Master of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain.
Master of Oral Surgery and Implant Dentistry, School of Dentistry, University of Granada, Granada, Spain; Biomedical Group (BIO277), University of Granada, Granada, Spain.
Int J Oral Maxillofac Surg. 2021 Jan;50(1):104-108. doi: 10.1016/j.ijom.2020.04.019. Epub 2020 May 23.
The aim of this study was to compare the effectiveness of three agents - two antibiotics (amoxicillin and clindamycin) and an antiseptic (chlorhexidine) - to decontaminate bone grafts obtained by low-speed drilling. The study included 248 bone tissue samples harvested from 62 patients by low-speed drilling before dental implant placement. Each of four samples obtained from every patient was dropped, using a sterile instrument, into a sterile tube containing a 500-μl solution of 400μg/mL amoxicillin, 150μg/mL clindamycin, 0.12% chlorhexidine, or physiological saline for 1min. The number of colony-forming units (CFU) was determined at 48h of culture. The use of clindamycin, amoxicillin, or chlorhexidine as decontaminant for 1min significantly reduced the CFU count when compared to physiological saline (control agent). In both anaerobic and CO-rich atmospheres, significant differences in CFU/mL were found between the control and chlorhexidine groups (P<0.001), control and amoxicillin groups (P<0.001), control and clindamycin groups (P<0.001), chlorhexidine and amoxicillin groups (P<0.0001), and chlorhexidine and clindamycin groups (P<0.0001). In conclusion, clindamycin had the highest decontaminating effect on bone particles obtained by low-speed drilling, followed by chlorhexidine and amoxicillin. Clindamycin may therefore be a valid alternative option for the routine decontamination of intraoral bone grafts.
本研究旨在比较三种试剂（两种抗生素[阿莫西林和克林霉素]和一种防腐剂[洗必泰]）对低速钻孔获得的骨移植物的去污效果。该研究纳入了 62 例患者在牙种植体植入前通过低速钻孔获得的 248 个骨组织样本。每位患者的四个样本中的每一个均使用无菌器械，将其滴入无菌管中，无菌管中含有 500μl 浓度为 400μg/ml 的阿莫西林、150μg/ml 克林霉素、0.12%洗必泰或生理盐水溶液中，作用 1 分钟。48 小时培养后，测定菌落形成单位（CFU）的数量。与生理盐水（对照试剂）相比，1 分钟内使用克林霉素、阿莫西林或洗必泰作为去污剂可显著降低 CFU 计数。在厌氧和富含 CO 的环境中，与对照组（生理盐水）相比，洗必泰组（P<0.001）、阿莫西林组（P<0.001）、克林霉素组（P<0.001）、洗必泰组和阿莫西林组（P<0.0001）和洗必泰组和克林霉素组（P<0.0001）CFU/ml 之间存在显著差异。总之，低速钻孔获得的骨颗粒中克林霉素的去污效果最高，其次是洗必泰和阿莫西林。因此，克林霉素可能是口腔内骨移植物常规去污的有效替代选择。
