Strooker H, Rohn S, Van Winkelhoff A J
Department of Oral Biochemistry, Academic Center for Dentistry, Amsterdam, The Netherlands.
Int J Oral Maxillofac Implants. 1998 Nov-Dec;13(6):845-50.
The aim of the present study was to compare the cleansing properties of mechanical supportive care for dental implants with the use of an etching gel. Sixteen patients underwent a 5-month clinical trial with monthly recalls. These patients, wearing maxillary complete dentures and mandibular overdentures supported by a bar device on 4 implants, were treated in a split-mouth study design. Test and control therapy were randomly assigned to left and right sides of the mandible. At the test side, 35% phosphoric etching gel (pH 1) was applied in the peri-implant sulcus. After 1 minute, the sulcus was thoroughly rinsed with a water spray for approximately 15 seconds per implants. Control therapy consisted of supra- and subgingival debridement using carbon fiber curettes and a rubber cup. Plaque, calculus, probing pocket depth, and modified Gingival Index were determined before each treatment. Microbiologic evaluation was performed at baseline, 1 month later, and 5 months later, just before and immediately after each treatment. Per treatment and per assessment, the mean scores of all clinical parameters were calculated for each patient. The number of colony-forming units was used as the primary efficacy variable in the analysis of microbiologic data. At baseline, no differences between test and control sites were observed for any of the clinical parameters. The mean Gingival Index and the mean probing pocket depth were reduced over the 5-month period. The mean reduction in Gingival Index at the test sites proved to be significantly larger at the control sites (P = .03). Both treatment modalities resulted in an instant reduction of the number of colony-forming units, where the reduction by chemical cleaning was larger (P < .05). This short-term study employing a high recall frequency indicates that local application of 35% phosphoric acid gel can be as effective as conventional mechanical supportive therapy.
本研究的目的是比较使用蚀刻凝胶对牙种植体进行机械支持护理的清洁性能。16名患者进行了为期5个月的临床试验，每月回访一次。这些患者上颌佩戴全口义齿，下颌覆盖义齿由4颗种植体上的杆装置支撑，采用分口研究设计进行治疗。测试和对照治疗随机分配到下颌的左侧和右侧。在测试侧，将35%的磷酸蚀刻凝胶（pH值1）应用于种植体周围龈沟。1分钟后，用喷水器对每个种植体龈沟进行约15秒的彻底冲洗。对照治疗包括使用碳纤维刮治器和橡胶杯进行龈上和龈下刮治。在每次治疗前测定菌斑、牙石、探诊袋深度和改良牙龈指数。在基线、1个月后、5个月后，即在每次治疗前和治疗后立即进行微生物学评估。每次治疗和每次评估时，计算每位患者所有临床参数的平均得分。在微生物学数据分析中，菌落形成单位的数量用作主要疗效变量。在基线时，测试部位和对照部位在任何临床参数上均未观察到差异。在5个月期间，平均牙龈指数和平均探诊袋深度有所降低。测试部位牙龈指数的平均降低幅度在对照部位显著更大（P = 0.03）。两种治疗方式均导致菌落形成单位数量立即减少，其中化学清洁的减少幅度更大（P < 0.05）。这项采用高回访频率的短期研究表明，局部应用35%磷酸凝胶与传统机械支持治疗一样有效。
