Sahrmann Philipp, Manz Andrea, Attin Thomas, Zbinden Reinhard, Schmidlin Patrick R
Clinic of Preventive Dentistry, Cariology and Periodontology, Center of Dental Medicine, University of Zurich, Zurich, Switzerland.
Institute of Medical Microbiology, University of Zurich, Zurich, Switzerland.
J Clin Periodontol. 2015 Jul;42(7):632-9. doi: 10.1111/jcpe.12416. Epub 2015 Jun 11.
To assess the effect of concomitant subgingival rinsing with 10% PVP-iodine during subgingival instrumentation on the prevalence and magnitude of bacteraemia of oral origin.
Subgingival instrumentation was performed with water or PVP-iodine rinse in patients with periodontitis. Prior to instrumentation, subjects gargled for 1 min with the allocated liquid. Pockets were then rinsed for 1 min and subgingivally instrumented with liquid-cooled (water/PVP-iodine) ultrasonic scalers (1 min). Two minutes later, a blood sample from the arm vein was drawn using a lysis centrifugation blood culture system for quantitative microbiological analysis. Non-parametric statistical tests were performed to assess differences in the prevalence and extent of bacteraemia between groups.
Of the 19 samples in each group, oral-borne bacteraemia was detected in 10 of the control and 2 of the test samples. With an average of 3.0 [1; 5] colony forming units, significantly less bacteria and bacteraemia were found in the test group compared to the controls (12.2 [1; 46]) (p = 0.003). Anaerobic bacteria were not found in the test group.
Bacteraemia after subgingival instrumentation with concomitant PVP-iodine rinsing is reduced but not eliminated. Therefore, it might be recommended for patients at a high risk of endocarditis or infection of endoprostheses. However, preventive antibiotic treatment should not be omitted.
评估龈下器械操作期间同时使用10%聚维酮碘进行龈下冲洗对口腔源性菌血症的发生率和严重程度的影响。
对牙周炎患者进行龈下器械操作时使用水或聚维酮碘冲洗。在器械操作前，受试者用分配的液体漱口1分钟。然后对牙周袋冲洗1分钟，并用液冷（水/聚维酮碘）超声洁牙器进行龈下器械操作（1分钟）。两分钟后，使用裂解离心血液培养系统从手臂静脉抽取血样进行定量微生物分析。进行非参数统计检验以评估两组之间菌血症发生率和程度的差异。
每组19个样本中，对照组10个样本和试验组2个样本检测到口腔源性菌血症。试验组平均有3.0[1;5]个菌落形成单位，与对照组（12.2[1;46]）相比，检测到的细菌和菌血症明显更少（p = 0.003）。试验组未发现厌氧菌。
龈下器械操作同时进行聚维酮碘冲洗后菌血症有所减少但未消除。因此，对于感染性心内膜炎或人工假体感染高风险患者可能推荐使用。然而，预防性抗生素治疗不应省略。
