Effects of chlorhexidine preprocedural rinse on bacteremia in periodontal patients: a randomized clinical trial.
Effects of chlorhexidine preprocedural rinse on bacteremia in periodontal patients: a randomized clinical trial.
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DOI：
10.1590/1678-7757-2017-0112
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发表时间：
2017-11
期刊：
影响因子：
--
通讯作者：
Cortelli SC
中科院分区：
文献类型：
--
作者：
Balejo RDP;Cortelli JR;Costa FO;Cyrino RM;Aquino DR;Cogo-Müller K;Miranda TB;Moura SP;Cortelli SC
单剂全身性抗生素和短期使用漱口水可减少菌血症。然而，单剂量的术前冲洗的效果仍然存在争议。这项研究在牙周病患者中评估了术前漱口对诱发菌血症的影响。将27例牙周炎或牙周炎患者随机分为两组：0.12%洗必泰术前冲洗组(13例牙周炎和牙周炎患者)和不冲洗组(牙周炎组14例和牙周炎组15例)。测量牙周探诊深度、临床附着水平、菌斑和牙龈指数，并采集龈下样本。分别在洁牙前、洁牙后2分钟和6分钟采集血样。用实时荧光定量聚合酶链式反应检测口腔和血液标本中的细菌总数和牙周炎假单胞菌的含量，同时通过血液标本中的培养来测定需氧和厌氧计数。主要结果是术前冲洗的抗菌效果。数据通过Mann-Whitney和Signal检验进行比较(p<；0.05)。在所有采样时间，聚合酶链式反应显示血液细菌水平高于培养(p<；0.0001)，而牙周炎患者血液中细菌水平低于牙周炎患者(p<；0.0001)。经历菌血症的个体表现出更差的平均临床附着水平(3.4mmvs.1.1mmvs.1.1 mm)和更多的龈下细菌(p<；0.005)。术前冲洗并不能减少诱导的菌血症。菌血症受牙周参数的影响。在牙周病患者中，术前冲洗对菌血症的控制效果不明显。
Single dose of systemic antibiotics and short-term use of mouthwashes reduce bacteremia. However, the effects of a single dose of preprocedural rinse are still controversial. This study evaluated, in periodontally diseased patients, the effects of a pre-procedural mouth rinse on induced bacteremia. Systemically healthy individuals with gingivitis (n=27) or periodontitis (n = 27) were randomly allocated through a sealed envelope system to: 0.12% chlorhexidine pre-procedural rinse (13 gingivitis and 13 periodontitis patients) or no rinse before dental scaling (14 gingivitis and 15 periodontitis patients). Periodontal probing depth, clinical attachment level, plaque, and gingival indices were measured and subgingival samples were collected. Blood samples were collected before dental scaling, 2 and 6 minutes after scaling. Total bacterial load and levels of P. gingivalis were determined in oral and blood samples by real-time polymerase chain reaction, while aerobic and anaerobic counts were determined by culture in blood samples. The primary outcome was the antimicrobial effect of the pre-procedural rinse. Data was compared by Mann-Whitney and Signal tests (p<0.05). In all sampling times, polymerase chain reaction revealed higher blood bacterial levels than culture (p<0.0001), while gingivitis patients presented lower bacterial levels in blood than periodontitis patients (p<0.0001). Individuals who experienced bacteremia showed worse mean clinical attachment level (3.4 mm vs. 1.1 mm) and more subgingival bacteria (p<0.005). The pre-procedural rinse did not reduce induced bacteremia. Bacteremia was influenced by periodontal parameters. In periodontally diseased patients, pre-procedural rinsing showed a discrete effect on bacteremia control.
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DOI：
10.1016/j.oooo.2012.11.019
发表时间：
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影响因子：
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