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氯己定是否能改善种植体周围黏膜炎或种植体周围炎非手术治疗的效果?系统评价和荟萃分析。

Does chlorhexidine improve outcomes in non-surgical management of peri-implant mucositis or peri-implantitis?: a systematic review and meta-analysis.

机构信息

Department of Stomatology affiliated Hospital of Shaoxing University 999 Zhongxing South Road, Shaoxing Zhejiang 312000, P.R. China

出版信息

Med Oral Patol Oral Cir Bucal. 2020 Sep 1;25(5):e608-e615. doi: 10.4317/medoral.23633.


DOI:10.4317/medoral.23633
PMID:32683389
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7473444/
Abstract

BACKGROUND: With greater number of implants being placed in clinical practice, incidence of peri-implant diseases are on the rise. It is not known whether chlorhexidine (CHX) improves outcomes in the management of peri-implant diseases. The aim of this systematic review and meta-analysis was to evaluate the role of CHX in improving outcomes with non-surgical management of peri-implant mucositis and peri-implantitis. MATERIAL AND METHODS: An electronic search of PubMed, Scopus, Embase, and CENTRAL (Cochrane Central Register of Controlled Trials) databases up to 1st August 2019 was carried out to search for studies evaluating the efficacy of CHX for non-surgical management of peri-implant diseases. RESULTS: Seven studies were included. Four studies evaluated the role of CHX in peri-implant mucositis and three in peri-implantitis. Oral prophylaxis with mechanical cleansing of implant surface prior to CHX use was carried out in all seven studies. Meta-analysis indicated that use of CHX did not improve probing depths in peri-implant mucositis (SMD= 0.11; 95% CI: -0.16 to 0.38; p=0.42, I2= 0%). Similarly, CHX did not significantly reduce probing depths in patients with peri-implantitis (MD= 1.57; 95% CI: -0.88 to 4.0; p=0.21, I2= 98%). Results on the efficacy of CHX in reducing BOP in peri-implantitis are conflicting. CONCLUSIONS: Results of our study indicate that adjunctive therapy with CHX may not improve outcomes with non-surgical management of peri-implant mucositis. Conclusions with regards to its role in non-surgical management of peri-implantitis cannot be drawn. There is a need for more homogenous RCTs with large sample size to define the role of CHX in non-surgical management of peri-implant mucositis and peri-implantitis.

摘要

背景:随着临床实践中植入物数量的增加,种植体周围疾病的发病率也在上升。目前尚不清楚洗必泰(CHX)是否能改善种植体周围疾病的管理效果。本系统评价和荟萃分析的目的是评估 CHX 在非手术治疗种植体周围黏膜炎和种植体周围炎方面改善结局的作用。

材料与方法:截至 2019 年 8 月 1 日,我们对 PubMed、Scopus、Embase 和 Cochrane 中央对照试验注册库(Cochrane Central Register of Controlled Trials)数据库进行了电子检索,以搜索评估 CHX 用于非手术治疗种植体周围疾病的疗效的研究。

结果:纳入了 7 项研究。其中 4 项研究评估了 CHX 在种植体周围黏膜炎中的作用,3 项研究评估了 CHX 在种植体周围炎中的作用。所有 7 项研究均在使用 CHX 之前对种植体表面进行机械清洁的口腔预防措施。荟萃分析表明,CHX 的使用并未改善种植体周围黏膜炎的探诊深度(SMD=0.11;95%CI:-0.16 至 0.38;p=0.42,I2=0%)。同样,CHX 也不能显著降低种植体周围炎患者的探诊深度(MD=1.57;95%CI:-0.88 至 4.0;p=0.21,I2=98%)。CHX 在减少种植体周围炎的 BOP 方面的疗效结果存在矛盾。

结论:我们的研究结果表明,CHX 辅助治疗可能无法改善种植体周围黏膜炎的非手术管理效果。对于其在种植体周围炎的非手术管理中的作用,尚不能得出结论。需要更多具有大样本量和同质性的 RCT 来确定 CHX 在种植体周围黏膜炎和种植体周围炎的非手术管理中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/489b/7473444/0438ad7bd341/medoral-25-e608-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/489b/7473444/9b4884b502d2/medoral-25-e608-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/489b/7473444/214a5578ac32/medoral-25-e608-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/489b/7473444/0438ad7bd341/medoral-25-e608-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/489b/7473444/9b4884b502d2/medoral-25-e608-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/489b/7473444/214a5578ac32/medoral-25-e608-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/489b/7473444/0438ad7bd341/medoral-25-e608-g003.jpg

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[5]
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[6]
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[8]
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本文引用的文献

[1]
Development and viability of biofilms grown on experimental abutments mimicking dental implants: An in vivo model.

Med Oral Patol Oral Cir Bucal. 2019-7-1

[2]
Nonsurgical Treatment of Peri-implantitis Without Eliminating Granulation Tissue: A 3-Year Study.

Implant Dent. 2019-2

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J Periodontol. 2017-5-11

[4]
Non-surgical treatment of peri-implant mucositis and peri-implantitis at two-piece zirconium implants: A clinical follow-up observation after up to 3 years.

J Clin Periodontol. 2017-6-20

[5]
Antimicrobial effect of chlorhexidine on Aggregatibacter actinomycetemcomitans biofilms associated with peri-implantitis.

J Dent Res Dent Clin Dent Prospects. 2016

[6]
Efficacy of 0.12% Chlorhexidine Gluconate for Non-Surgical Treatment of Peri-Implant Mucositis.

J Periodontol. 2016-11

[7]
Mechanical and chemical implant decontamination in surgical peri-implantitis treatment: preclinical "in vivo" study.

J Clin Periodontol. 2016-6-13

[8]
Antimicrobial Agents Used in the Treatment of Peri-Implantitis Alter the Physicochemistry and Cytocompatibility of Titanium Surfaces.

J Periodontol. 2016-7

[9]
Non-surgical treatment of peri-implant mucositis and peri-implantitis at zirconia implants: a prospective case series.

J Clin Periodontol. 2015-8

[10]
Chlorhexidine Uptake and Release From Modified Titanium Surfaces and Its Antimicrobial Activity.

J Periodontol. 2015-11

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