Implant decontamination with 2% chlorhexidine during surgical peri-implantitis treatment: a randomized, double-blind, controlled trial
Implant decontamination with 2% chlorhexidine during surgical peri-implantitis treatment: a randomized, double-blind, controlled trial
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DOI：
10.1111/clr.12419
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发表时间：
2015-09-01
影响因子：
4.3
通讯作者：
van Winkelhoff, A. J.
中科院分区：
文献类型：
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作者：
de Waal, Y. C. M.;Raghoebar, G. M.;van Winkelhoff, A. J.
目的 这项随机、双盲、对照试验的目的是评估在切除性手术种植体周围炎治疗过程中，与 0.12% 洗必泰 + 0.05% 氯化十六烷基吡啶 (CPC) 溶液相比，使用 2% 洗必泰 (CHX) 溶液进行种植体表面净化的临床、放射学和微生物学效果。 材料和方法 44 名患者（108 个种植体）种植体周围炎采用切除手术治疗，包括骨轮廓重建、表面清创和化学去污以及根尖重新定位皮瓣。患者被随机分配使用 2% CHX 溶液（测试组）或 0.12% CHX+0.05% CPC（对照组）进行净化。记录治疗前（基线）以及治疗后 3、6 和 12 个月的临床和放射学参数。手术期间记录微生物参数。结果多级分析显示，在 3 次随访测量（3、6 和 12 个月）中，对照组和测试组之间的出血、化脓、探诊袋深度和放射线骨丢失与基线相比没有显着差异。两种净化程序均导致种植体表面厌氧菌计数显着减少，但对照组和测试组之间没有显着差异（平均 log 3.372.34 对比 3.65 +/- 2.87，P=0.99）。结论 与相比，在切除性种植体周围炎治疗期间使用 2% CHX 溶液进行种植体表面净化并不会改善临床、放射学或微生物学结果用0.12%CHX+0.05%CPC溶液。总体而言，额外使用 CHX 比单独机械清创更好地减少了种植体表面的厌氧细菌负荷，但似乎并没有提高临床治疗效果（ClinicalTrials.gov 编号 NCT01852253）。
ObjectiveThe objective of this randomized, double-blind, controlled trial was to evaluate the clinical, radiographic, and microbiological effects of implant surface decontamination with a 2% chlorhexidine (CHX) solution in comparison with a 0.12% chlorhexidine+0.05% cetylpyridinium chloride (CPC) solution during resective surgical peri-implantitis treatment.Material and methodsForty-four patients (108 implants) with peri-implantitis were treated with resective surgical treatment consisting of bone re-contouring, surface debridement and chemical decontamination, and apically repositioned flap. Patients were randomly allocated to decontamination with a 2% CHX solution (test group) or 0.12% CHX+0.05% CPC (control group). Clinical and radiographic parameters were recorded before treatment (baseline), and at 3, 6, and 12months after treatment. Microbiological parameters were recorded during surgery.ResultsMultilevel analysis showed no significant differences in bleeding, suppuration, probing pocket depth, and radiographic bone loss between control and test group over three follow-up measurements (3, 6, and 12months) from baseline. Both decontamination procedures resulted in significant reductions in anaerobic bacterial counts on the implant surface, but no significant difference was noted between control and test group (mean log 3.372.34 vs. 3.65 +/- 2.87, P=0.99).ConclusionsThe use of a 2% CHX solution for implant surface decontamination during resective peri-implantitis therapy does not lead to improved clinical, radiographic, or microbiological results compared with a 0.12% CHX+0.05% CPC solution. Overall, the additional use of CHX reduces anaerobic bacterial load on the implant surface better than mechanical debridement alone, but does not seem to enhance clinical treatment outcomes (ClinicalTrials.gov number NCT01852253).