Sekino Satoshi, Ramberg Per, Uzel Naciye Guzin, Socransky Sigmund, Lindhe Jan
Department of Periodontology, Göteborg University, Sweden.
J Clin Periodontol. 2003 Oct;30(10):919-25. doi: 10.1034/j.1600-051x.2003.00420.x.
The aim of the present experiment was to study the effect of different chlorhexidine regimens on the number of bacteria in saliva, and on de novo plaque formation.
Ten subjects with gingivitis, but no signs of destructive periodontitis, were recruited. Following a screening examination, the volunteers were given oral hygiene instruction, meticulous scaling and professional mechanical tooth cleaning (PTC). The PTC was repeated once every 3 days during a 2-week period to establish healthy gingival conditions. The study was designed as a double-blind cross-over clinical trial including three phases. Each experimental phase comprised one preparatory period of 7 days and one plaque accumulation period (no oral hygiene measures) of 4 days. During all preparatory periods, the volunteers (i) performed mechanical tooth cleaning using a toothbrush and dentifrice and (ii) were, in addition, given two sessions of PTC. The final PTC was delivered after bacterial sampling had been made on Day 0. Preparatory period A: the participants continued the self-performed plaque control regimen that employed only mechanical means. Preparatory period B: the participants were in addition instructed to rinse and gargle, twice daily, with a 0.2% chlorhexidine mouthrinse. Preparatory period C: in addition to the above, the participants were instructed to brush the dorsum of the tongue for 60 s, twice daily, with a 1.0% chlorhexidine gel. Following each plaque accumulation period, there was a 10-day washout interval. The presence and amount of dental plaque (QHI) was scored after 1, 2 and 4 days of no oral hygiene. Samples of saliva were obtained on Day 0 and after 1 and 2 days. The samples were placed on Brucella agar plates and incubated (anaerobically) for 5 days. The total number of colony-forming units was determined and used to estimate the density of bacteria in saliva.
In period A, the mean QHI increased from 1.0 (Day 1) to 1.4 (Day 2) and 2.1 (Day 4). The corresponding scores for periods B and C were 0.5, 0.8, 1.6 and 0.3, 0.8, 1.2, respectively. At all re-examination intervals more plaque formed during period A than during periods B and C. Further, during period C, less plaque formed than that during period B. Saliva samples from Day 0 in period A contained a larger number of TVC than the baseline samples in periods B and C. There was no significant difference in TVC among the groups on Day 2.
The daily use of chlorhexidine as an adjunct to mechanical tooth cleaning markedly reduced the number of microorganisms that could be detected in saliva. The number of salivary bacteria may have influenced the amount of plaque that formed during an early phase of no oral hygiene.
本实验旨在研究不同洗必泰治疗方案对唾液中细菌数量及新菌斑形成的影响。
招募了10名患有牙龈炎但无破坏性牙周炎迹象的受试者。经过筛查检查后，对志愿者进行口腔卫生指导、细致的龈上洁治和专业的机械牙齿清洁（PTC）。在为期2周的时间内，每3天重复进行一次PTC，以建立健康的牙龈状况。该研究设计为一项双盲交叉临床试验，包括三个阶段。每个实验阶段包括一个为期7天的准备期和一个为期4天的菌斑积聚期（不采取口腔卫生措施）。在所有准备期内，志愿者（i）使用牙刷和牙膏进行机械牙齿清洁，（ii）此外，还接受两次PTC。在第0天进行细菌采样后进行最后一次PTC。准备期A：参与者继续仅采用机械方法的自我菌斑控制方案。准备期B：参与者还被指示每天用0.2%洗必泰漱口水漱口两次。准备期C：除上述措施外，参与者被指示每天用1.0%洗必泰凝胶刷舌背60秒两次。在每个菌斑积聚期之后，有一个为期10天的洗脱期。在停止口腔卫生措施1天、2天和4天后对牙菌斑（QHI）的存在和数量进行评分。在第0天以及1天和2天后采集唾液样本。将样本置于布鲁氏菌琼脂平板上，（厌氧）培养5天。确定形成菌落单位的总数，并用于估计唾液中细菌的密度。
在A期，平均QHI从第1天的1.0增加到第2天的1.4和第4天的2.1。B期和C期的相应评分分别为0.5、0.8、1.6和0.3、0.8、1.2。在所有复查间隔期，A期形成的菌斑均多于B期和C期。此外，在C期形成的菌斑少于B期。A期第0天的唾液样本中总需氧菌数（TVC）多于B期和C期的基线样本。第2天各组之间的TVC无显著差异。
每天使用洗必泰作为机械牙齿清洁的辅助手段可显著减少唾液中可检测到的微生物数量。唾液细菌数量可能影响了在早期停止口腔卫生措施期间形成的菌斑量。
