Postgraduate student, Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Federal University of Ceará (FFOE-UFC), Fortaleza, Brazil.
Adjunct Professor, Department of Restorative Dentistry, Faculty of Pharmacy, Dentistry and Nursing, Federal University of Federal University of Ceará (FFOE-UFC), Fortaleza, Brazil.
J Prosthet Dent. 2024 Oct;132(4):704-713. doi: 10.1016/j.prosdent.2022.09.013. Epub 2022 Nov 7.
Given the wide use of cobalt chromium (Co-Cr) alloys, especially for removable partial dentures, and the importance of chemical solutions to complement the cleaning of dental prostheses, safe disinfection products should be identified for the regular decontamination of Co-Cr dental prostheses.
The purpose of this systematic review of in vitro studies was to determine the effects on the properties of Co-Cr dental alloys of the various chemical agents used to clean dental prostheses.
In vitro studies were included based on a literature search conducted in March 2022 in the Medline/PubMed, SCOPUS, Web of Science, Virtual Health Library, and Embase databases. Independent reviewers performed the search, selection, extraction, and analysis of the data. The review was performed based on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The quality of the included articles was evaluated by using parameters adapted from the Consolidated Standards of Reporting Trials (CONSORT) guidelines, and the risk of bias analysis was performed based on previous studies.
Among the 15 included studies, the chemical agents evaluated were alkaline peroxides and hypochlorites, mouthwashes containing cetylpyridinium chloride and chlorhexidine, diluted acids, and enzymes. Some peroxides produced increased ion release, surface roughness, and mass loss of the alloys. The hypochlorites were responsible for the greatest surface corrosion, yielding dark stains, rough regions, and depressions. Acetic and peracetic acids and mouthwashes containing chlorhexidine and cetylpyridinium did not produce significant changes in Co-Cr alloys. Most studies presented moderate risk of bias.
According to the included studies, mouth rinses containing cetylpyridinium chloride or chlorhexidine and solutions with acetic and peracetic acid could be safely used to chemically sanitize Co-Cr prostheses. Alkaline peroxides should be used with caution, and alkaline hypochlorite solutions should be avoided.
鉴于钴铬（Co-Cr）合金的广泛应用，特别是在可摘局部义齿中，以及化学溶液在补充牙科修复体清洁方面的重要性，应确定安全的消毒产品，以定期对 Co-Cr 牙科修复体进行去污。
本系统评价体外研究的目的是确定用于清洁牙科修复体的各种化学剂对 Co-Cr 牙科合金性能的影响。
根据 2022 年 3 月在 Medline/PubMed、SCOPUS、Web of Science、Virtual Health Library 和 Embase 数据库中进行的文献检索，纳入了体外研究。独立评审员进行了搜索、选择、提取和数据分析。该综述是根据系统评价和荟萃分析的首选报告项目（PRISMA）指南进行的。通过使用改编自临床试验报告统一标准（CONSORT）指南的参数评估纳入文章的质量，并根据先前的研究进行偏倚风险分析。
在纳入的 15 项研究中，评估的化学剂包括碱性过氧化物和次氯酸盐、含有十六烷基吡啶氯和洗必泰的漱口水、稀释酸和酶。一些过氧化物会导致合金的离子释放、表面粗糙度和质量损失增加。次氯酸盐是导致最大表面腐蚀的原因，会产生暗斑、粗糙区域和凹陷。乙酸和过氧乙酸以及含有洗必泰和十六烷基吡啶的漱口水不会对 Co-Cr 合金产生显著变化。大多数研究存在中度偏倚风险。
根据纳入的研究，含有十六烷基吡啶氯或洗必泰的漱口液和含有乙酸和过氧乙酸的溶液可安全地用于化学消毒 Co-Cr 修复体。应谨慎使用碱性过氧化物，避免使用碱性次氯酸盐溶液。
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