Freitas Amanda Osório Ayres de, Colombo Ana Paula Vieira, Alviano Celuta Sales, Alviano Daniela Sales, Souto Renata Martins do, Leite Deborah Catharine de Assis, Lima Isabela Lopes Vale Pedrosa, Nojima Matilde da Cunha Gonçalves
Federal University of Rio de Janeiro, Dental School, Department of Pediatric Dentistry and Orthodontics (Rio de Janeiro/RJ, Brazil).
Federal University of Rio de Janeiro, Center for Health Sciences, Department of Oral Microbiology (Rio de Janeiro/RJ, Brazil).
Dental Press J Orthod. 2025 Mar 24;30(1):e2524108. doi: 10.1590/2177-6709.30.1.e2524108.oar. eCollection 2025.
The aim of this study was to evaluate the effectiveness of four hygiene protocols for orthodontic mini-implants in reducing the subgingival bacterial load in the peri-implant sulcus.
Thirty-nine healthy individuals who had fifty-nine as-received mini-implants (20 men, 19 women, 20 to 42 years old) were randomly distributed into four groups of hygiene protocols: mechanical hygiene (M); mechanical hygiene associated with 0.12% digluconate chlorhexidine (CHX), 0.03% triclosan (T), or 0.05% cetylpyridinium chloride (CP). All individuals were instructed regarding the hygiene procedures (T0). For bacterial load analysis, the gingival crevicular fluid from peri-implant sulcus was collected and submitted to quantitative real-time PCR at baseline (T1) and after 21 days following the hygiene protocols (T2). Wilcoxon test was applied for intergroup comparisons, whereas differences among groups at each time point were examined by Kruskal-Wallis test. The significance level was 5%.
Significant difference was detected between baseline and post-protocol times for bacterial total counts, comparing intergroup results, except for mechanical hygiene associated with cetylpyridinium chloride (M p=0.018, CHX p=0.028, T p=0.012, CP p=0.065). No significant difference was detected among the evaluated methods (p=0.181).
The mechanical hygiene of orthodontic mini-implants itself was capable to reduce total bacteria load and keep devices clean. Commonly, orthodontists prescribe, in addition to mechanical biofilm removal, some protocols combining adjunctive chemical agents as chlorhexidine. The authors believe that results have large importance for dental community, as they can protect patients from overtreatment.
本研究旨在评估四种正畸微型种植体卫生方案在降低种植体周围龈沟内龈下细菌载量方面的有效性。
39名健康个体，共植入59颗未使用过的微型种植体（男性20名，女性19名，年龄20至42岁），随机分为四组卫生方案：机械清洁（M）；机械清洁联合0.12%葡萄糖酸氯己定（CHX）、0.03%三氯生（T）或0.05%氯化十六烷基吡啶（CP）。所有个体均接受卫生程序指导（T0）。为进行细菌载量分析，在基线时（T1）以及卫生方案实施21天后（T2），收集种植体周围龈沟内的龈沟液，并进行定量实时聚合酶链反应。组间比较采用Wilcoxon检验，各时间点组间差异采用Kruskal-Wallis检验。显著性水平为5%。
比较组间结果，除机械清洁联合氯化十六烷基吡啶外（M p = 0.018，CHX p = 0.028，T p = 0.012，CP p = 0.065），细菌总数在基线和方案实施后时间点之间检测到显著差异。评估方法之间未检测到显著差异（p = 0.181）。
正畸微型种植体本身的机械清洁能够降低细菌总数并保持器械清洁。通常，正畸医生除了进行机械性生物膜清除外，还会开出一些联合使用氯己定等辅助化学药剂的方案。作者认为这些结果对牙科界具有重要意义，因为它们可以保护患者避免过度治疗。
