牙科植入手术的综合评估:不同抗生素预防方案的比较研究

V. R. Gabidullina, A. Tsitsiashvili, A. V. Volkov, N. Stankova, A. V. Zaborovsky, V. Tsarev, A. Panin, V. V. Podporina
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摘要

相关性。在种植手术中使用抗生素可预防化脓性炎症。常用的治疗方案有两种:术前单次用药或术后长期使用抗生素。由于伦理方面的限制,抗生素疗效的某些参数无法在临床试验中直接评估。这些参数包括种植体-下颌节段微生物群的状态以及种植部位组织炎症反应的组织学参数。本研究采用了一个由 10 头雄性猪组成的微型猪模型。实验组平均分为两组,每组五只。第一组在术前按每 20 千克体重注射阿莫西林/克拉维酸 2 毫升。第二组在植入前接受相同的初始剂量,术后每天按每 20 千克体重 1 毫升的剂量服用阿莫西林/克拉维酸,持续五天。每只动物接受六颗牙科植入物。术前、术后第 1、3、7 和 14 天对种植部位进行微生物检测。在术后的同一天对组织进行组织学检查。微生物检测显示,第 2 组在术后第 3 天的链球菌属(p = 0.04)和第 7 天的卟啉单胞菌属(p = 0.04)含量较低。第 1 组在第 1 天(p = 0.02)和第 1 天(p = 0.012)的镰刀菌属和卟啉单胞菌属水平均有所降低。对种植部位组织学检测结果的比较分析表明,无论采用哪种抗生素预防方案,组织炎症反应都是相同的。使用阿莫西林/克拉维酸进行牙科种植的单剂量和长效抗生素预防方案均显示出种植部位组织炎症的相似组织学模式,以及种植部位内相似的微生物群谱。口腔粘膜中的葡萄球菌和链球菌数量增加,这可能会导致耐药菌株以及念珠菌的产生,从而增加念珠菌感染发病的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comprehensive assessment of dental implant procedures: a comparative study on different antibiotic prophylaxis regimens
Relevance. The administration of antibiotics in implantology is indicated to prevent suppurative inflammation conditions. Two regimens are commonly used: a single preoperative dose or prolonged postoperative antibiotic administration. Due to ethical constraints, certain parameters of antibiotic efficacy cannot be directly evaluated within clinical trials. These include the status of the implant-mandibular segment microbiome and the histological parameters of the tissue's inflammatory response at the implant site.Materials and methods. This study employed a miniature pig model comprising 10 males. The cohort was equally divided into two groups of five animals each. Group 1 received a single preoperative dose of amoxicillin/clavulanic acid 2 ml per 20 kg body weight. Group 2 received the same initial dose prior to implantation, followed by a daily postoperative dose of amoxicillin/clavulanic acid at 1 ml per 20 kg body weight for five days. Each animal received six dental implants. An implant site microbiological test was performed pre-surgery, on Day 1, 3, 7 and 14 post-surgery. Core needle biopsies for histological examination of the tissues were performed on the same postoperative days.Results. Microbiological testing revealed that Group 2 exhibited lower levels of Streptococcus spp. on Day 3 (p = 0.04) and Porphyromonas spp. on Day 7 (p = 0.04). Group 1 demonstrated reduced levels of Fusobacterium spp. on Day 1 (p = 0.02) and Porphyromonas spp. both pre-surgery (p = 0.04) and on Day 1 (p = 0.012). Comparative analysis of histological assays from the implant sites indicated identical tissue inflammatory responses, regardless of the antibiotic prophylaxis regimen.Conclusion. Both the single-dose and the prolonged antibiotic prophylaxis regimens, using amoxicillin/clavulanic acid for dental implantation, demonstrated similar histological patterns of tissue inflammation at the implant site, along with comparable microbiota profiles within the implant site. The oral mucosa exhibited an increased population of Staphylococcus spp. and Streptococcus spp., which might contribute to the development of resistant strains, as well as Candida spp., potentially increasing the risk of candidiasis infection onset.
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