Department of Oral Surgery and Implantology, Catholic University of the Sacred Heart, Rome, Italy.
Department of Surgery, Geneva University Hospitals, University of Geneva, Unit of Oral Surgery and Implantology, Service of Maxillofacial and Buccal Surgery, Geneva, Switzerland.
J Periodontol. 2018 Mar;89(3):325-330. doi: 10.1002/JPER.17-0325. Epub 2018 Feb 28.
Peri-implant infections are associated with the establishment and maturation of a bacterial biofilm characterized by a predominance of Gram-negative fusiform anaerobic species. The decontamination of implant surfaces is then crucial for a successful peri-implant therapy.
Twenty-one smooth and 21 rough implants, divided into four groups according to surface and treatment modality, were contaminated with Streptococcus sanguinis and then placed in an incubator with the atmosphere of 5% CO2 at 37°C for 24 hours to allow the bacteria to grow. After 24 hours, the test groups were treated with controlled release 14% doxycycline gel injecting the gel circumferentially over the surface of the implant for 3 minutes, while the control groups were irrigated with sterile saline for 1 minute. The implants were then vortexed into triptych soy broth to allow the bacteria to detach from the surface, diluted 1:100 and plated. Colony forming units (CFU) were counted 48 hours after incubation.
The use of a 14% doxycycline gel minimized CFU counts compared to control groups, with the difference being statistically significant (P < 0.05). The reduction of CFUs in the smooth test group is more marked than in the rough test group, but the difference doesn't reach statistically significance (P = 0.215).
The use of 14% doxycycline gel in implant surface decontamination was efficacious in this in-vitro study. Adjunctive use of locally delivered 14% doxycycline gel might be a viable option in the management of peri-implantitis and peri-implant mucositis considering its efficacy in reducing bacterial colonization.
种植体周围感染与细菌生物膜的建立和成熟有关，其特征是革兰氏阴性梭形厌氧物种占优势。因此，种植体表面的去污对于成功的种植体治疗至关重要。
将 21 个光滑种植体和 21 个粗糙种植体根据表面和治疗方式分为四组，用 S. sanguinis 污染，然后放置在 37°C 下含 5%CO2 的孵育箱中 24 小时，使细菌生长。24 小时后，测试组用控制释放 14%盐酸多西环素凝胶处理，将凝胶沿种植体表面环绕注射 3 分钟，而对照组用无菌生理盐水冲洗 1 分钟。然后将种植体涡旋到三联大豆肉汤中，使细菌从表面脱落，稀释 1:100 并接种平板。孵育 48 小时后计数菌落形成单位 (CFU)。
与对照组相比，使用 14%盐酸多西环素凝胶最大限度地减少了 CFU 计数，差异具有统计学意义（P < 0.05）。与粗糙组相比，光滑组的 CFU 减少更明显，但差异无统计学意义（P = 0.215）。
在这项体外研究中，使用 14%盐酸多西环素凝胶对种植体表面去污是有效的。局部应用 14%盐酸多西环素凝胶可能是治疗种植体周围炎和种植体周围黏膜炎的可行选择，因为它在减少细菌定植方面具有疗效。
