Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
Department of Clinical Sciences, Pharmacology and Preventive Dentistry, Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada.
Int Dent J. 2022 Jun;72(3):269-277. doi: 10.1016/j.identj.2022.01.005. Epub 2022 Mar 12.
The aim of this work was to review the current uses of chlorhexidine (CHX) in dentistry based on its mechanism of action, whilst highlighting the most effective protocols that render the highest clinical efficacy whilst limiting adverse drug reactions.
A literature search was conducted using the key words chlorhexidine, mechanism of action, adverse effects, and dentistry using databases in the University of Toronto library system. The titles and abstracts were read, and relevant articles were selected.
A total of 1100 publications were identified, 100 were investigated, and 67 of them were used. Out of the 67 selected articles, 12 were reviews on CHX; 5 articles focussed on CHX gels; 13 focussed on CHX mouthwashes; 8 focussed on CHX products; 13 discussed adverse effects associated with CHX; 13 focussed on periodontal pathology and treatment; 6 focussed on implant periodontal and dental surgeries; 7 evaluated effects on caries; 6 looked at the mechanisms of action; and 12 focussed on the antibacterial and antimicrobial impact on the oral biome. There were multiple areas of overlap amongst the articles, and results showed that CHX provides different uses, but mainly as an adjunct to various treatments. Mouthwash was the most superior medium when used in short time spans when mechanical prophylaxis was not possible for the prevention of gingivitis and maintenance of oral hygiene. CHX products are often used in periodontics, post-oral surgical procedures, and as a prophylaxis for multiple invasive procedures with minimal adverse effects. Tooth staining was the most negative adverse effect reported by patients.
CHX's antimicrobial properties make it an ideal prophylactic when mechanical debridement is not possible. CHX mouthwash appears to be more effective compared to gels. Concentrations of 0.12% to 0.2% are recommended; any mouthwash with concentrations above 0.2% will unnecessarily increase the unwanted side effects. CHX is useful amongst various areas of dentistry including oral surgery, periodontics, and even general dentistry. For long-term treatments, especially in periodontitis patients (stage I-III) undergoing nonsurgical treatments, CHX chips are recommended. CHX chips are also recommended as an adjunct to implant debridement in patients with peri-implant mucositis and peri-implantitis over CHX mouthwash and gels.
本研究旨在通过探讨洗必泰的作用机制，综述其在口腔医学领域的应用，并强调在限制药物不良反应的同时达到最佳临床疗效的最有效方案。
在多伦多大学图书馆系统的数据库中使用关键词“洗必泰”、“作用机制”、“不良反应”和“牙科”进行文献检索。阅读标题和摘要，选择相关文章。
共确定 1100 篇出版物，调查了 100 篇，其中 67 篇被使用。在选择的 67 篇文章中，有 12 篇是关于洗必泰的综述；5 篇文章专注于洗必泰凝胶；13 篇文章聚焦于洗必泰漱口水；8 篇文章专注于洗必泰产品；13 篇文章讨论了与洗必泰相关的不良反应；13 篇文章聚焦于牙周病学和治疗；6 篇文章评估了对龋齿的影响；6 篇文章研究了作用机制；12 篇文章聚焦于口腔生物抗菌和抗微生物作用。文章之间存在多个重叠领域，结果表明洗必泰提供了不同的用途，但主要是作为各种治疗的辅助手段。在机械预防不可行时，漱口水是预防牙龈炎和维持口腔卫生的最佳短期使用介质。洗必泰产品常用于牙周病学、口腔手术后以及作为多种侵入性程序的预防措施，具有最小的不良反应。牙齿染色是患者报告的最负面的不良反应。
洗必泰的抗菌特性使其成为机械清创不可行时的理想预防剂。与凝胶相比，洗必泰漱口水似乎更有效。推荐使用 0.12%至 0.2%的浓度；任何浓度超过 0.2%的漱口水都会不必要地增加不必要的副作用。洗必泰在口腔医学的各个领域都有应用，包括口腔外科、牙周病学，甚至普通牙科。对于长期治疗，特别是在接受非手术治疗的牙周炎患者（I-III 期）中，建议使用洗必泰牙片。对于患有种植体周围黏膜炎和种植体周围炎的患者，建议将洗必泰牙片作为种植体清创的辅助手段，优于洗必泰漱口水和凝胶。
