Pedrazzi Vinicius, Escobar Elaine Cristina, Cortelli José Roberto, Haas Alex Nogueira, Andrade Ana Karina Pinto de, Pannuti Claudio Mendes, Almeida Eliete Rodrigues de, Costa Fernando Oliveira, Cortelli Sheila Cavalca, Rode Sigmar de Mello
Department of Dental Materials and Prosthesis, School of Dentistry of Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
Periodontology Department, School of Dentistry, Faculdades Metropolitanas Unidas, São Paulo, SP, Brazil.
Braz Oral Res. 2014;28 Spec No. doi: 10.1590/1807-3107BOR-2014.vol28.0022. Epub 2014 Jul 4.
Great possibilities for oral rehabilitation emerged as a result of scientific consolidation, as well as a large number of dental implant applications. Along with implants appeared diseases such as mucositis and peri-implantitis, requiring management through several strategies applied at different stages. Biofilm accumulation is associated with clinical signs manifest by both tooth and implant inflammation. With this in mind, regular and complete biofilm elimination becomes essential for disease prevention and host protection. Chemical control of biofilms, as an adjuvant to mechanical oral hygiene, is fully justified by its simplicity and efficacy proven by studies based on clinical evidence. The purpose of this review was to present a consensus regarding the importance of antimicrobial mouthrinse use as an auxiliary method in chemical peri-implant biofilm control. The active ingredients of the several available mouthrinses include bis-biguanide, essential oils, phenols, quaternary ammonium compounds, oxygenating compounds, chlorine derivatives, plant extracts, fluorides, antibiotics and antimicrobial agent combinations. It was concluded that there is strong clinical evidence that at least two mouthrinses have scientifically proven efficacy against different oral biofilms, i.e., chlorhexidine digluconate and essential oils; however, 0.12% chlorhexidine digluconate presents a number of unwanted side effects and should be prescribed with caution. Chemical agents seem beneficial in controlling peri-implant inflammation, although they require further investigation. We recommend a scientifically proven antiseptic, with significant short and long term efficacy and with no unwanted side effects, for the prevention and/or treatment of peri-implant disease.
由于科学的整合以及大量牙种植体的应用，口腔修复出现了巨大的可能性。随着种植体的出现，诸如黏膜炎和种植体周围炎等疾病也随之出现，需要在不同阶段采用多种策略进行管理。生物膜的积聚与牙齿和种植体炎症所表现出的临床症状相关。考虑到这一点，定期且彻底地清除生物膜对于疾病预防和保护宿主至关重要。作为机械口腔卫生的辅助手段，生物膜的化学控制因其简单性和基于临床证据的研究证实的有效性而完全合理。本综述的目的是就使用抗菌漱口水作为化学性种植体周围生物膜控制的辅助方法的重要性达成共识。几种可用漱口水的活性成分包括双胍类、精油、酚类、季铵化合物、氧化化合物、氯衍生物、植物提取物、氟化物、抗生素和抗菌剂组合。得出的结论是，有强有力的临床证据表明，至少有两种漱口水已被科学证明对不同的口腔生物膜有效，即葡萄糖酸洗必泰漱口水和精油漱口水；然而，0.12%的葡萄糖酸洗必泰漱口水存在一些不良副作用，应谨慎开处方。化学药剂似乎有助于控制种植体周围炎症，尽管它们还需要进一步研究。我们推荐一种经科学证明的防腐剂，具有显著的短期和长期疗效且无不良副作用，用于预防和/或治疗种植体周围疾病。
