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用于治疗牙种植体表面种植体周围炎的局部给药制剂的特性:一项临床前研究。

Characteristics of Local Delivery Agents for Treating Peri-Implantitis on Dental Implant Surfaces: A Preclinical Study.

作者信息

Lee Jong-Bin, Kweon Helen Hye-In, Cho Hyun-Jae, Kim Chang-Sung, Kim Young-Taek

机构信息

1   Department of Periodontology, Ewha Womans University Mokdong Hospital, Seoul, Republic of Korea.

2   Department of Periodontology, Research Institute for Periodontal Regeneration, College of Dentistry, Yonsei University, Seoul, Republic of Korea.

出版信息

J Oral Implantol. 2019 Apr;45(2):116-126. doi: 10.1563/aaid-joi-D-17-00261. Epub 2018 Nov 19.

Abstract

Local delivery agents (LDAs) are widely used in peri-implantitis treatments. The aim of this study was to identify LDAs remaining on the dental implant surfaces and to analyze the components of these residues after applying various cleaning methods. Implants were prepared with a sand-blasted, large-grit, acid-etched surface. Four kinds of LDAs were applied on the implant surfaces: chlorhexidine gel (group 2), tetracycline solution (group 3), and 2 kinds of minocycline hydrochloride agents (groups 4 and 5). Group 1 received normal saline as a control. Two cleaning methods were applied for different durations as follows: (1) running distilled water for 10 seconds (subgroup A), 5 minutes (subgroup B), and 15 minutes (subgroup C); and (2) water spray of a dental-unit chair for 10 seconds (subgroup D) and 5 minutes (subgroup E). Scanning electron microscopy and energy-dispersive x-ray spectroscopy were used to analyze the surface morphology and residue components for all implants. The amount of LDA removed from the implant surfaces in groups 1, 2, 3, and 5 increased with the cleaning duration and pressure. However, Minocline remained coated on the implant surfaces in group 4 under all cleaning conditions. Minocline could not be cleaned off well by water due to its hydrophobicity. Therefore, directly using this agent on implant surfaces with peri-implantitis should be carefully considered. The presence of LDA residues without drug efficacies on implant surfaces might interfere with reosseointegration and act as a reservoir of microorganisms.

摘要

局部给药制剂(LDAs)广泛应用于种植体周围炎的治疗。本研究的目的是确定残留在牙种植体表面的局部给药制剂,并分析应用各种清洁方法后这些残留物的成分。种植体采用喷砂、大颗粒、酸蚀表面处理。在种植体表面应用四种局部给药制剂:洗必泰凝胶(第2组)、四环素溶液(第3组)和两种盐酸米诺环素制剂(第4组和第5组)。第1组接受生理盐水作为对照。对不同持续时间应用两种清洁方法如下:(1)蒸馏水冲洗10秒(A亚组)、5分钟(B亚组)和15分钟(C亚组);(2)牙科治疗椅喷水10秒(D亚组)和5分钟(E亚组)。使用扫描电子显微镜和能量色散X射线光谱仪分析所有种植体的表面形态和残留成分。第1、2、3和5组中从种植体表面去除的局部给药制剂的量随着清洁持续时间和压力的增加而增加。然而,在所有清洁条件下,第4组中的米诺环素仍附着在种植体表面。由于米诺环素的疏水性,水不能很好地将其清洗掉。因此,如果要在患有种植体周围炎的种植体表面直接使用这种制剂,应谨慎考虑。种植体表面存在无药物疗效的局部给药制剂残留物可能会干扰再骨结合,并成为微生物的储存库。

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