Managutti Anil, Managutti Sunita A, Patel Jigar, Puthanakar Nagaraj Y
Department of Oral and Maxillofacial Surgery, Narsinhbhai Patel Dental College and Hospital, Visnagar, Gujarat India.
Department of Oral and Maxillofacial Pathology, Narsinhbhai Patel Dental College and Hospital, Visnagar, Gujarat India.
J Maxillofac Oral Surg. 2017 Dec;16(4):485-490. doi: 10.1007/s12663-016-0976-5. Epub 2016 Nov 1.
Microorganisms may invade the blood stream by oral routes through surgical procedures like extractions, fractured teeth and periodontal pockets. The incidence of bacteremia is 70-80 % following tooth extraction, sub gingival scaling and intra ligament injection.
Aim of study was to evaluate and compare the efficacy of two topical antimicrobial agents for the prevention of post-surgical bacteremia during mandibular third molar surgery. And objectives were to suggest need of proper topical antimicrobial agents and select proper antibiotics before oral surgical procedures in high risk cardiac patients.
Thirty patients with Class 1, Position B mesioangular impacted mandibular third molar were randomly included in study and divided into 3 groups, each group containing 10 patients. Group I; sterile water group, Group II: povidone-iodine (5 %) group, Group III: chlorhexidine (Q, 2 %) group, pre and post-surgical blood samples were collected and Microbiological analyses of the blood samples were done. The organisms were identified by standard method on grams staining and identification of bacterial species by biochemical tests.
The clinical parameters like oral hygiene index simplified and periodontal index of Russel showed that all patients in three groups had fair oral hygiene with simple gingivitis on mean. In some individuals with slightly higher OHIS and PI scores, bacteremia was noted. All the pre surgical blood samples were negative for the growth of bacteria after 7 days of culture. In total 30 patients, 12 subjects had postoperative bacteremia. Out of those 12 patients 6 cases (60 %) of group I showed positive bacterial growth in the post surgical blood sample, while 4 cases in group III and 2 cases (20 %) in group II showed the same.
Use of povidone-iodine and chlorhexidine prior to the oral surgical procedures decreases the incidence of bacteremia as compared to sterile water irrigation. Povidone-iodine significantly reduces the incidence bacteremia and number of organisms compared to chlorhexidine and sterile water.
微生物可能通过拔牙、牙齿折断和牙周袋等外科手术经口腔途径侵入血流。拔牙、龈下刮治和韧带内注射后菌血症的发生率为70%-80%。
本研究的目的是评估和比较两种局部抗菌剂在下颌第三磨牙手术中预防术后菌血症的疗效。目标是提出高危心脏病患者在口腔外科手术前使用合适的局部抗菌剂和选择合适抗生素的必要性。
将30例1类、B位近中阻生下颌第三磨牙患者随机纳入研究，分为3组，每组10例。第一组：无菌水组；第二组：聚维酮碘（5%）组；第三组：氯己定（0.2%）组。术前和术后采集血样并进行血样的微生物学分析。通过革兰氏染色的标准方法鉴定微生物，并通过生化试验鉴定细菌种类。
简化口腔卫生指数和Russel牙周指数等临床参数显示，三组所有患者口腔卫生状况一般，平均患有轻度牙龈炎。在一些口腔卫生指数简化和牙周指数得分略高的个体中，发现了菌血症。所有术前血样在培养7天后细菌生长均为阴性。30例患者中，12例有术后菌血症。在这12例患者中，第一组6例（60%）术后血样细菌生长呈阳性，而第三组4例，第二组2例（20%）呈阳性。
与无菌水冲洗相比，口腔外科手术前使用聚维酮碘和氯己定可降低菌血症的发生率。与氯己定和无菌水相比，聚维酮碘可显著降低菌血症的发生率和微生物数量。
