Elemental surface concentration ratios and surface free energies of human enamel after application of chlorhexidine and adsorption of salivary constituents.

In vitro adsorption of chlorhexidine from a commercially available chlorhexidine-containing (0.12%) mouthrinse (Peridex) on both ground and polished and on saliva-coated enamel was studied by X-ray photoelectron spectroscopy and contact angle measurements. Furthermore, adsorption of salivary constituents was studied on chlorhexidine-treated enamel. Changes in the elemental surface composition obtained by X-ray photoelectron spectroscopy clearly demonstrated adsorption of chlorhexidine from the mouthrinse as indicated by increased N and C signals which were in all cases accompanied by a higher enamel surface free energy, estimated from the contact angle data. In addition, it was found that salivary constituents adsorb less to chlorhexidine-treated enamel than to ground and polished enamel and, moreover, that adsorbed salivary constituents were desorbed by chlorhexidine. In vivo, the effect of a 3-week use of chlorhexidine was compared with the use of a placebo and habitual oral hygiene of 10 volunteers by means of clinical contact angle measurements. Also in vivo adsorption of chlorhexidine yielded elevated surface free energies with respect to habitual oral hygiene or a placebo. Thus in vivo, the well-known favourable effects of the bactericidal properties of chlorhexidine completely overrule the unfavourable effects of high enamel surface free energies.