[Bone collected with a bone collector during dental implant surgery].
BACKGROUND
Simultaneous implantation and augmentation using autogenous bone collected during implant surgery is a well-established procedure in oral implantology. The aims of this study were (1) to identify any bacterial contamination of bone obtained with a bone collector, and (2) to verify the antimicrobial effect of rinsing the bone collector with a 0.1% chlorhexidine solution prior to augmentation.


METHODS
A total of 39 patients undergoing a simultaneous implantation and augmentation procedure were examined. All patients rinsed their mouths with a 0.1% chlorhexidine solution for 2 min prior to surgery. Bone was collected with the Osseous Coagulum Trap, while saliva was collected with a separate suction tip. Once bone collection was complete a microbiological swab was taken from the bone collector (sample 1); before the bone was taken from it 200 ml of a 0.1% chlorhexidine solution was aspirated into the collector, after which the bone was removed and the collector sieve was (sample 2) sent for microbiological analysis which included aerobic and anaerobic cultivation of microorganisms and their identification and semiquantitative assessment of microbial growth.


RESULTS
Before the collector was rinsed with chlorhexidine microbial contamination was found in 34 (82.7%) of the 39 samples, and 37 different microbial species were identified in cultures. When the collector had been rinsed with 200 ml 0.1% chlorhexidine a significantly lower rate of microbial contamination was found: 66.7% of the samples were sterile.


CONCLUSIONS
Despite separate suction techniques for bone dust and saliva and preoperative use of a chlorhexidine mouthwash, bacterial contamination of bone obtained from the mouth with a bone collector has to be anticipated. Not only the physiological bacteria of the oral flora, but also the microorganisms frequently associated with implant failure can be found. Rinsing the bone collector with 200 ml of a 0.1% chlorhexidine solution significantly reduces microbial contamination. The effects on bone vitality must be studied before routine rinsing with chlorhexidine can be recommended.
Kuttenberger
Johannes J
JJ
Klinik für Mund-, Kiefer- und Gesichtschirurgie, Kantonsspital Luzern, Luzern. johannes.kuttenberger@ksl.ch
Hardt
Nicolas
N
Rutz
Trudy
T
Pfyffer
Gaby E
GE
D000328:Adult; D000540:Alveolar Ridge Augmentation / Q000295:instrumentation*; D001431:Bacteriological Techniques; D016025:Bone Transplantation / Q000379:methods*; D001842:Bone and Bones / Q000382:microbiology*; D002710:Chlorhexidine / Q000494:pharmacology*; D015169:Colony Count, Microbial; D003758:Dental Implantation, Endosseous / Q000295:instrumentation* / Q000382:microbiology; D004866:Equipment Contamination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000494:pharmacology*; D012307:Risk Factors; D012463:Saliva / Q000382:microbiology; D020858:Tissue and Organ Harvesting / Q000295:instrumentation*
D009067:Mouthwashes; D002710:Chlorhexidine