J Am Dent Assoc. 2017 Jul;148(7):493-499. doi: 10.1016/j.adaj.2017.03.006. Epub 2017 Apr 24.
Application of astringent hemostatic agents is the most widely used technique for gingival retraction, and a variety of products are offered commercially. However, these products may have additional unintended yet clinically beneficial properties. The authors assessed the antimicrobial activities of marketed retraction products against plaque-associated bacteria in both planktonic and biofilm assays, in vitro.
The authors assessed hemostatic solutions, gels, pellets, retraction cords, pastes, and their listed active agents against a collection of microorganisms by means of conventional agar diffusion and minimum bacteriostatic and bactericidal concentration determinations. The authors then tested the most active products against monospecies biofilms grown on hydroxyapatite disks.
All of the tested retraction products exhibited some antimicrobial activity. The results of the most active products were comparable with those of a marketed mouthwash. The listed retraction-active agents displayed relatively little activity when tested in pure form. At 10% dilution, some products evidenced inhibitory activity against most tested bacteria within 3 minutes of exposure, whereas others displayed variable effects after 10 minutes. The most active agents reduced, but did not completely prevent, the metabolic activity of a monospecies biofilm.
Commercial gingival retraction products exhibit antimicrobial effects to various degrees in vitro. Some products display rapid bactericidal activity. The antimicrobial activity is not owing to the retraction-active agents. Biofilm bacteria are less sensitive to the antimicrobial effects of the agents.
The rapidity of killing by some hemostatic agents suggests an antimicrobial effect that may be efficacious during clinical placement. The results of this in vitro study suggest that clinicians should be aware of the potential antimicrobial effects of some hemostatic agents, but more research is needed to confirm these observations in clinical use.
收敛止血剂的应用是最广泛的牙龈退缩技术,有多种产品在商业上提供。然而,这些产品可能具有额外的非预期但临床上有益的特性。作者评估了市售收缩产品对浮游和生物膜检测中菌斑相关细菌的抗菌活性。
作者通过常规琼脂扩散和最低抑菌和杀菌浓度测定,评估了止血溶液、凝胶、颗粒、收缩线、糊剂及其列出的活性剂对微生物集合的抗菌活性。然后,作者测试了最有效的产品对羟基磷灰石盘上生长的单种生物膜的抗菌活性。
所有测试的收缩产品都表现出一定的抗菌活性。最有效的产品的结果与市售漱口水相当。以纯形式测试时,列出的收缩活性剂活性较小。在 10%稀释度下,一些产品在暴露 3 分钟内对大多数测试细菌具有抑制活性,而其他产品在 10 分钟后显示出不同的效果。最有效的制剂可减少但不能完全阻止单种生物膜的代谢活性。
商业牙龈收缩产品在体外表现出不同程度的抗菌作用。一些产品显示出快速杀菌活性。抗菌活性不是由于收缩活性剂引起的。生物膜细菌对这些制剂的抗菌作用不敏感。
一些止血剂的快速杀菌作用表明在临床放置期间可能具有抗菌效果。这项体外研究的结果表明,临床医生应该意识到一些止血剂的潜在抗菌作用,但需要更多的研究来确认这些在临床应用中的观察结果。