Current uses of chlorhexidine for management of oral disease: a narrative review.
Current uses of chlorhexidine for management of oral disease: a narrative review.
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DOI：
10.1016/j.jdent.2020.103497
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发表时间：
2020-12
影响因子：
4.4
通讯作者：
Roberts A
中科院分区：
文献类型：
--
作者：
Brookes ZLS;Bescos R;Belfield LA;Ali K;Roberts A
氯己定（CHX）是一种常用的抗菌漱口水，由于其抗菌作用，牙科医生和公众使用。本文的目的是提供一个叙述性的审查，目前的抗菌用途的CHX相关牙科在口腔疾病的背景下，强调需要进一步的研究，以支持其安全和适当的使用。查阅随机对照试验、系统性综述和国家（英国和美国）指南（如有），将每个受试者类别的检索词输入MEDLINE、PubMed、Google Scholar和科克伦数据库。一些证据支持短期连续使用CHX来管理牙菌斑，减少牙龈炎、干槽症的临床症状，以及减少细菌的气溶胶化。然而，使用必须与CHX的不太理想的效果一起权衡，包括牙齿的外在染色，对防腐剂的抗菌耐药性以及对CHX的罕见但致命的过敏反应。相反，氯己定治疗或预防牙周炎、龋齿、坏死性牙周病、种植体周围炎以及与拔牙和雾化病毒相关的感染的有效性证据仍然不太确定。CHX在牙科和口腔保健中的使用仍然很广泛，因此牙科医生必须了解，基于其对不同微生物的不同作用机制，CHX的适当临床和牙科使用应针对口腔疾病。然而，在提出全面建议之前，还需要进一步的科学和临床研究。
Chlorhexidine (CHX) is a commonly used antiseptic mouthwash, used by dental practitioners and the public, due to its antimicrobial effects. The aim of this article was to provide a narrative review of current antimicrobial uses of CHX relevant to dentistry in the context of oral diseases, highlighting need for further studies to support its safe and appropriate use. Randomised controlled trials, systematic reviews and national (UK and US) guidelines were consulted where available, with search terms for each subject category entered into MEDLINE, PubMed, Google Scholar and the Cochrane database. Some evidence existed to support adjunctive short-term use of CHX to manage dental plaque, and reduce clinical symptoms of gingivitis, dry socket, as well as reduce aerosolisation of bacteria. However, use must be weighed alongside the less desirable effects of CHX, including extrinsic staining of teeth, antimicrobial resistance to antiseptic agents and the rare, but fatal, allergic reactions to CHX. Conversely, evidence for the effectiveness of chlorhexidine to manage or prevent periodontitis, dental caries, necrotising periodontal diseases, peri-implantitis, and infections associated with extraction and aerosolised viruses remains less certain. The use of CHX in dentistry and oral healthcare continues to be widespread and thus it is important that dental practitioners understand that, based on its differential mechanisms of action on different microbes, appropriate clinical and dental use of CHX should be oral disease specific. However, further scientific and clinical research is required before full recommendations can be made.
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