Seminar on

Chitosan
Submitted by:
Aditi Chandra
MDS- 2012
Department of conservative
dentistry and endodontics

INTRODUCTION
CHITIN is the second most ubiquitous natural polysaccharide after cellulose on earth.
Often considered as cellulose derivative, even though it does not occur in organisms
producing cellulose.
Composed of (14)-linked D-glucose (N-acetylglucosamine) with a three dimensional
-helical configuration stabilized by intramolecular hydrogen bonding.
The principle derivative of chitin is CHITOSAN.
Linear polymer of (14)-linked 2-amino-2-deoxy-D-glucopyranose.
Is consequently a copolymer of N-acetylglucosamine and glucosamine.
Therefore, chitin and chitosan are essentially the same polymer but with arbitrarily
defined degrees of deacetylation (DD).
If the DD is more than 40%, the term CHITOSAN is used.

HISTORY
CHITIN was first discovered in mushrooms by French scientist Braconnot in 1811.
It was also isolated from the cuticle of insect and named as CHITIN, which means
envelop, i.e. exoskeleton of life in Greek, by French scientist Odier in 1823.
De-acetylated chitin was discovered by Roughet in 1859, and named as CHITOSAN
by German scientist Hoppe Seyler in 1894.

SOURCES
Chitosan can be extracted from the shells of shrimp, crab, or lobster.
It is also found in yeast and some fungi.
Another inexpensive source of chitin is "squid pens," a byproduct of squid processing;
these are small, plastic-like, inedible pieces of squid that are removed prior to eating.

MANUFACTURE
Chitosan is commercially produced in different parts of the world (Japan, North
America, Poland, Italy, Russia, Norway and India).
A common method for the synthesis of chitosan is the deacetylation of chitin using
sodium hydroxide in excess as a reagent and water as a solvent.
The basic process for the manufacture of chitosan:
1. Before the treatment, the shells are ground to make them more accessible.
2. Removal of proteins and minerals such as calcium carbonate and calcium phosphate, by
treatment with alkali and acid, respectively.
3. After the completion of the manufacturing procedure, chitin is dried so that it can be
stored as a stable intermediate for deacetylation to chitosan at a later stage.
4. The process of deacetylation is achieved by treating chitin with a strong solution of
sodium hydroxide at an elevated temperature.

PHYSIOCHEMICAL PROPERTIES

Parameters

Specification

Appearance

White Flakes/Powder

Smell

Odorless

Viscosity (1% acetic acid soln.)

10-2000cps range

Degree of Deacetylation

65%- 90% ( as per customer requirement)

Bulk Density

0.15 to 0.7gm/ml ( as per customer requirement)

Loss on Drying ( at 105oC)

<10%
7.5 - 8.5

Ph
Residue on Ignition

<1%

Heavy Metals(as lead)

< 10ppm

Arsenic

< 0.8ppm

Total Plate Count

<1000cfu/gm

Pathogens

Absent

Particle Size

6mesh, 20mesh, 40mesh, 80mesh, 100mesh

Packing: In 10kgs Polypropylene Bags with inside LDPE Liner or as per customer
requirement
Storage: Store in a cool and dry place. Keep away from direct light

WHAT S THE MPORTANCE OF DA?

The degree of N-acetylation (DA) together with the molecular weight are the most
important parameters for characterization.
The DA, which is by definition the molar fraction of N-acetylated units, is a structural
parameter influencing charge density, crystallinity and solubility, including the
propensity to enzymatic degradation, with higher DAs leading to faster biodegradation
rates.
The degree of deacetylation (%DD) can be determined by NMR spectroscopy.

 the %DD in commercial chitosans ranges from 60 to 100%.

Molecular weight of commercially produced chitosan is between 3800 and
20,000 Daltons

BIOLOGICAL PROPERTIES OF CHITOSAN

1. Biocompatible
2. Natural polymer
3. Biodegradable to normal body constituents
4. Safe and non-toxic
5. Binds to mammalian and microbial cells aggressively.
6. Accelerates the formation of osteoblast responsible for bone formation.
7. Hemostatic
8. Fungistatic
9. Spermicidal
10.Antitumor
11.Anticholesteremic
12.Immunoadjuvant

DRAWBACKS
It is only soluble in aqueous medium in the presence of a small amount of acid such as Acetic
Acid (C2H5OH) and its mechanical properties are not good for some biomedical application.
Therefore many researchers tried to modify its properties.

DERIVATIVES

N-phthaloyl
Chitosan

Dendronized Chitosan-sialic Acid

Hybrids

Methylthiocarbamoyl and
Phenylthiocarbamoyl Chitosans

Lactic/glycolic Acid-chitosan
Hydrogels

Fully deacetylated chitosan was treated with phthalic

anhydride in DMF to give N-phthaloyl- chitosan. It
was readily soluble in polar organic solvents.

To improve water-solubility, Sashiwa et al.27 has

successfully synthesized dendronized chitosan-sialic
acid hybrids by using gallic acid as focal point and
tri(ethylene glycol) as spacer arm

Baba et al.28 have synthesized

methylthiocarbamoyl and phenylthiocarbamoyl
chitosan derivatives to examine the
selectivity toward metal ions from aqueous
ammonium nitrate solution

The synthesis of chitosan hydrogels

was carried out by Qu et al. by direct
grafting of D,L-lactic and/or glycolic
acid onto chitosan in the absence of
catalysts.
They demonstrated stronger
interaction existed between water
and chitosan chains.
Useful for biomedical applications
such as, wound dressings and drug
delivery systems

CdS Quantum dots (QDs) Chitosan

Biocomposite

Achieved by mixing chitosan with Cd(Ac)2 and

subsequently dissolving in 1 per cent HAc aqueous
solution, followed by the treatment with CdS.
Improve aqueous solubility and stability of
chitosan.

Nanocomposite from Natural

Polysaccharide
(Chitin/chitosan):

Synthesized by ball-milling a polysaccharide with

synthetic polymer

APPLICATIONS OF CHITOSAN

Haemostatic agent-surgical sponges, wound dressing, non-woven

fabrics for surgical use
Sustained release of medicines
Burn/ Wound care, Bed Sore treatment, Ulcer
care-Patches
Medical
Artificial Skin

Tumor Inhibition

Bone and tissue regeneration

Food & Nutrition

Fat absorber/Cholesterol lowering effect

Dietary Fiber

Preservatives-Meat products
Color stabilization
Clarification of beverages like fruit juice, wine,
beer etc
Animal feed additives
Removal of pesticides residues from fruits and
vegetables
Anti-bacterial yarn
Textiles
Dyeing, Sizing, Printing

Skin Care- UV protection, Moisturiser, Emulsifiers,

Emollients

Hair Care- Hair setting, Antistatic agent, Anti-dandruff

Cosmetics

Soap & Shampoo- Antibacterial agent

Oral Care-Toothpaste
Nail polish

Membranes

Reverse Osmosis
Permeability control

Seed & Leaf coating -Antifungal &

Anti-bacterial agent
Fertilizer- Growth promoter
Sustained release pesticides & fertilisers for
Agriculture & Veterinary

foliar
applications
Anti-Mastitis in milking cow, External ulcer
treatment in animals
Anti-viral spray in poultry farms
Improving functional properties like water
resistance,

Pulp & Paper

tensile strength, printability

Photographic paper, Carbonless Copier paper

Clarification-Flocculant/Coagulant
Water Treatment
Filtration, removal of metal ions

APPLICATIONS IN DENTISTRY

Chitosan possesses Antibacterial properties and has been used in various forms to
promote dental and periodontal health.
According to Drugs.com, chitosan chewing gum, mouthwashes and gels have all been
used to reduce plaque and kill germs.
A 2010 study by T.M. Arnaud et al., published in the "Journal of Dentistry," found that
chitosan prevented demineralization of the teeth because it inhibited the release of
phosphorus.

ANTIMICROBIAL ACTIVITY
Most of the information on the antimicrobial activity of chitosan derives from experiments with
the gram-negative bacterium Escherichia coli, which is often used as a model organism.
Liu et al. (2001) demonstrated that the antibacterial activity of chitosan (DDA: 73 85 %)
intensified with increasing molecular weight valid only for the cases with a molecular
weight below 91,600 Da.
In contrast, the antibacterial activity of chitosan decreased with increasing molecular weight
above 91,600 Da.
In addition, the antibacterial activity of chitosan increases with increasing degree of
deacetylation (Liu et al., 2001; Chung et al., 2004).

Higher temperatures (25 and 37 C) and acidic pH increase the bactericidal effects of
chitosan (Tsai & Su, 1999; Liu et al., 2001; Chung et al., 2004).
In alkaline conditions, at a pH > 7, the antibacterial activity of chitosan was strongly
inhibited (Liu et al., 2001). Sodium ions (Na2+ [100 mM]) might form complexes with chitosan
and accordingly reduce chitosans activity against E. coli.
Bivalent cations reduced the antibacterial activity of chitosan, in the order of Ba2+ > Ca2+ >
Mg2+ [10 and 25 mM] (Tsai & Su, 1999).
Age of a E. coli culture affects its interaction with chitosan, as bacterial cells, which are in
the late exponential phase are most sensitive to chitosan (Tsai & Su, 1999).

Study on antimicrobial activity of chitosan with different molecular weights

E. Coli and Staphylococcus aureus are used to study the antimicrobial activity
of chitosan of different molecular weights (MW). The effect of the concentration and
MW of chitosan were investigated, respectively, and the antimicrobial mechanism
was discussed.

The antimicrobial activity of chitosan with MW below 305 kDa, was studied.

As the concentration of chitosan

increased, the antimicrobial effect was strengthened.

When the concentration reached 1.0%, the inhibition rate reached 100% for both E.
coli and S. aureus.

For S. aureus, a gram +ve bacteria, as the MW of chitosan increased,

the antimicrobial effect
decreased.
The main reason might be the chitosan of
which inhibits nutrient adsorptions.

higher MW forms a lm

For E. coli, a gram-ve bacteria, as the MW of chitosan decreased

the antimicrobial effect
was enhanced.
The main reason might be that the chitosan of lower MW enters the microbial
cell more easily, which disturbed the metabolism of the cell.

Susceptibility of Candida albicans and Enterococcus faecalis to Chitosan, Chlorhexidine

gluconate and their combination in vitro
Aim: Analyse the sustain release of Chlorhexidine with Chitosan and to investigate the
antimicrobial activity of 2% Chlorhexidine gel, 2% Chitosan gel and their combination against
Candida albicans and Enterococcus faecalis.
The study suggests that 2% Chlorhexidine gel in combination with 2% Chitosan gel has the
highest antimicrobial effect against C. albicans and E. faecalis compared with 2%
Chlorhexidine gel or 2% Chitosan gel alone.

Chitosan-EDTA new combination is a promising candidate for treatment of bacterial and

fungal infections.
Aim: Evaluate the antimicrobial activities of chitosan derivatives, EDTA, and the newly
developed chitosan-EDTA combination against Gram-negative and Gram-positive bacteria as
well as Candida albicans.
Results: Indicated a synergistic antimicrobial activity of the new combination against
Staphylococcus aureus and an additive effect against other microorganisms. Moreover, a short
microbial exposure to chitosan EDTA combination (20-30 min) caused complete eradication.

PERIODONTITIS

Periodontitis is caused by Porphyromonas gingivalis.

P. gingivalis has been considered as an aggressive periodontal pathogen due to of its high
association with periodontal destruction in humans, and it is reported to prolong
inflammation and progression of attachment loss.

The impact of chitosan formulation (either as gel or film) against the periodontal
pathogen P. gingivalis was investigated. Furthermore the viscosity, bioadhesive
properties and antibacterial activity of different chitosan derivates (different
molecular weight and degree of deacetylation) were investigated (kinci et al.,2002).

Both, the chitosan gel and the chitosan film exerted bioadhesive properties.

Chitosan is shown to have an antimicrobial activity against P. gingivalis, and this effect
was even higher using high-molecular weight chitosan.

However, the antibacterial activity which was achieved when the low concentrated high
molecular weight chitosan gel (1 %) was similar to that of the high concentrated (3 %)
low molecular weight chitosan gel.

Changes in the degree of deacetylation did not have any effect on antibacterial activity.

Chitosan ascorbate, obtained by mixing chitosan with ascorbic acid and sodium
ascorbate, was produced in gel, suitable for the treatment of periodontitis (Muzzarelli
et al., 1989).

Chitosan was progresively reabsorbed by the host. In vivo, the tooth mobility and
tooth pocket depths were significantly reduced.

Clinical and Radiographic Evaluations of Chitosan Gel in Periodontal Intraosseous

Defects: A Pilot Study
Aim: Evaluate effects of chitosan on periodontal regeneration.
Twenty chronic periodontitis patients were recruited.
Following initial therapy, the patients were divided into four groups: group A, receiving
chitosan gel (1% w/v); group B, receiving chitosan gel + demineralize bone matrix;
group C: receiving chitosan gel + collagenous membrane; and group D, receiving
flap only (control group).
Clinical and radiographic measurements were recorded at baseline,
month), and day 180 (6th month) after surgery.

day 90 (3rd

For clinical data, no significant differences were obtained among the treatment groups.
Radiographic data revealed that except control group, all the other groups showed
statistically significant bone fills indicating that chitosan gel alone or its combination
with demineralize bone matrix/collagenous membrane is promising for periodontal
regeneration.
Application of Chitosan Gel in the Treatment of Chronic Periodontitis
Aim: Evaluate the clinical effectiveness of chitosan, both as a carrier in gel form and as an
active agent in the treatment of chronic periodontitis.

 The chitosan gel (1% w/w) incorporated with or without 15% metronidazole was
prepared and applied adjunctive to scaling and root planing (SRP) in comparison to
SRP alone (control group).
Probing depth (PD), clinical attachment level, the amount of gingival recession,
plaque index, gingival index, and gingival bleeding time index were recorded at
baseline and at weeks 6, 12, and 24.
In all groups, significant improvements were observed between baseline and week
24 (p < 0.05).
No complications related to the chitosan were observed in patients throughout the
study period.
It is suggested that chitosan itself is effective as well as its combination with
metronidazole in CP treatment due to its antimicrobial properties.

ANTI-PLAQUE AGENT
A synergistic chlorhexidine/ chitosan combination for improved antiplaque strategies
Background: The minor efficacy of chlorhexidine (CHX) on other cariogenic bacteria than
mutans streptococci
such as Streptococcus sanguinis may contribute to uneffective antiplaque strategies.
Methods : In addition to CHX (0.1%) as positive control and saline as negative control, two
chitosan derivatives (0.2%) and their CHX combinations were applied to planktonic and
attached sanguinis streptococci for 2 min. The efficacy of the test agents on streptococci was
screened by the following parameters: vitality status, colony-forming units (CFU)/ ml and cell
density on enamel.
Results: The first combination reduced the bacterial vitality to 0% and yielded a strong
CFU reduction of 23 log units, much stronger than CHX alone. Furthermore, the first
chitosan derivative showed a significant decrease of the surface coverage with these treated
streptococci after attachment to enamel.
Conclusions: Based on these results, a new CHX formulation would be beneficial unifying
the bioadhesive properties of chitosan with the antibacterial activity of CHX synergistically
resulting in a superior antiplaque effect than CHX alone.

Effect of water-soluble reduced chitosan on Streptococcus mutans, plaque regrowth and

biofilm vitality
Aim: Examine the effects of a newly developed water-soluble reduced chitosan on
Streptococcus mutans, plaque regrowth, and biofilm vitality.
Method: 1.0%, water-soluble reduced chitosan, with pH ranging from 6.0 to 6.5,
molecular weights between 3,000 and 5,000 Da, and 70% degree of deacetylation, was used.
To determine antibacterial and anti-plaque potency of chitosan, minimal inhibitory
concentrations (MICs) for S. mutans and S. sanguinis short-term exposure to S. mutans, and
clinical trial of plaque regrowth and biofilm vitality were conducted.
Result: The water-soluble reduced chitosan exhibited potent antibacterial effect on S.
mutans, and displayed a significant antibacterial and plaque reducing action during the 4day plaque regrowth.

DENTAL CARIES

Dental caries is the most common oral disease in humans.

Dental caries is caused by the demineralisation of dental hard tissues, enamel and
dentine, which occurs through fermentation of indigenous bacteria, like
Streptococcus mutans.
Y. Hayashi et al. published a study in the "Archives of Oral Biology" in 2007 that
found individuals who chewed chitosan gum had less oral bacteria than those who
did not chew the gum.

(Tarsi et al 1997) Chitosan has been shown to be an interesting candidate capable

of preventing the adherence of Streptococcus mutans to hydroxyapatite in dental
caries.
This effect was attributed to the ability of chitosan to stimulate ordered regeneration
of oral soft tissues, prevention of the deleterious effects of organic acids and
bactericidal effects.

 The desorptive effect of chitosan was weaker when Streptococcus mutans had adhered to
the saliva coated hydroxyapatite in the presence of sucrose.
Results: indicated the potential of the presence of minor amounts of chitosan in
toothpastes, mouthrinses or chewing gums to impair the colonisation of the tooth
surface
Chitosan microparticles for the controlled delivery of fluoride
Objectives: To manufacture and characterise chitosan/fluoride microparticles prepared
by spray drying and assess their utility as controlled release vehicles for fluoride.
Conclusions: Bioadhesive chitosan/fluoride microparticles manufactured using a
spray-drying protocol have been extensively characterised and further opportunity for
optimisation identified.
These microparticles may provide a means of increasing fluoride uptake from oral
care products to provide increased protection against caries, however further work is
required to demonstrate this principle in vivo.

HAEMOSTATIC AGENT
Chitosan is also found to have a haemostatic effect.
Proposed to be due to an interaction between the cell membrane of erythrocytes and
chitosan, and was independent of the classical coagulation cascade (Rao & Sharma
1997).
Chitosan stimulates the fibroblastic cells to release chemotactic inflammatory
cytokinesis (Mori, 1997; Muzzarelli et al., 1989).
Histological findings indicated that chitosan induces the migration of
polymorphonuclear leukocytes and macrophages in the investigated tissue at the
early stage (Hidaka et al., 1999; Lu et al., 1999).
At the final stage of wound healing process using chitosan, angiogenesis ,
reorganisation of the extracellular matrix, and granulation tissue have been
demonstrated.

 Klokkevold et al (1999), found that topical application of chitosan to lingual incisions

effectively decreased the intraoral bleeding time in a therapeutically anticoagulated
(heparinised) rabbit model.
Chitosan was able to facilitate lingual haemostasis, possibly through interaction with
erythrocytes, linking them together to establish a cellular clot or a haemostatic plug.

A study performed by R. Valentine et al., published in the "American Journal of

Rhinology and Allergy," found that a chitosan gel applied to surgical wounds postsurgery significantly decreased bleeding time when compared to patients who did not
have the gel applied.

The Food and Drug Administration has approved the use of chitosan-treated bandages
for controlling blood loss in emergency situations.

Several chitosan-based wound dressings are available on the market for clinical use, including
HemCon Bandage and ChitoFlex wound dressings (HemCon Medical Technologies, UK), as
well as CELOX (Medtrade Products, England); both of which stated to be FDA approved.

ORTHOPEDIC AND CRANIOFACIAL IMPLANT DEVICES

Bumgardner et al. (2003) used chitosan as bioactive coating to improve Osseointegration of
orthopaedic and Cranifacial implant devices.
Coating material was made from 91.2 % deacetylated chitosan (MW: 200,000 Da),
which was chemical linked to titanium coupons.
The bonded coatings exhibited minimal degradation within 8 weeks in cell cultures.
They supported increased osteoblastic cell attachment and proliferation as compared
to uncoated titanium controls.

CHITOSAN MONOMER PROMOTES TISSUE REGENERATION ON

DENTAL PULP WOUNDS
Aim: Evaluate the applicability of chitosan monomer (d-glucosamine hydrochloride) as a pulp
capping medicament.
After 1 day, inflammatory cell infiltrations were observed to be weak when compared
with the application of chitosan polymer.

 After 3 days, a remarkable proliferation of fibroblasts was seen near the applied chitosan
monomer. The inflammatory cell infiltration had almost completely disappeared.
After 5 days, the fibroblastic proliferation progressed, and some odontoblastic cells
appeared at the periphery of the proliferated fibroblasts.
These findings indicate that the present study is the first report that chitosan monomer acts
as a biocompatibly stable medicament even at the initial stage of wound healing in
comparison with the application of chitosan polymer.

EFFECTS OF CHITOSAN ON DENTAL BONE REPAIR

Aim: Assess effects of chitosan on socket repair after dental extraction.
Method: Twenty four dental sockets of 15-24 year-old patients were visited by a
maxillofacial surgeon for extracting premolar teeth for orthodontic purposes.

The sockets in one side were filled-in by chitosan. In the other side, the sockets were left
unfilled. After 10 weeks, periapical radiographs were obtained and each socket was divided
into coronal, middle and apical. Dental density of each socket in case and control groups
was recorded. The density of regenerated bone was compared against the maximum bone
density of each individual. Wilcoxon Singed-Rank test and paired t-test were used for data
analysis.
Results: Bone density in middle and apical sections in case group was significantly more
than control group. In apical section in case group regenerated bone reached up to 98.2%
of normal bone density. In each patient, the bone density in apical and middle sections was
increase 29.3% and 10.8% of normal bone density.
Conclusions: Chitosan significantly increased bone density in apical and
middle sections. Chitosan can be used for bone repair in cases of bone loss.

CHITOSAN-BASED CEMENTS
Bioactivity of chitosan in dentistry. Preliminary data on chitosan-based cements.

BACKGROUND: The chemical association of chitosan with inorganic salts, such

as calcium phosphate, finds a promising application in dentistry as room-temperature selfhardening cement.
We present the physical, chemical and crystallographic characterization of newly-developed
cements made of 1) calcium-phosphate and a chitosan gel obtained by acetic acid treatment,
and 2) calcium phosphate and a chitosan gel obtained by ascorbic acid treatment. Both
cements are self-hardening at room temperature.
METHODS: The cements were characterized by X-ray diffractography, scanning electron
microscopy and fluorine-selective electrode analysis.
RESULTS: The chitosan-hydroxyapatite cements had hardness comparable to spongy bone
CONCLUSIONS: The cements are promising for application in endodontics and restorative
dentistry.

Properties of elastomeric calcium phosphate cementchitosan composites

In the present study, chitosan was evaluated as the matrix for preparing CPC-chitosan
composites.
Methods: Cement specimens were prepared by mixing CPC powder (an equimolar mixture
of tetracalcium phosphate and dicalcium phosphate anhydrous) with a chitosan solution at a
powder/liquid ratio of 22.5
Results: The CPCchitosan composites were more stable in water than conventional CPC.
They did not disintegrate even when placed in water immediately after mixing. The CPC
chitosan paste hardened within 10 min in all cases.
Significance: This study demonstrates that CPCchitosan composites are stable in a wet
environment and have acceptable mechanical strengths for clinical applications.

SMEAR LAYER REMOVAL

Chitosan: a new solution for removal of smear layer after root canal instrumentation

Aim: To evaluate, by scanning electron microscopy (SEM), the efficacy of smear layer
removal using chitosan compared with different chelating agents, and to quantify, by atomic
absorption spectrophotometry with flame (AASF), the concentration of calcium ions in these
solutions after irrigation.
Method: The root canals of twenty-five canines were prepared using a crown-down technique
and irrigated with 1% sodium hypochlorite.
The teeth were randomly divided into groups (n=5), according to the type of final irrigation:
15% EDTA, 0.2% chitosan, 10% citric acid, 1% acetic acid and control (without final
irrigation).
Conclusions: 15% EDTA, 0.2% chitosan and 10% citric acid effectively removed smear layer
from the middle and apical thirds of the root canal. 15% EDTA and 0.2% chitosan were
associated with the greatest effect on root dentine demineralisation, followed by 10% citric acid
and 1% acetic acid.
Time-Dependent Effects of Chitosan on Dentin Structures
Objective: Evaluate the effects of chitosan in dentins smear layer removal and erosion, in
different time points and concentrations, by scanning electron microscopy (SEM) analysis.
Method: Twenty canines were prepared by Crown-Down Technique and irrigated with 1%
sodium hypochlorite. The teeth were randomly divided into ten groups, according to final
irrigation type:
G1 0.37% Chitosan (5 minutes), G2 - 0.1% Chitosan (5 minutes), G3 - 0.15% Chitosan (5
minutes), G4 - 0.2% Chitosan (5 minutes), G5 - 0.37% Chitosan (3 minutes), G6 - 0.1%
Chitosan (3 minutes), G7 - 0.2% Chitosan (3 minutes), G8 - 0.37% Chitosan (1 minute) and
G9 15% EDTA (3 minutes).
The control group (G10) did not receive irrigation.
Result: The results showed that the specimens irrigated with 0.1% chitosan solution showed the
entire surface covered by smear layer, regardless of timing.
The 0.15% chitosan group presented partially covering of smear layer on the surface with
visible presence of few tubules and large amount of smear plug.
The 0.37% chitosan group (5 and 3 minutes) caused excessive peritubular and intertubular
dentinal erosion.
Conclusion: Final irrigation with 0.2% Chitosan (3 minutes) provided the best results
among all experimental groups and most similar to 15% EDTA in smear layer removal.

SPECIAL PRECAUTIONS & WARNINGS

Chitosan is POSSIBLY SAFE for most people when taken by mouth short-term (up to six
months) or applied to the skin. When taken by mouth, it might cause
mildstomach upset, constipation, or gas.
Pregnancy and breast-feeding: Not enough is known about the use of chitosan during
pregnancy and breast-feeding. Stay on the safe side and avoid use.
Shellfish allergy: Chitosan is taken from the outer skeleton of shellfish. There is a concern that
people with allergies to shellfish might also be allergic to chitosan.
Warfarin (Coumadin) interacts with CHITOSAN: There is some concern that taking chitosan
might increase the blood thinning effects of warfarin (Coumadin). Taking chitosan with
warfarin (Coumadin) could increase the chance of bruising or bleeding. If you take
warfarin, avoid taking chitosan.
There is significant evidence that long-term, high-dose chitosan supplementation can result
in malabsorption of some crucial vitamins and
minerals including calcium, magnesium, selenium, and vitamins A, D, E, and K.
Another possible risk of long-term ingestion of high doses of chitosan is that it could change the
intestinal flora and allow the growth of unhealthful bacteria.
Finally, there has been a case report of arsenic poisoning caused by long-term use of chitosan
supplement

CONCLUSION
The abundance of chitin and chitosan in nature and its safe toxicological properties
has prompted researchers world-wide to investigate the potential applications of this
unique biopolymer.
As chitosan is principally obtained by partial deacetylation of chitin, the second
most abundant natural polymer, a number of chitosan polymers varying in their
physicochemical characteristics may be obtained by changing the degree of
deacetylation.
Chitosan possesses antibacterial effects enhances the wound healing by establishing
optimal environmental conditions and is biocompatible and does not interfere with

human immun system. These properties make it attractive for usage in dental
medicine .
In view of the above mentioned, varied and unique applications of chitosan and its
derivatives, it may be pragmatic to say that these polymers have the potential to be
used not only as pharmaceutical adjuvants for conventional or novel drug delivery
systems, but also as biologically active compounds.

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