Gupta Gunjan, Mitra Dipika, Ashok K P, Gupta Arun, Soni Sweta, Ahmed Sameer, Arya Ashtha
Department of Periodontics, Vyas Dental College and Hospital, Jodhpur, India.
J Periodontol. 2014 Apr;85(4):562-8. doi: 10.1902/jop.2013.120616. Epub 2013 Jul 15.
The aerosol generated by an ultrasonic scaler contains microorganisms that can penetrate into the body through the respiratory system of dental surgeons and patients. The aim of this pilot study is to evaluate and compare the efficacy of commercially available preprocedural mouthrinses containing 0.2% chlorhexidine gluconate, an herbal mouthwash, and water in reducing the levels of viable bacteria in aerosols.
This single-center, double-masked, placebo-controlled, randomized, three-group parallel design was conducted over a period of 45 days. Twenty-four patients with chronic periodontitis were divided randomly into three groups (A, B, and C) of eight patients each to receive 0.2% chlorhexidine gluconate, herbal mouthwash, and water, respectively, as a preprocedural rinse. The aerosol produced by the ultrasonic unit was collected at patient's chest area, doctor's chest area, and assistant's chest area on blood agar plates in all three groups. The blood agar plates were incubated at 37°C for 48 hours, and the total number of colony-forming units (CFUs) was counted and statistically analyzed.
The results showed that CFUs in groups A and B were significantly reduced compared with group C, P <0.001 (analysis of variance). Also, CFUs in group A were significantly reduced compared with group B, P <0.05 (independent t-test). The numbers of CFUs were highest at the patient's chest area and lowest at the assistant's chest area.
This study suggests that a routine preprocedural mouthrinse could eliminate the majority of bacterial aerosols generated by the use of an ultrasonic unit, and that 0.2% chlorhexidine gluconate is more effective than herbal mouthwash.
超声洁牙机产生的气溶胶含有微生物,可通过牙科医生和患者的呼吸系统进入体内。本初步研究的目的是评估和比较含0.2%葡萄糖酸氯己定的市售前程序漱口水、草药漱口水和水在降低气溶胶中活菌水平方面的效果。
本研究采用单中心、双盲、安慰剂对照、随机、三组平行设计,为期45天。24例慢性牙周炎患者随机分为三组(A组、B组和C组),每组8例,分别接受0.2%葡萄糖酸氯己定、草药漱口水和水作为前程序漱口水。在所有三组中,将超声设备产生的气溶胶收集在患者胸部区域、医生胸部区域和助手胸部区域的血琼脂平板上。血琼脂平板在37°C下孵育48小时,计算菌落形成单位(CFU)总数并进行统计分析。
结果显示,与C组相比,A组和B组的CFU显著降低,P<0.001(方差分析)。此外,与B组相比,A组的CFU显著降低,P<0.05(独立t检验)。CFU数量在患者胸部区域最高,在助手胸部区域最低。
本研究表明,常规的前程序漱口水可以消除使用超声设备产生的大部分细菌气溶胶,并且0.2%葡萄糖酸氯己定比草药漱口水更有效。