Comparison of clindamycin and chlorhexidine for decontamination of the autogenous bone collected by bone filter during implant osteotomy: A clinical and microbiological study

Tezulas E. Comparison of clindamycin and chlorhexidine for decontamination of the autogenous bone collected by bone filter during implant osteotomy: a clinical and microbiological study. Yeditepe University Health Sciences Institute MSc Thesis in Oral Implantology, İstanbul, 2007. Intraoral bony defects can be filled with bony particles that are collected in a bone filter during implant osteotomy. However, the collected bone particles are contaminated with oral bacteria. Therefore, the bacterial contamination of the bony particles must be reduced because the implantation of contaminated bone particles may cause possibly augmentation failure and might even compromise the dental implants augmented with this material. The aim of this study is to determine quantitatively, the degree of the bacterial contamination and the effect of clindamycin and chlorhexidine for decontamination of the bony particles that is collected with stringent aspiration protocol and pre-operative chlorhexidine oral rinse. This study was designed to obtain 14 bone material from implant osteotomies of 19 implants placed in 8 healthy patients (mean age of 35,5 years). The implants were placed to the patients who were admitted to the Yeditepe University, Department of Oral Implantology for prosthetical reasons. Bone collection and tissue fluid control is achieved using seperate suction tips and the bone collector is restricted within the surgical site only (stringent aspiration protocol). Pre-operative rinsing with chorhexidine mouthrinse and stringent aspiration protocol is used in this study to reduce the bacterial contamination of the collected bony particles. Two equal amounts of samples are taken from the collected bone material. The first sample is taken without any decontamination process (Control Group). The second sample is decontaminated randomly by clindamycin (CLD Group) or chlorhexidine (CHX Group). The microbial analysis of the collected bone samples were assessed and the bacterial levels between the 3 groups were compared statistically. In conclusion; although reducing the bacterial contamination level of the collected bone particles by using stringent aspiration protocol and pre-operative chlorhexidine oral rinse, the collected bone particles has found to be contaminated. If the collected bone debris is to be implanted, the bacteria present in the collected bone particles risks infectious complications. Therefore, decontamination is applied to the collected bone particles. Clindamycin and chlohexidine are the agents that are used for decontamination of the collected bone particles. Both of these agents efficiently decontaminated the collected bone particles. The effects of chlorhexidine on the osteogenic potential of the autogenous bone is unknown and also, chlorhexidine causes delayed wound healing. When we consider the results of this study with these negtive side effects of chlorhexidine, we recommend using clindamycin for decontamination of the collected bone debris. Key Words: Microbial Analysis, Implant Osteotomy, Autogenous Bone, Decontamination, Clindamycin, Chlorhexidine.