Kürkçü Mehmet, Oz I Attila, Köksal Fatih, Benlidayi M Emre, Güneşli Aylin
Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Cukurova University, 01330 Balcali, Adana, Turkey.
J Oral Maxillofac Surg. 2005 Nov;63(11):1593-8. doi: 10.1016/j.joms.2005.07.016.
The purposes of the study presented are to identify the microbial content of the collected bone debris and to determine the antibacterial efficiency of chlorhexidine mouth rinse in reducing the microbial content of the collected bone debris.
Twenty-five patients who had asymptomatic fully impacted mandibular third molars bilaterally underwent surgical removal for prophylactic and orthodontic considerations. Immediately before surgery all patients rinsed with 10 mL of their assigned solution (chlorhexidine or sterile saline) for 2 minutes. Before surgical removal of the teeth, bone debris was collected with a stringent aspiration protocol from the ramus by bone filter. The microbial content of the bone debris was assessed and the bacterial levels between the 2 groups were compared statistically.
All samples from both groups (chlorhexidine or sterile saline) yielded viable microorganisms. There was no significant difference between the mean/median colony-forming units (CFU)/g values of both group samples, for aerobes (Streptococcus salivarius) and anaerobes (Bacteroides, Peptococcus, Peptostreptococcus, and Veillonella species). With regard to total microorganisms, the mean CFU/g derived from the chlorhexidine group samples were 1.5 x 10(8) CFU/g per bone sample compared with 1.5 x 10(9) CFU/g for the sterile saline control group (P < .05).
Although chlorhexidine rinsing immediately before surgery reduced the levels of total microorganisms when compared with stringent aspiration protocol alone, it has not been found effective on aerobic Streptococcus salivarius and, importantly, on anaerobes. The reduced bacterial levels may still carry high infectious risk and may lead to failure in autogenous grafting procedures in oral surgery.
本研究的目的是确定所收集骨碎片的微生物含量，并确定洗必泰漱口水在降低所收集骨碎片微生物含量方面的抗菌效果。
25例双侧无症状完全阻生下颌第三磨牙患者因预防性和正畸性考虑接受手术拔除。术前所有患者均用10毫升指定溶液（洗必泰或无菌生理盐水）漱口2分钟。在手术拔除牙齿前，通过骨过滤器采用严格的抽吸方案从下颌支收集骨碎片。评估骨碎片的微生物含量，并对两组之间的细菌水平进行统计学比较。
两组（洗必泰组或无菌生理盐水组）的所有样本均培养出活的微生物。两组样本中需氧菌（唾液链球菌）和厌氧菌（拟杆菌属、消化球菌属、消化链球菌属和韦荣球菌属）的平均/中位数菌落形成单位（CFU）/克值之间无显著差异。就总微生物而言，洗必泰组样本的平均CFU/克为每块骨样本1.5×10⁸CFU/克，而无菌生理盐水对照组为1.5×10⁹CFU/克（P<.05）。
尽管术前立即使用洗必泰漱口与单独采用严格的抽吸方案相比可降低总微生物水平，但未发现其对需氧唾液链球菌有效，重要的是，对厌氧菌也无效。细菌水平的降低可能仍具有较高的感染风险，并可能导致口腔外科自体移植手术失败。
