Department of Oral Surgery, Wroclaw Medical University, Poland.
Private practice, Sofia, Bulgaria.
Adv Clin Exp Med. 2020 Mar;29(3):355-363. doi: 10.17219/acem/115087.
Dental implant surgery has become routine practice for replacing missing teeth. Little is known about the use of local antisepsis to control the development of bacterial plaque and to facilitate healing, as current practice guidelines do not address this issue.
The objectives of this study were to describe antiseptic practices for implant surgery and to assess plaque control at the operative site as well as the investigator's satisfaction.
This prospective, observational study conducted in 4 European countries enrolled 911 adult patients receiving a single or multiple implant on the day of inclusion. Any medication prescribed during the preor postoperative periods was documented, particularly antibiotics, antiseptic mouthwashes and topical antiseptic gels. At a follow-up visit, the presence of plaque was documented on teeth adjacent to the implant and its extent determined using the Silness-Löe index.
Oral antibiotics were prescribed prior to surgery in 53.8% of the patients. Antiseptic mouthwashes were prescribed to patients (49.6-65.7%) according to country. Following dental implant placement, 84.1-94.7% of patients were prescribed oral antibiotics, 45.6-86.5% of patients were prescribed antiseptic mouthwash and 72.8-100% of patients were prescribed an antiseptic gel. At the follow-up visit, plaque was observed in 45.4% of the patients. The mean Silness-Löe plaque index was 0.7 or 0.8, indicating a low level of plaque accumulation. The Löe and Silness gingival index was 0.6 or 0.7, which is consistent with a low level of gingival inflammation.
Use of antibiotics preand post-surgery is frequent in implant surgery, despite it being discouraged in practice guidelines. Use of antiseptic mouthwashes and topical antiseptic gels is widespread, although treatment paradigms vary widely. Practice guidelines covering antisepsis provision would be useful, since those products could be used as an alternative to antibiotics to facilitate wound healing.
种植牙手术已成为修复缺失牙齿的常规方法。目前的实践指南并未涉及局部抗菌以控制细菌菌斑的发展和促进愈合的问题，因此对于种植牙手术中使用局部抗菌的情况知之甚少。
本研究旨在描述种植牙手术中的抗菌方法，并评估手术部位的菌斑控制情况以及研究者的满意度。
本研究为在欧洲 4 个国家开展的前瞻性、观察性研究，共纳入 911 名成年患者，他们在纳入当天接受了单颗或多颗种植牙手术。记录了围手术期和术后期间开处的所有药物，特别是抗生素、抗菌漱口水和局部抗菌凝胶。在随访时，使用 Silness-Löe 指数记录了种植体相邻牙齿上的菌斑情况，并确定其严重程度。
53.8%的患者在手术前开具了口腔抗生素。根据国家的不同，抗菌漱口水的使用情况为 49.6%-65.7%。种植牙放置后，84.1%-94.7%的患者开具了口服抗生素，45.6%-86.5%的患者开具了抗菌漱口水，72.8%-100%的患者开具了抗菌凝胶。在随访时，45.4%的患者观察到菌斑。平均 Silness-Löe 菌斑指数为 0.7 或 0.8，表明菌斑积累程度较低。Löe 和 Silness 牙龈指数为 0.6 或 0.7，表明牙龈炎症程度较低。
尽管实践指南不鼓励在种植牙手术中使用，但手术前后使用抗生素仍很常见。抗菌漱口水和局部抗菌凝胶的使用非常广泛，尽管治疗方案差异很大。涵盖抗菌提供的实践指南将是有用的，因为这些产品可作为抗生素的替代品，以促进伤口愈合。
