agents is compared. Vehicles for administration of chlorhexidine to the oral cavity are mouthrinses, gels and varnishes. The majority of cariogenic and periodontopathogenic germs were susceptible against chlorhexidine formulations in vitro. The recolonisation of actinomyces and streptococci in supragingival plaque should be disturbed and furthermore, the recolonisation of gramnegative germs in the subgingival plaque especially P. gingivalis. S. aureus (implants) and C. albicans (stomatitis) were inhibited by chlorhexidine as well. Gramnegative germs, especially P. gingivalis, were inhibited by the PerioChip®. Gels could be demonstrated to be more effective than mouthrinses and the effectiveness of 0,1 % and 0,2 % mouthrinses were comparable.
Schlüsselwörter
Chlorhexidin - Wirkungsweise - Verabreichungsformen - Sensibles Keimspektrum
Key words
Chlorhexidine - Mode of Action - Vehicles - Susceptibility among Germs
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Korrespondenzadresse
Prof. Susanne Kneist
Universitätsklinikum Jena Medizinische Fakultät Zentrum für Zahn-, Mund- und Kieferheilkunde (Geschäftsführender Direktor Prof. Dr. H. Küpper) Biologisches Forschungslabor
Bachstraße 18
07740 Jena
Email: Susanne.Kneist@med.uni-jena.de