Analysis of Chlorhexidine Modified Cement in Orthodontic Patients: A Double-Blinded, Randomized, Controlled Trial

Abstract Objectives The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX) for the purpose of cementing bands to the teeth of orthodontic patients. Materials and Methods Ten patients, between the ages of 19 an...

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Published inEuropean journal of dentistry Vol. 15; no. 4; pp. 639 - 646
Main Authors Araújo, José Lucas dos Santos, Alvim, Mariana Massi Afonso, Campos, Márcio José da Silva, Apolônio, Ana Carolina Morais, Carvalho, Fabíola Galbiatti, Lacerda-Santos, Rogério
Format Journal Article
LanguageEnglish
Published A-12, 2nd Floor, Sector 2, Noida-201301 UP, India Thieme Medical and Scientific Publishers Pvt. Ltd 01.10.2021
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microbiota
orthodontic
glass ionomer cement
chlorhexidine
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Abstract Abstract Objectives The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX) for the purpose of cementing bands to the teeth of orthodontic patients. Materials and Methods Ten patients, between the ages of 19 and 33 years, in the initial stage of orthodontic treatment, were randomly designated to two groups using the split-mouth design ( n = 10). One group (GICEX) had bands cemented with GIC modified by CLX and a Control group (GIC), evaluated at time intervals before (T0), 3 months (T3), and 6 months (T6) after cementation. Total microbiological counts were performed, and color stability of tooth enamel, salivary pH, and the adhesive remnant index (ARI) were evaluated. Statistical Analysis The Friedman and Dunn’s tests, Mann–Whitney, one-way analysis of variance, and Tukey, and paired and non-paired t -tests ( p < 0.05) were used. Results In T3, there was evidence of significant reduction in the quantity of colony forming unit (CFU) in GICEX group in comparison with the Control ( p = 0.041). In T6, the quantity of CFU was similar to the quantity in T3 and significantly different to control ( p = 0.045); Control group demonstrated a similar quantity of CFU between the experimental time intervals ( p = 0.066). Salivary pH demonstrated significant difference only between the time intervals T0 and T6 ( p = 0.022). The tooth enamel color ( p = 0.366) and ARI ( p = 0.343) values demonstrated no significant changes. Conclusion The incorporation of CLX into GIC demonstrated effective antibacterial action, allowed a good bond of the cement to the enamel, a high rate of survival of the bands, did not change the color of the tooth enamel, and maintained the salivary pH at physiological levels.
AbstractList OBJECTIVESThe aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX) for the purpose of cementing bands to the teeth of orthodontic patients. MATERIALS AND METHODSTen patients, between the ages of 19 and 33 years, in the initial stage of orthodontic treatment, were randomly designated to two groups using the split-mouth design (n = 10). One group (GICEX) had bands cemented with GIC modified by CLX and a Control group (GIC), evaluated at time intervals before (T0), 3 months (T3), and 6 months (T6) after cementation. Total microbiological counts were performed, and color stability of tooth enamel, salivary pH, and the adhesive remnant index (ARI) were evaluated. STATISTICAL ANALYSISThe Friedman and Dunn's tests, Mann-Whitney, one-way analysis of variance, and Tukey, and paired and non-paired t-tests (p< 0.05) were used. RESULTSIn T3, there was evidence of significant reduction in the quantity of colony forming unit (CFU) in GICEX group in comparison with the Control (p = 0.041). In T6, the quantity of CFU was similar to the quantity in T3 and significantly different to control (p = 0.045); Control group demonstrated a similar quantity of CFU between the experimental time intervals (p = 0.066). Salivary pH demonstrated significant difference only between the time intervals T0 and T6 (p = 0.022). The tooth enamel color (p = 0.366) and ARI (p = 0.343) values demonstrated no significant changes. CONCLUSIONThe incorporation of CLX into GIC demonstrated effective antibacterial action, allowed a good bond of the cement to the enamel, a high rate of survival of the bands, did not change the color of the tooth enamel, and maintained the salivary pH at physiological levels.
Abstract Objectives The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX) for the purpose of cementing bands to the teeth of orthodontic patients. Materials and Methods Ten patients, between the ages of 19 and 33 years, in the initial stage of orthodontic treatment, were randomly designated to two groups using the split-mouth design (n = 10). One group (GICEX) had bands cemented with GIC modified by CLX and a Control group (GIC), evaluated at time intervals before (T0), 3 months (T3), and 6 months (T6) after cementation. Total microbiological counts were performed, and color stability of tooth enamel, salivary pH, and the adhesive remnant index (ARI) were evaluated. Statistical Analysis The Friedman and Dunn’s tests, Mann–Whitney, one-way analysis of variance, and Tukey, and paired and non-paired t-tests (p< 0.05) were used. Results In T3, there was evidence of significant reduction in the quantity of colony forming unit (CFU) in GICEX group in comparison with the Control (p = 0.041). In T6, the quantity of CFU was similar to the quantity in T3 and significantly different to control (p = 0.045); Control group demonstrated a similar quantity of CFU between the experimental time intervals (p = 0.066). Salivary pH demonstrated significant difference only between the time intervals T0 and T6 (p = 0.022). The tooth enamel color (p = 0.366) and ARI (p = 0.343) values demonstrated no significant changes. Conclusion The incorporation of CLX into GIC demonstrated effective antibacterial action, allowed a good bond of the cement to the enamel, a high rate of survival of the bands, did not change the color of the tooth enamel, and maintained the salivary pH at physiological levels.
Abstract Objectives The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX) for the purpose of cementing bands to the teeth of orthodontic patients. Materials and Methods Ten patients, between the ages of 19 and 33 years, in the initial stage of orthodontic treatment, were randomly designated to two groups using the split-mouth design ( n = 10). One group (GICEX) had bands cemented with GIC modified by CLX and a Control group (GIC), evaluated at time intervals before (T0), 3 months (T3), and 6 months (T6) after cementation. Total microbiological counts were performed, and color stability of tooth enamel, salivary pH, and the adhesive remnant index (ARI) were evaluated. Statistical Analysis The Friedman and Dunn’s tests, Mann–Whitney, one-way analysis of variance, and Tukey, and paired and non-paired t -tests ( p < 0.05) were used. Results In T3, there was evidence of significant reduction in the quantity of colony forming unit (CFU) in GICEX group in comparison with the Control ( p = 0.041). In T6, the quantity of CFU was similar to the quantity in T3 and significantly different to control ( p = 0.045); Control group demonstrated a similar quantity of CFU between the experimental time intervals ( p = 0.066). Salivary pH demonstrated significant difference only between the time intervals T0 and T6 ( p = 0.022). The tooth enamel color ( p = 0.366) and ARI ( p = 0.343) values demonstrated no significant changes. Conclusion The incorporation of CLX into GIC demonstrated effective antibacterial action, allowed a good bond of the cement to the enamel, a high rate of survival of the bands, did not change the color of the tooth enamel, and maintained the salivary pH at physiological levels.
The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX) for the purpose of cementing bands to the teeth of orthodontic patients. Ten patients, between the ages of 19 and 33 years, in the initial stage of orthodontic treatment, were randomly designated to two groups using the split-mouth design ( = 10). One group (GICEX) had bands cemented with GIC modified by CLX and a Control group (GIC), evaluated at time intervals before (T0), 3 months (T3), and 6 months (T6) after cementation. Total microbiological counts were performed, and color stability of tooth enamel, salivary pH, and the adhesive remnant index (ARI) were evaluated. The Friedman and Dunn's tests, Mann-Whitney, one-way analysis of variance, and Tukey, and paired and non-paired -tests ( < 0.05) were used. In T3, there was evidence of significant reduction in the quantity of colony forming unit (CFU) in GICEX group in comparison with the Control ( = 0.041). In T6, the quantity of CFU was similar to the quantity in T3 and significantly different to control ( = 0.045); Control group demonstrated a similar quantity of CFU between the experimental time intervals ( = 0.066). Salivary pH demonstrated significant difference only between the time intervals T0 and T6 ( = 0.022). The tooth enamel color ( = 0.366) and ARI ( = 0.343) values demonstrated no significant changes. The incorporation of CLX into GIC demonstrated effective antibacterial action, allowed a good bond of the cement to the enamel, a high rate of survival of the bands, did not change the color of the tooth enamel, and maintained the salivary pH at physiological levels.
Objectives The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX) for the purpose of cementing bands to the teeth of orthodontic patients. Materials and Methods Ten patients, between the ages of 19 and 33 years, in the initial stage of orthodontic treatment, were randomly designated to two groups using the split-mouth design ( n = 10). One group (GICEX) had bands cemented with GIC modified by CLX and a Control group (GIC), evaluated at time intervals before (T0), 3 months (T3), and 6 months (T6) after cementation. Total microbiological counts were performed, and color stability of tooth enamel, salivary pH, and the adhesive remnant index (ARI) were evaluated. Statistical Analysis The Friedman and Dunn’s tests, Mann–Whitney, one-way analysis of variance, and Tukey, and paired and non-paired t -tests ( p < 0.05) were used. Results In T3, there was evidence of significant reduction in the quantity of colony forming unit (CFU) in GICEX group in comparison with the Control ( p = 0.041). In T6, the quantity of CFU was similar to the quantity in T3 and significantly different to control ( p = 0.045); Control group demonstrated a similar quantity of CFU between the experimental time intervals ( p = 0.066). Salivary pH demonstrated significant difference only between the time intervals T0 and T6 ( p = 0.022). The tooth enamel color ( p = 0.366) and ARI ( p = 0.343) values demonstrated no significant changes. Conclusion The incorporation of CLX into GIC demonstrated effective antibacterial action, allowed a good bond of the cement to the enamel, a high rate of survival of the bands, did not change the color of the tooth enamel, and maintained the salivary pH at physiological levels.
Author Alvim, Mariana Massi Afonso
Araújo, José Lucas dos Santos
Carvalho, Fabíola Galbiatti
Lacerda-Santos, Rogério
Campos, Márcio José da Silva
Apolônio, Ana Carolina Morais
AuthorAffiliation 1 Graduate Program in Dentistry, Dental School, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
2 Rua José Lourenço Kelmer, São Pedro, Brazil
4 Department of Orthodontics, Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais, Brazil
3 Pharmacy School, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
AuthorAffiliation_xml – name: 4 Department of Orthodontics, Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais, Brazil
– name: 2 Rua José Lourenço Kelmer, São Pedro, Brazil
– name: 3 Pharmacy School, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
– name: 1 Graduate Program in Dentistry, Dental School, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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  givenname: José Lucas dos Santos
  surname: Araújo
  fullname: Araújo, José Lucas dos Santos
  organization: Rua José Lourenço Kelmer, São Pedro, Brazil
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  givenname: Mariana Massi Afonso
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  fullname: Alvim, Mariana Massi Afonso
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  givenname: Márcio José da Silva
  surname: Campos
  fullname: Campos, Márcio José da Silva
  organization: Department of Orthodontics, Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais, Brazil
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  givenname: Ana Carolina Morais
  surname: Apolônio
  fullname: Apolônio, Ana Carolina Morais
  organization: Department of Orthodontics, Faculty of Dentistry, Federal University of Juiz de Fora, Minas Gerais, Brazil
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  givenname: Fabíola Galbiatti
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  givenname: Rogério
  orcidid: 0000-0002-6213-9206
  surname: Lacerda-Santos
  fullname: Lacerda-Santos, Rogério
  organization: Department of Orthodontics, Faculty of Dentistry, Federal University of Juiz de Fora
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Cites_doi 10.1111/j.1601-6343.2008.00432.x
10.1186/s40510-018-0230-4
10.1002/jemt.22822
10.1055/s-0040-1714453
10.2341/08-20
10.4317/jced.56308
10.1177/154405910208100815
10.1590/S1678-77572010000500015
10.1080/14653125.2016.1221214
10.2319/090310-518.1
10.1016/j.ajodo.2019.03.027
10.1007/PL00001917
10.1179/14653120522502078
10.1055/s-0040-1702255
10.5005/jp-journals-10005-1342
10.1590/S1678-77572010000100010
10.1038/sj.bdj.4800959
10.1177/00220345750540022601
10.1016/j.ajodo.2018.12.018
10.4012/dmj.2019-046
10.1590/0001-3765201720170329
10.1111/j.1601-6343.2007.00396.x
10.2319/032914-234.1
10.1016/j.jdent.2006.02.002
10.1179/bjo.18.1.15
10.1016/j.ajodo.2012.07.017
10.1016/0197-2456(95)00134-4
10.1093/ejo/23.1.91
10.2319/0003-3219(2007)077[0331:IODOBO]2.0.CO;2
10.1111/j.1600-051X.1995.tb01775.x
10.1179/bjo.22.2.161
10.1007/s10266-019-00465-z
10.2341/07-71
10.1055/s-0040-1703999
10.1111/j.1601-0825.2005.01217.x
10.1093/ortho/27.2.149
10.1007/s00784-017-2088-0
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European Journal of Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). 2021 European Journal of Dentistry
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– notice: European Journal of Dentistry. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/). 2021 European Journal of Dentistry
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Keywords microbiota
orthodontic
glass ionomer cement
chlorhexidine
Language English
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References A A Dos Santos (ref28) 2015; 85
A Z Bergamo (ref5) 2016; 43
R Torres-Rosas (ref12) 2020; 14
J Brandt (ref20) 2017; 21
C Dawes (ref32) 2003; 69
A S Coelho (ref13) 2020; 108
B Bagis (ref39) 2011; 42
J A Mesquita (ref3) 2017; 89
J Almeida Mesquita (ref2) 2017; 80
I Sifakakis (ref30) 2018; 19
S J Hodges (ref41) 2001; 23
N Pandis (ref7) 2008; 11
F C Lessa (ref25) 2010; 18
A R Jadad (ref22) 1996; 17
M M Farret (ref1) 2011; 81
D R Stirrups (ref44) 1991; 18
C Daniels (ref18) 2000; 27
L E do Nascimento (ref19) 2013; 143
F Jenatschke (ref46) 2001; 62
D T Millett (ref42) 1995; 22
D J Aframian (ref29) 2006; 12
I HC Meneses (ref14) 2020; 14
M Ristic (ref34) 2007; 10
P Ramberg (ref33) 1995; 22
S S Meireles (ref21) 2008; 33
M I Brusca (ref23) 2007; 77
D T Millett (ref10) 2005; 32
T Walsh (ref45) 2015
G M Sampaio (ref16) 2020; 12
Y R Vandersluis (ref4) 2020; 157
A Watts (ref36) 2001; 190
E Reichardt (ref6) 2019; 156
D T Millett (ref43) 2001; 71
D Aguilar-Perez (ref8) 2020; 39
A J Hassel (ref37) 2005; 18
F B Zanatta (ref40) 2010; 18
S Paul (ref35) 2002; 81
A Joiner (ref38) 2006; 34
A CP Serratine (ref31) 2009; 9
F Ripari (ref11) 2020; 14
G AM Sampaio (ref15) 2020; 22
A Hoszek (ref27) 2008; 33
J V Yadiki (ref24) 2016; 9
R Lacerda-Santos (ref9) 2016; 18
G Rölla (ref26) 1975; 54 Spec No B
References_xml – volume: 11
  start-page: 211
  issue: 04
  year: 2008
  ident: ref7
  article-title: Periodontal condition of the mandibular anterior dentition in patients with conventional and self-ligating brackets
  publication-title: Orthod Craniofac Res
  doi: 10.1111/j.1601-6343.2008.00432.x
  contributor:
    fullname: N Pandis
– volume: 19
  start-page: 25
  issue: 01
  year: 2018
  ident: ref30
  article-title: Salivary levels of cariogenic bacterial species during orthodontic treatment with thermoplastic aligners or fixed appliances: a prospective cohort study
  publication-title: Prog Orthod
  doi: 10.1186/s40510-018-0230-4
  contributor:
    fullname: I Sifakakis
– volume: 80
  start-page: 504
  issue: 05
  year: 2017
  ident: ref2
  article-title: Morphological and immunohistochemical analysis of the biocompatibility of resin-modified cements
  publication-title: Microsc Res Tech
  doi: 10.1002/jemt.22822
  contributor:
    fullname: J Almeida Mesquita
– volume: 14
  start-page: 397
  issue: 03
  year: 2020
  ident: ref12
  article-title: Anti-inflammatory and antibacterial activity of the chitosan/chlorhexidine gel commercial preparation for postexodontia treatment: an in vitro study
  publication-title: Eur J Dent
  doi: 10.1055/s-0040-1714453
  contributor:
    fullname: R Torres-Rosas
– volume: 33
  start-page: 696
  issue: 06
  year: 2008
  ident: ref27
  article-title: In vitro fluoride release and the antibacterial effect of glass ionomers containing chlorhexidine gluconate
  publication-title: Oper Dent
  doi: 10.2341/08-20
  contributor:
    fullname: A Hoszek
– volume: 12
  start-page: e178
  issue: 02
  year: 2020
  ident: ref16
  article-title: Antimicrobial, mechanical and biocompatibility analysis of chlorhexidine digluconate-modified cements
  publication-title: J Clin Exp Dent
  doi: 10.4317/jced.56308
  contributor:
    fullname: G M Sampaio
– volume: 69
  start-page: 722
  issue: 11
  year: 2003
  ident: ref32
  article-title: What is the critical pH and why does a tooth dissolve in acid?
  publication-title: J Can Dent Assoc
  contributor:
    fullname: C Dawes
– volume: 81
  start-page: 578
  issue: 08
  year: 2002
  ident: ref35
  article-title: Visual and spectrophotometric shade analysis of human teeth
  publication-title: J Dent Res
  doi: 10.1177/154405910208100815
  contributor:
    fullname: S Paul
– volume: 18
  start-page: 515
  issue: 05
  year: 2010
  ident: ref40
  article-title: Staining and calculus formation after 0.12% chlorhexidine rinses in plaque-free and plaque covered surfaces: a randomized trial
  publication-title: J Appl Oral Sci
  doi: 10.1590/S1678-77572010000500015
  contributor:
    fullname: F B Zanatta
– volume: 43
  start-page: 260
  issue: 04
  year: 2016
  ident: ref5
  article-title: Gingival crevicular fluid volume and periodontal parameters alterations after use of conventional and self-ligating brackets
  publication-title: J Orthod
  doi: 10.1080/14653125.2016.1221214
  contributor:
    fullname: A Z Bergamo
– volume: 81
  start-page: 496
  issue: 03
  year: 2011
  ident: ref1
  article-title: Can we add chlorhexidine into glass ionomer cements for band cementation?
  publication-title: Angle Orthod
  doi: 10.2319/090310-518.1
  contributor:
    fullname: M M Farret
– volume: 157
  start-page: 19
  issue: 01
  year: 2020
  ident: ref4
  article-title: Infective endocarditis and orthodontic implications in children: a review of the literature
  publication-title: Am J Orthod Dentofacial Orthop
  doi: 10.1016/j.ajodo.2019.03.027
  contributor:
    fullname: Y R Vandersluis
– volume: 62
  start-page: 36
  issue: 01
  year: 2001
  ident: ref46
  article-title: Influence of repeated chlorhexidine varnish applications on mutans streptococci counts and caries increment in patients treated with fixed orthodontic appliances
  publication-title: J Orofac Orthop
  doi: 10.1007/PL00001917
  contributor:
    fullname: F Jenatschke
– volume: 32
  start-page: 36
  issue: 01
  year: 2005
  ident: ref10
  article-title: Chlorhexidine- modified glass ionomer for band cementation? An in vitro study
  publication-title: J Orthod
  doi: 10.1179/14653120522502078
  contributor:
    fullname: D T Millett
– volume: 14
  start-page: 77
  issue: 01
  year: 2020
  ident: ref14
  article-title: In vivo biocompatibility, mechanical, and antibacterial properties of cements modified with propolis in different concentrations
  publication-title: Eur J Dent
  doi: 10.1055/s-0040-1702255
  contributor:
    fullname: I HC Meneses
– volume: 9
  start-page: 99
  issue: 02
  year: 2016
  ident: ref24
  article-title: Comparative evaluation of the antimicrobial properties of glass ionomer cements with and without chlorhexidine gluconate
  publication-title: Int J Clin Pediatr Dent
  doi: 10.5005/jp-journals-10005-1342
  contributor:
    fullname: J V Yadiki
– volume: 18
  start-page: 50
  issue: 01
  year: 2010
  ident: ref25
  article-title: Toxicity of chlorhexidine on odontoblast-like cells
  publication-title: J Appl Oral Sci
  doi: 10.1590/S1678-77572010000100010
  contributor:
    fullname: F C Lessa
– start-page: CD008457
  issue: 04
  year: 2015
  ident: ref45
  article-title: Chlorhexidine treatment for the prevention of dental caries in children and adolescents
  publication-title: Cochrane Database Syst Rev
  contributor:
    fullname: T Walsh
– volume: 190
  start-page: 309
  issue: 06
  year: 2001
  ident: ref36
  article-title: Tooth discolouration and staining: a review of the literature
  publication-title: Br Dent J
  doi: 10.1038/sj.bdj.4800959
  contributor:
    fullname: A Watts
– volume: 54 Spec No B
  start-page: B57
  year: 1975
  ident: ref26
  article-title: On the mechanism of the plaque inhibition by chlorhexidine
  publication-title: J Dent Res
  doi: 10.1177/00220345750540022601
  contributor:
    fullname: G Rölla
– volume: 156
  start-page: 735
  issue: 06
  year: 2019
  ident: ref6
  article-title: Qualitative and quantitative changes in the oral bacterial flora occur shortly after implementation of fixed orthodontic appliances
  publication-title: Am J Orthod Dentofacial Orthop
  doi: 10.1016/j.ajodo.2018.12.018
  contributor:
    fullname: E Reichardt
– volume: 39
  start-page: 389
  issue: 03
  year: 2020
  ident: ref8
  article-title: Antibacterial activity of a glass ionomer cement doped with copper nanoparticles
  publication-title: Dent Mater J
  doi: 10.4012/dmj.2019-046
  contributor:
    fullname: D Aguilar-Perez
– volume: 89
  start-page: 2433
  issue: S 03
  year: 2017
  ident: ref3
  article-title: Evaluation in vivo of biocompatibility of differents resin-modified cements for bonding orthodontic bands
  publication-title: An Acad Bras Cienc
  doi: 10.1590/0001-3765201720170329
  contributor:
    fullname: J A Mesquita
– volume: 10
  start-page: 187
  issue: 04
  year: 2007
  ident: ref34
  article-title: Clinical and microbiological effects of fixed orthodontic appliances on periodontal tissues in adolescents
  publication-title: Orthod Craniofac Res
  doi: 10.1111/j.1601-6343.2007.00396.x
  contributor:
    fullname: M Ristic
– volume: 85
  start-page: 298
  issue: 02
  year: 2015
  ident: ref28
  article-title: Effect of time and pH on physical-chemical properties of orthodontic brackets and wires
  publication-title: Angle Orthod
  doi: 10.2319/032914-234.1
  contributor:
    fullname: A A Dos Santos
– volume: 9
  start-page: 217
  issue: 02
  year: 2009
  ident: ref31
  article-title: Validation of a simplified method for evaluation of salivary pH in children
  publication-title: Pesqui Bras Odontopediatria Clin Integr
  contributor:
    fullname: A CP Serratine
– volume: 18
  start-page: 422
  issue: 05
  year: 2005
  ident: ref37
  article-title: Clinical effect of different shade guide systems on the tooth shades of ceramic-veneered restorations
  publication-title: Int J Prosthodont
  contributor:
    fullname: A J Hassel
– volume: 34
  start-page: 412
  issue: 07
  year: 2006
  ident: ref38
  article-title: The bleaching of teeth: a review of the literature
  publication-title: J Dent
  doi: 10.1016/j.jdent.2006.02.002
  contributor:
    fullname: A Joiner
– volume: 18
  start-page: 15
  issue: 01
  year: 1991
  ident: ref44
  article-title: A comparative clinical trial of a glass ionomer and a zinc phosphate cement for securing orthodontic bands
  publication-title: Br J Orthod
  doi: 10.1179/bjo.18.1.15
  contributor:
    fullname: D R Stirrups
– volume: 143
  start-page: S72
  issue: 04
  year: 2013
  ident: ref19
  article-title: Colonization ofStreptococcus mutanson esthetic brackets: self-ligating vs conventional
  publication-title: Am J Orthod Dentofacial Orthop
  doi: 10.1016/j.ajodo.2012.07.017
  contributor:
    fullname: L E do Nascimento
– volume: 17
  start-page: 1
  issue: 01
  year: 1996
  ident: ref22
  article-title: Assessing the quality of reports of randomized clinical trials: is blinding necessary?
  publication-title: Control Clin Trials
  doi: 10.1016/0197-2456(95)00134-4
  contributor:
    fullname: A R Jadad
– volume: 23
  start-page: 91
  issue: 01
  year: 2001
  ident: ref41
  article-title: The effect of micro-etching on the retention of orthodontic molar bands: a clinical trial
  publication-title: Eur J Orthod
  doi: 10.1093/ejo/23.1.91
  contributor:
    fullname: S J Hodges
– volume: 77
  start-page: 331
  issue: 02
  year: 2007
  ident: ref23
  article-title: Influence of different orthodontic brackets on adherence of microorganisms in vitro
  publication-title: Angle Orthod
  doi: 10.2319/0003-3219(2007)077[0331:IODOBO]2.0.CO;2
  contributor:
    fullname: M I Brusca
– volume: 22
  start-page: 85
  issue: 01
  year: 1995
  ident: ref33
  article-title: Plaque formation at healthy and inflamed gingival sites in young individuals
  publication-title: J Clin Periodontol
  doi: 10.1111/j.1600-051X.1995.tb01775.x
  contributor:
    fullname: P Ramberg
– volume: 18
  start-page: 325
  issue: 04
  year: 2016
  ident: ref9
  article-title: Effect of different concentrations of chlorhexidine in glass-ionomer cements on in vivo biocompatibility
  publication-title: J Adhes Dent
  contributor:
    fullname: R Lacerda-Santos
– volume: 22
  start-page: 161
  issue: 02
  year: 1995
  ident: ref42
  article-title: The effect of sandblasting on the retention of first molar orthodontic bands cemented with glass ionomer cement
  publication-title: Br J Orthod
  doi: 10.1179/bjo.22.2.161
  contributor:
    fullname: D T Millett
– volume: 22
  start-page: 515
  issue: 05
  year: 2020
  ident: ref15
  article-title: Biocompatibility of ionomeric cements modified by red propolis: a morphological and immunohistochemical analysis
  publication-title: J Adhes Dent
  contributor:
    fullname: G AM Sampaio
– volume: 108
  start-page: 260
  issue: 02
  year: 2020
  ident: ref13
  article-title: Cytotoxic effects of a chlorhexidine mouthwash and of an enzymatic mouthwash on human gingival fibroblasts
  publication-title: Odontology
  doi: 10.1007/s10266-019-00465-z
  contributor:
    fullname: A S Coelho
– volume: 33
  start-page: 121
  issue: 02
  year: 2008
  ident: ref21
  article-title: Validation and reliability of visual assessment with a shade guide for tooth-color classification
  publication-title: Oper Dent
  doi: 10.2341/07-71
  contributor:
    fullname: S S Meireles
– volume: 14
  start-page: 55
  issue: 01
  year: 2020
  ident: ref11
  article-title: Tea tree oil versus chlorhexidine mouthwash in treatment of gingivitis: a pilot randomized, double blinded clinical trial
  publication-title: Eur J Dent
  doi: 10.1055/s-0040-1703999
  contributor:
    fullname: F Ripari
– volume: 42
  start-page: 213
  issue: 03
  year: 2011
  ident: ref39
  article-title: Evaluation of chlorhexidine gluconate mouthrinse-induced staining using a digital colorimeter: an in vivo study
  publication-title: Quintessence Int
  contributor:
    fullname: B Bagis
– volume: 71
  start-page: 470
  issue: 06
  year: 2001
  ident: ref43
  article-title: A clinical retrospective evaluation of 2 orthodontic band cements
  publication-title: Angle Orthod
  contributor:
    fullname: D T Millett
– volume: 12
  start-page: 420
  issue: 04
  year: 2006
  ident: ref29
  article-title: The distribution of oral mucosal pH values in healthy saliva secretors
  publication-title: Oral Dis
  doi: 10.1111/j.1601-0825.2005.01217.x
  contributor:
    fullname: D J Aframian
– volume: 27
  start-page: 149
  issue: 02
  year: 2000
  ident: ref18
  article-title: The development of the index of complexity, outcome and need (ICON).
  publication-title: J Orthod
  doi: 10.1093/ortho/27.2.149
  contributor:
    fullname: C Daniels
– volume: 21
  start-page: 2863
  issue: 09
  year: 2017
  ident: ref20
  article-title: von Hehn U, Brandt S. In vivo study for tooth colour determination-visual versus digital
  publication-title: Clin Oral Investig
  doi: 10.1007/s00784-017-2088-0
  contributor:
    fullname: J Brandt
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Snippet Abstract Objectives The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine...
The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX) for the...
Abstract Objectives The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine...
OBJECTIVESThe aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX) for...
Objectives The aim of this study was to evaluate the microbiological and mechanical properties of glass ionomer cement (GIC) modified by chlorhexidine (CLX)...
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Title Analysis of Chlorhexidine Modified Cement in Orthodontic Patients: A Double-Blinded, Randomized, Controlled Trial
URI http://dx.doi.org/10.1055/s-0041-1727556
https://www.ncbi.nlm.nih.gov/pubmed/34428840
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https://pubmed.ncbi.nlm.nih.gov/PMC8630966
Volume 15
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