Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.04219
Revista de Odontologia da UNESP
Original Article

Sutures modified by incorporation of chlorhexidine and cinnamaldehyde: anti-Candida effect, bioavailability and mechanical properties

Suturas modificadas pela incorporação de clorexidina e cinamaldeído: 
efeito anti-Candida, biodisponibilidade e propriedades mecânicas

Raphael Cavalcante COSTA; Yuri Wanderley CAVALCANTI; Ana Maria Gondim VALENÇA; Leopoldina de Fátima Dantas de ALMEIDA

Downloads: 0
Views: 63

Abstract

Abstract: Introduction: Antimicrobial sutures are a therapeutic alternative for the control of oral infections.

Objective: Incorporate Chlorhexidine (CHX) and Cinnamaldehyde (CN) in sutures and evaluate the anti-Candida effect, release of antimicrobials and mechanical properties.

Material and method: Silk (S) and Polyglactin 910 (P) sutures were aseptically sectioned (20 mm) and immersed for incorporation in 0.12% CHX, 0.4% CN and 0.9% saline solutions under stirring for 60 minutes (n = 10 / group). Suspensions of 500 μL of Candida albicans (ATCC 90028/ 1 × 106 CFU/mL) were used to evaluate fungal adhesion after the 48 h period at 37°C. The release of CLX and CN were evaluated at 0, 24 and 48 hours (n=3/group) by UV-VIS spectrophotometer (275 nm). The tensile strength and displacement (n=5/group) were evaluated after incorporation (30 mm/min, 50N). Data were analyzed by Anova and Tukey (α = 5%).

Result: No anti-Candida effect was observed on S and P sutures incorporated with CLX and CN (p>0.05). However, progressive release was verified up to 48 after treatment with CLX (S = 0.075 / P = 0.073 μg/mL) and CN (S = 35.33 /P= 5.72 μg/mL). There was a decrease in tensile strength in S (CLX = 9.9 / CN = 9.9 N) and P (CLX = 14.4 / CN = 15.5 N) (p<0.05). No differences were observed for the displacement for S (CLX = 19.3 / CN=20.7 mm) and P (CLX = 16.2 / CN=15.8 mm) (p>0.05).

Conclusion: The incorporation of CLX and CN did not have a positive effect on the biological and mechanical properties of the sutures evaluated.

Keywords

Sutures, Candida albicans, drug liberation, tensile strength

Resumo

Resumo: Introdução: Fios de suturas com antimicrobianos são uma alternativa terapêutica para o controle de infecções orais.

Objetivo: Incorporar Clorexidina (CHX) e Cinamaldeído (CN) em fios de sutura e avaliar o efeito anti-Candida, liberação de antimicrobianos e as propriedades mecânicas.

Material e método: Fios de Seda (S) e Poliglactina 910 (P) foram seccionadas assepticamente (20 mm) e imersos para incorporação em CHX a 0,12%, CN a 0,4% e solução fisiológica a 0,9% sob agitação por 60 minutos (n = 10 / grupo). Suspensões de 500 μL de Candida albicans (ATCC 90028/1 × 106 UFC / mL) foram utilizadas para avaliar a aderência fúngica após o período de 48 horas a 37 ° C. A liberação de CLX e CN foi avaliada em 0, 24 e 48 horas (n = 3 / grupo) por espectrofotômetro UV-VIS (275 nm). A resistência à tração e o deslocamento (n = 5 / grupo) foram avaliados após a incorporação (30 mm / min, 50N). Os dados foram analisados ​​por Anova e Tukey (α = 5%).

Resultado: Não foi observado efeito anti-Candida nas suturas S e P incorporadas com CLX e CN (p> 0,05). No entanto, a liberação progressiva foi verificada até 48 após o tratamento com CLX (S = 0,075 / P = 0,073 μg / mL) e CN (S = 35,33 / P= 5,72 μg / mL). Houve uma diminuição na resistência à tração em S (CLX = 9,9 / CN = 9,9 N) e P (CLX = 14,4 / CN = 15,5 N) (p <0,05). Não foram observadas diferenças para o deslocamento para S (CLX = 19,3 / CN=20,7 mm) e P (CLX = 16,2 /CN= 15,8 mm) (p> 0,05).

Conclusão: A incorporação de CLX e CN não teve efeito positivo sobre as propriedades biológicas e mecânicas das suturas avaliadas.
 

Palavras-chave

Suturas, Candida albicans, libertação de drogas, resistência à tração

References

Selvi F, Cakarer S, Can T, Kirli Topcu Sİ, Palancioglu A, Keskin B, Bilgic B, Yaltirik M, Keskin C. Effects of different suture materials on tissue healing. J Istanb Univ Fac Dent. 2016 Jan 12;50(1):35-42. http://dx.doi.org/10.17096/jiufd.79438. PMid: 28955553.

Costa OC No, Lobo LA, Iorio NL, Vasconcelos MFC, Maia LC, Tannure PN, et al. Oral bacteria adherence to suture threads: an in vitro study. Oral Maxillofac Surg. 2015 Sep;19(3):275-80. http://dx.doi.org/10.1007/s10006-015-0487-4. PMid:25711725.

Reinbold J, Uhde AK, Müller I, Weindl T, Geis-Gerstorfer J, Schlensak C, et al. Preventing surgical site infections using a natural, biodegradable, antibacterial coating on surgical sutures. Molecules. 2017 Sep;22(9):E1570. http://dx.doi.org/10.3390/molecules22091570. PMid:28925959.

Venema S, Abbas F, van de Belt-Gritter B, van der Mei HC, Busscher HJ, van Hoogmoed CG. In vitro oral biofilm formation on triclosan-coated sutures in the absence and presence of additional antiplaque treatment. J Oral Maxillofac Surg. 2011 Apr;69(4):980-5. http://dx.doi.org/10.1016/j.joms.2010.02.030. PMid:20674122.

Alencar CRB, de Andrade FJP, Catão MHCV. Cirurgia oral em pacientes idosos: considerações clínicas, cirúrgicas e avaliação de riscos. RSBO Revista Sul-Brasileira de Odontologia. 2011 Jun;8(2):200-10.

Sethi KS, Karde PA, Joshi CP. Comparative evaluation of sutures coated with triclosan and chlorhexidine for oral biofilm inhibition potential and antimicrobial activity against periodontal pathogens: an in vitro study. Indian J Dent Res. 2016 Sep-Oct;27(5):535-9. http://dx.doi.org/10.4103/0970-9290.195644. PMid:27966513.

Cavalcanti YW, Morse DJ, da Silva WJ, Del-Bel-Cury AA, Wei X, Wilson M, et al. Virulence and pathogenicity of Candida albicans is enhanced in biofilms containing oral bacteria. Biofouling. 2015;31(1):27-38. http://dx.doi.org/10.1080/08927014.2014.996143. PMid:25574582.

Boonstra JM, van der Elst KC, Veringa A, Jongedijk EM, Brüggemann RJ, Koster RA, et al. Pharmacokinetic properties of micafungin in critically ill patients diagnosed with invasive candidiasis. Antimicrob Agents Chemother. 2017 Nov 22;61(12):pii: e01398-17. http://dx.doi.org/10.1128/AAC.01398-17. PMid: 28971861.

Morse DJ, Wilson MJ, Wei X, Lewis MAO, Bradshaw DJ, Murdoch C, et al. Denture-associated biofilm infection in three-dimensional oral mucosal tissue models. J Med Microbiol. 2018 Mar;67(3):364-75. http://dx.doi.org/10.1099/jmm.0.000677. PMid:29458673.

Marzo G, Loffredi R, Marchetti E, Di Martino S, Di Pietro C, Marinelli G. In vitro antibacterial efficacy of Vicryl Plus suture (coated Polyglactin 910 with triclosan) using zone of inibition assays. Oral Implantol (Rome). 2008 Apr;1(1):43-8. PMid:23285335.

Pelz K, Tödtmann N, Otten JE. Comparison of antibacterial-coated and non-coated suture material in intraoral surgery by isolation of adherent bacteria. Ann Agric Environ Med. 2015;22(3):551-5. http://dx.doi.org/10.5604/12321966.1167733. PMid:26403133.

Pons-Vicente O, López-Jiménez L, Sánchez-Garcés MA, Sala-Pérez S, Gay-Escoda C. A comparative study between two different suture materials in oral implantology. Clin Oral Implants Res. 2011 Mar;22(3):282-8. http://dx.doi.org/10.1111/j.1600-0501.2010.01993.x. PMid:21039893.

Cruz F, Leite F, Cruz G, Cruz S, Reis J, Pierce M, et al. Sutures coated with antiseptic pomade to prevent bacterial colonization: a randomized clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol. 2013 Aug;116(2):e103-9. http://dx.doi.org/10.1016/j.oooo.2011.12.016. PMid:22841431.

Bucci M, Borgonovo A, Bianchi A, Zanellato A, Re D. Microbiological analysis of bacterial plaque on three different threads in oral surgery. Minerva Stomatol. 2016 Feb;66(1):28-34. http://dx.doi.org/10.23736/S0926-4970.16.03966-7. PMid:27583530.

Obermeier A, Schneider J, Wehner S, Matl FD, Schieker M, von Eisenhart-Rothe R, et al. Novel high efficient coatings for anti-microbial surgical sutures using chlorhexidine in fatty acid slow-release carrier systems. PLoS One. 2014 Jul 1;9(7):e101426. http://dx.doi.org/ 10.1371/journal.pone.0101426. PMid: 24983633.

Obermeier A, Schneider J, Harrasser N, Tübel J, Mühlhofer H, Pförringer D, et al. Viable adhered Staphylococcus aureus highly reduced on novel antimicrobial sutures using chlorhexidine and octenidine to avoid surgical site infection (SSI). PLoS One. 2018 Jan 9;13(1):e0190912. http://dx.doi.org/10.1371/journal.pone.0190912. PMid: 29315313.

Almeida LF, Paula JF, Almeida RV, Williams DW, Hebling J, Cavalcanti YW. Efficacy of citronella and cinnamon essential oils on Candida albicans biofilms. Acta Odontol Scand. 2016 Jul;74(5):393-8. http://dx.doi.org/10.3109/00016357.2016.1166261. PMid:27098375.

Chen W, Golden DA, Critzer FJ, Davidson PM. Antimicrobial activity of cinnamaldehyde, carvacrol, and lauric arginate against salmonella tennessee in a glycerol-sucrose model and peanut paste at different fat concentrations. J Food Prot. 2015 Aug;78(8):1488-95. http://dx.doi.org/10.4315/0362-028X.JFP-14-599. PMid:26219362.

ABNT: Associação Brasileira de Normas Técnicas. NBR 13904:2003- fios para sutura cirúrgica. Rio de Janeiro: ABNT; 2003.

Johnson & Johnson Medical Devices Companies [Internet]. USA: Medical Devices Business Services, Inc.; 2019 [cited 2019 Apr 16]. Available from: www.ethicon.com

Colgate-Palmolive [Internet]. New York: Colgate-Palmolive Comercial Ltda; 2019 [cited 2019 Apr 16]. Available from: www.colgate.com.br

Merck [Internet]. São Paulo: Sigma-Aldrich Co.; 2019 [cited 2019 Apr 16]. Available from: www.sigmaaldrich.com

Sawada K, Fujioka-Kobayashi M, Kobayashi E, Schaller B, Miron RJ. Effects of antiseptic solutions commonly used in dentistry on bone viability, bone morphology, and release of growth factors. J Oral Maxillofac Surg. 2016 Feb;74(2):247-54. http://dx.doi.org/10.1016/j.joms.2015.09.029. PMid:26501425.

Faria RL, Cardoso LM, Akisue G, Pereira CA, Junqueira JC, Jorge AO, et al. Antimicrobial activity of Calendula officinalis, Camellia sinensis and chlorhexidine against the adherence of microorganisms to sutures after extraction of unerupted third molars. J Appl Oral Sci. 2011 Oct;19(5):476-82. http://dx.doi.org/10.1590/S1678-77572011000500007. PMid:21986652.

Wiwattanarattanabut K, Choonharuangdej S, Srithavaj T. In vitro anti-cariogenic plaque effects of essential oils extracted from culinary herbs. J Clin Diagn Res. 2017 Sep;11(9):DC30-5. http://dx.doi.org/10.7860/JCDR/2017/28327.10668. PMid:29207708.

Castro HL, Bona AD, Ávila VJB. Propriedades físicas dos fios de sutura usados na odontologia. Braz Dent Sci. 2010 Abr-Jun;10(2):85-90.

Rampat R, Jain S. The effect of commonly used surgical solutions on the tensile strength of sutures. J Pediatr Ophthalmol Strabismus. 2014 May-Jun;51(3):189-90. http://dx.doi.org/10.3928/01913913-20140318-01. PMid:24654799.

Sardenberg T, Müller SS, Silvares PRA, Mendonça AB, Moraes RRL. Assessment of mechanical properties and dimensions of suture threads utilized in orthopedic surgeries. Acta Ortop Bras. 2003 Apr;11(2):88-94. http://dx.doi.org/10.1590/S1413-78522003000200004.
 

5d5beb270e8825d3273dd022 rou Articles
Links & Downloads

Rev. odontol. UNESP

Share this page
Page Sections