de Melo Menezes Karyna, Roncalli da Costa Oliveira Ângelo Giuseppe, de Vasconcelos Gurgel Bruno César
Int J Oral Maxillofac Implants. 2021 Nov-Dec;36(6):1188-1197. doi: 10.11607/jomi.8994.
This study investigated the impact of 0.12% chlorhexidine gluconate mouthwash on dental implants with periimplant mucositis and contralateral teeth with gingivitis at 6 months of follow-up after nonsurgical treatment.
This was a secondary analysis of data from a previous controlled, randomized, double-blinded clinical trial of 30 patients diagnosed with peri-implant mucositis and gingivitis in contralateral teeth, at 6 months following treatment. Patients were randomly assigned into a test group (basic periodontal therapy + 0.12% chlorhexidine mouthwash) or a control group (basic periodontal therapy + placebo). Therapy consisted of an adaptation of the full-mouth scaling and root planing protocol. The clinical parameters of visible Plaque Index, Gingival Bleeding Index, probing depth, bleeding on probing, keratinized mucosa width, and gingival and peri-implant phenotype were evaluated at baseline and at 1, 3, and 6 months posttherapy. Data were analyzed using Poisson multilevel regression analysis with a significance level of .05.
The study analyzed 47 implants and contralateral teeth (376 sites) in the test group and 49 implants and contralateral teeth (392 sites) in the control group. No differences were found between the groups at the patient level. At the site level, the teeth and implants presented statistical differences in bleeding on probing, probing depth, and keratinized mucosa width at 3 months for both treatment groups. However, no difference was observed in bleeding on probing in the test group (P = .484) at 6 months, whereas the control group demonstrated increased bleeding on probing (indicating more inflammation) at implant sites than at teeth sites (P = .039). Additionally, implant sites with a thin peri-implant phenotype (P < .001) and located posteriorly (P = .002) presented greater inflammation.
Use of a 0.12% chlorhexidine mouthwash for 14 days was beneficial for implant sites with peri-implant mucositis, compared to contralateral teeth sites with gingivitis, as indicated by the reduced percentage of teeth with bleeding on probing.
本研究调查了0.12%葡萄糖酸氯己定漱口水对种植体周围黏膜炎的牙种植体以及非手术治疗后6个月对侧患牙龈炎牙齿的影响。
这是对先前一项对照、随机、双盲临床试验数据的二次分析，该试验涉及30例被诊断为种植体周围黏膜炎且对侧牙齿患牙龈炎的患者，在治疗后6个月进行。患者被随机分为试验组（基础牙周治疗+0.12%氯己定漱口水）或对照组（基础牙周治疗+安慰剂）。治疗包括调整全口洁治和根面平整方案。在基线以及治疗后1、3和6个月评估可见菌斑指数、牙龈出血指数、探诊深度、探诊出血、角化黏膜宽度以及牙龈和种植体周围表型等临床参数。使用泊松多水平回归分析对数据进行分析，显著性水平为0.05。
本研究分析了试验组的47颗种植体和对侧牙齿（376个部位）以及对照组的49颗种植体和对侧牙齿（392个部位）。在患者层面，两组之间未发现差异。在部位层面，两个治疗组在3个月时，牙齿和种植体在探诊出血、探诊深度和角化黏膜宽度方面存在统计学差异。然而，试验组在6个月时探诊出血无差异（P = 0.484），而对照组在种植体部位的探诊出血比牙齿部位增加（表明炎症更严重）（P = 0.039）。此外，种植体周围表型薄的种植体部位（P < 0.001）和位于后部的种植体部位（P = 0.002）炎症更严重。
与对侧患牙龈炎的牙齿部位相比，使用0.12%氯己定漱口水14天对种植体周围黏膜炎的种植体部位有益，这表现为探诊出血牙齿的百分比降低。
