Baehni P C, Takeuchi Y
Department of Preventive Dental Medicine, School of Dental Medicine, University of Geneva, Geneva, Switzerland.
Oral Dis. 2003;9 Suppl 1:23-9. doi: 10.1034/j.1601-0825.9.s1.5.x.
The prevention of dental caries and periodontal diseases is targeted at the control of dental plaque. In this context, chemical agents could represent a valuable complement to mechanical plaque control. The active agents should prevent biofilm formation without affecting the biological equilibrium within the oral cavity. Depending on the goals of the preventive measures, various strategies may be considered. Anti-plaque agents with properties other than bactericidal or bacteriostatic activities may be used in primary prevention. In this approach, a modest antiplaque effect may be sufficient or even desirable, as it would decrease the side effects of the active agent. Antimicrobial agents are best indicated in secondary and tertiary prevention, as the objectives are to restore health and to prevent disease recurrence. The rational is to prevent or delay subgingival recolonization by pathogenic micro-organisms. The development of in vitro oral biofilm models certainly represents a major advance for studying and testing oral anti-plaque agents in recent years. The results of these studies have shown that chlorhexidine, hexetidine, delmopinol, amine fluoride/stannous fluoride, triclosan, phenolic compounds, among others, may inhibit biofilm development and maturation as well as affect bacterial metabolism.
预防龋齿和牙周疾病旨在控制牙菌斑。在这种情况下，化学药剂可以成为机械性牙菌斑控制的一种有价值的补充。活性剂应能防止生物膜形成，同时不影响口腔内的生物平衡。根据预防措施的目标，可以考虑各种策略。具有杀菌或抑菌活性以外特性的抗牙菌斑剂可用于一级预防。在这种方法中，适度的抗牙菌斑效果可能就足够了，甚至是可取的，因为这会减少活性剂的副作用。抗菌剂最适用于二级和三级预防，因为目标是恢复健康并预防疾病复发。其原理是防止或延迟致病微生物在龈下再定植。近年来，体外口腔生物膜模型的开发无疑是研究和测试口腔抗牙菌斑剂的一项重大进展。这些研究结果表明，洗必泰、己脒定、地莫匹醇、胺氟化物/氟化亚锡、三氯生、酚类化合物等可能会抑制生物膜的形成和成熟，并影响细菌代谢。
