Department of Special Needs, School of Medicine and Dentistry, Santiago de Compostela University, Galicia, Spain.
Clin Oral Implants Res. 2010 Sep;21(9):913-8. doi: 10.1111/j.1600-0501.2010.01928.x.
To investigate the prevalence, duration and aetiology of bacteraemias following the placement of implants as well as the prophylactic efficacy of a chlorhexidine digluconate (CHX) mouthrinse.
Fifty patients undergoing implant placement were randomly distributed into two groups:
30 patients with no prophylactic intervention before surgery. CHX group: 20 patients who performed a 0.2% CHX mouthrinse before surgery. Blood samples were collected at baseline, at 30 s after the insertion of implants and at 15 min after completion of the suturing of the mucoperiosteal flap. Samples were processed in the Bactec 9240, and the subculture and further identification of the isolates were performed using conventional microbiological techniques.
The prevalence of bacteraemias was 2% at baseline. In the control group, the prevalence of bacteraemias was 6.7% at 30 s and 3.3% at 15 min, but no statistically significant differences were achieved compared with the baseline percentage. In the CHX group, there were no positive cultures from blood samples obtained at 30 s or at 15 min.
Implant placement via a mucoperiosteal flap does not carry a significant risk of developing bacteraemias. The use of antibiotic prophylaxis for the prevention of focal infections such as bacterial endocarditis in "at-risk" patients undergoing dental implants is therefore questionable. Although its efficacy has not been confirmed statistically, we recommend a 0.2% CHX mouthrinse before treatment as proposed previously by the British Society for Antimicrobial Chemotherapy.
调查植入物放置后菌血症的流行率、持续时间和病因，以及洗必泰葡萄糖酸（CHX）漱口液的预防效果。
50 名接受植入物放置的患者被随机分为两组：
30 名患者在手术前无预防干预。CHX 组：20 名患者在手术前进行 0.2% CHX 漱口。在基线、植入物插入后 30 秒和黏膜骨膜瓣缝合完成后 15 分钟采集血样。使用 Bactec 9240 处理样本，使用常规微生物学技术进行亚培养和进一步鉴定分离株。
基线时菌血症的患病率为 2%。在对照组中，植入后 30 秒时菌血症的患病率为 6.7%，15 分钟时为 3.3%，但与基线百分比相比，无统计学差异。在 CHX 组中，30 秒和 15 分钟时采集的血样均未培养出阳性。
通过黏膜骨膜瓣植入物放置不会导致菌血症的发生风险显著增加。因此，对于接受牙种植体的“高危”患者，预防性使用抗生素预防局灶性感染（如细菌性心内膜炎）是值得怀疑的。尽管其疗效尚未得到统计学证实，但我们建议在治疗前使用 0.2% CHX 漱口液，这是英国抗菌化疗学会之前提出的建议。
