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氯己定漱口后早期牙周组织愈合的随机临床试验。

Early periodontal wound healing after chlorhexidine rinsing: a randomized clinical trial.

机构信息

Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy.

University of Split School of Medicine, Šoltanska 2, 21000, Split, Croatia.

出版信息

Clin Oral Investig. 2024 Jun 4;28(6):354. doi: 10.1007/s00784-024-05643-0.

Abstract

OBJECTIVES

This single-center randomized, parallel design, clinical trial with a 2-week follow-up involved patients affected by periodontitis undergoing periodontal surgery. The aim was to evaluate periodontal surgical wound healing with the use of chlorhexidine-based mouth rinses versus an untreated control group.

MATERIALS AND METHODS

Periodontal surgery was performed following a standardized protocol. Patients were randomly prescribed i) chlorhexidine (CHX) + anti-discoloration system (ADS) + hyaluronic acid (HA), ii) CHX + ADS or iii) no treatment (control group). Plaque score, gingival inflammation, and Early Healing Index (EHI), assessing the degree of wound closure and the presence of fibrin and necrosis, were evaluated at 3, 7 and 14 days after surgery.

RESULTS

In total, 33 patients were enrolled. Patients were comparable at baseline for all measured clinical parameters. At 3-days wound healing was significantly improved in all patients treated with CHX + ADS-based mouth rinses with a lower EHI score at the interdental papillae compared with control group (p < 0.01). CHX + ADS + HA group presented improved healing across all time points in terms of EHI, plaque containment, and gingival inflammation when compared to control group (p < 0.01).

CONCLUSIONS

The usage of CHX-ADS following periodontal surgery improved early wound healing, reduced plaque accumulation and gingival inflammation. During the early post-operative period the adjunct of HA further improved soft tissue closure.

CLINICAL RELEVANCE

This study aims at evaluating the response of gingival tissues to mouth rinsing with chlorhexidine and anti-discoloration system (CHX + ADS) or CHX + ADS + hyaluronic acid (CHX + ADS + HA) versus no rinse in terms of healing of the periodontal surgical wound. CHX + ADS mouth rinses enhanced early soft tissue closure after periodontal surgery and contributed to the reduction in plaque accumulation and gingival inflammation. The adjunct of HA may be beneficial especially in the early post-operative period. CHX + ADS administration following periodontal surgery may improve soft tissue healing in the first two post-operative weeks.

摘要

目的

本单中心随机平行设计临床试验随访 2 周,纳入牙周炎患者行牙周手术,评估氯己定(CHX)基漱口水与未治疗对照组相比对牙周手术伤口愈合的影响。

材料与方法

按照标准化方案行牙周手术。患者随机接受以下治疗:i)CHX+抗变色系统(ADS)+透明质酸(HA)、ii)CHX+ADS 或 iii)未治疗(对照组)。术后 3、7、14 天分别评估菌斑指数、牙龈炎症和早期愈合指数(EHI),以评估伤口闭合程度以及纤维蛋白和坏死的存在。

结果

共纳入 33 例患者。所有测量的临床参数在基线时,患者均具有可比性。术后 3 天,所有接受 CHX+ADS 基漱口水治疗的患者的伤口愈合均显著改善,与对照组相比,牙间乳头的 EHI 评分更低(p<0.01)。与对照组相比,CHX+ADS+HA 组在所有时间点的 EHI、菌斑控制和牙龈炎症方面均表现出更好的愈合(p<0.01)。

结论

牙周手术后使用 CHX-ADS 可改善早期伤口愈合,减少菌斑堆积和牙龈炎症。在术后早期,HA 的辅助作用进一步改善了软组织闭合。

临床意义

本研究旨在评估氯己定和抗变色系统(CHX+ADS)或 CHX+ADS+透明质酸(CHX+ADS+HA)漱口与不漱口对牙周手术伤口愈合的牙龈组织反应,CHX+ADS 漱口水可增强牙周手术后早期软组织闭合,并有助于减少菌斑堆积和牙龈炎症。HA 的辅助作用可能特别有益于术后早期。牙周手术后使用 CHX+ADS 可能会改善术后前两周的软组织愈合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9da1/11150287/b60bc04458ed/784_2024_5643_Fig1_HTML.jpg

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