Made available in DSpace on 2016-02-05T18:30:11Z (GMT). No. of bitstreams: 0 Previous issue date: 2015-06-19. Added 1 bitstream(s) on 2016-02-05T18:34:21Z : No. of bitstreams: 1 000857956.pdf: 866745 bytes, checksum: fb055a97d4a8338f7a5931747ee578f0 (MD5) / OBJETIVO: Este estudo avaliou o efeito do veículo na eficácia da irrigação com agulha associada ou não com irrigação ultrassônica passiva (IUP) na remoção da pasta tri antibiótica do canal radicular. MÉTODOS: O canal radicular de 60 dentes uniradiculares foi preparado com instrumento rotatório ProTaper até a lima F4. Vinte canais radiculares foram obturados com pasta triantibiótica (PTA), preparados com macrogol mais propilenoglicol, água destilada ou propilenoglicol. Após 4 semanas de armazenamento em estufa, foi realizada irrigação com agulha utilizando hipoclorito de sódio a 2,5%, associada ou não com a IUP para a remoção da PTA. Seis grupos de 10 espécimes foram tratados de acordo com o protocolo de veículos e de irrigação. As raízes foram divididas longitudinalmente e a quantidade de pasta antibiótica restantes foi avaliada através de estereomicroscópico com aumento de 20 vezes e por MEV utilizando um sistema de pontuação 4-grades. Os dados foram avaliados estatisticamente através dos testes Kruskal Wallis e Dunn's com um nível de confiança de 95% (p = 0,05). RESULTADOS: O uso da IUP não melhorou a remoção da PTA (p> 0,05). Não houve diferença estatisticamente significante entre os terços coronal, médio e apical(p> 0,05). Nos terços médio e apical, a PTA com propilenoglicol como veículo apresentou mais resíduos do que a PTA preparada com água destilada (p <0,05). Água destilada ou macrogol mais propilenoglicol foram semelhantes independentemente do terço do canal radicular considerado. CONCLUSÕES: Não foi possível remover completamente a PTA dos canais radiculares mesmo com a utilização da IUP. Água destilada ou macrogol mais propilenoglicol são melhores como veículo para favorecer a remoção de qualquer resíduo da PTA / AIM: This study evaluated the interference of the triple antibiotic paste vehicle on its removal from the root canal using needle irrigation with or without passive ultrasonic irrigation (PUI). METHODS: Sixty root canals were prepared up to F4 ProTaper and were filled with triple antibiotic pastes (TAP) prepared with macrogol plus propylene glycol, distilled water, or propylene glycol. After 4 weeks of stove storage, needle irrigation with 2.5% sodium hypochlorite with or without PUI was used for TAP removal. The roots were longitudinally split and the amount of remaining antibiotic pastes and cleaning of the dentinal tubule were evaluated under a stereomicroscope and SEM. The data were statistically evaluated using the Kruskal Wallis and Dunn's tests (p = .05). RESULTS: In the middle and apical thirds, TAP with propylene glycol remained more than that prepared with distilled water (p < .05). Distilled water or macrogol plus propylene glycol were similar independently of the root canal third. The use of PUI did not improve the removal of the TAP (p > .05). There were no statistically significant differences between the coronal, medium or apical thirds (p > .05). CONCLUSIONS: None vehicle allowed the complete paste removal and cleaning of the dentinal tubule from the root canal and despite the use of PUI. Distilled water or macrogol plus propylene glycol as vehicle favored smaller remnant of TAP in the apical and middle thirds

Orientador: João Eduardo Gomes Filho / Banca: Marco Antônio Hungaro Duarte / Banca: Eloi Dezan Júnior / Banca: Arnaldo Sant'Anna Júnior / Banca: Luciano Tavares Angelo Cintra / Resumo: OBJETIVO: Este estudo avaliou o efeito do veículo na eficácia da irrigação com agulha associada ou não com irrigação ultrassônica passiva (IUP) na remoção da pasta tri antibiótica do canal radicular. MÉTODOS: O canal radicular de 60 dentes uniradiculares foi preparado com instrumento rotatório ProTaper até a lima F4. Vinte canais radiculares foram obturados com pasta triantibiótica (PTA), preparados com macrogol mais propilenoglicol, água destilada ou propilenoglicol. Após 4 semanas de armazenamento em estufa, foi realizada irrigação com agulha utilizando hipoclorito de sódio a 2,5%, associada ou não com a IUP para a remoção da PTA. Seis grupos de 10 espécimes foram tratados de acordo com o protocolo de veículos e de irrigação. As raízes foram divididas longitudinalmente e a quantidade de pasta antibiótica restantes foi avaliada através de estereomicroscópico com aumento de 20 vezes e por MEV utilizando um sistema de pontuação 4-grades. Os dados foram avaliados estatisticamente através dos testes Kruskal Wallis e Dunn's com um nível de confiança de 95% (p = 0,05). RESULTADOS: O uso da IUP não melhorou a remoção da PTA (p> 0,05). Não houve diferença estatisticamente significante entre os terços coronal, médio e apical(p> 0,05). Nos terços médio e apical, a PTA com propilenoglicol como veículo apresentou mais resíduos do que a PTA preparada com água destilada (p <0,05). Água destilada ou macrogol mais propilenoglicol foram semelhantes independentemente do terço do canal radicular considerado. CONCLUSÕES: Não foi possível remover completamente a PTA dos canais radiculares mesmo com a utilização da IUP. Água destilada ou macrogol mais propilenoglicol são melhores como veículo para favorecer a remoção de qualquer resíduo da PTA / Abstract: AIM: This study evaluated the interference of the triple antibiotic paste vehicle on its removal from the root canal using needle irrigation with or without passive ultrasonic irrigation (PUI). METHODS: Sixty root canals were prepared up to F4 ProTaper and were filled with triple antibiotic pastes (TAP) prepared with macrogol plus propylene glycol, distilled water, or propylene glycol. After 4 weeks of stove storage, needle irrigation with 2.5% sodium hypochlorite with or without PUI was used for TAP removal. The roots were longitudinally split and the amount of remaining antibiotic pastes and cleaning of the dentinal tubule were evaluated under a stereomicroscope and SEM. The data were statistically evaluated using the Kruskal Wallis and Dunn's tests (p = .05). RESULTS: In the middle and apical thirds, TAP with propylene glycol remained more than that prepared with distilled water (p < .05). Distilled water or macrogol plus propylene glycol were similar independently of the root canal third. The use of PUI did not improve the removal of the TAP (p > .05). There were no statistically significant differences between the coronal, medium or apical thirds (p > .05). CONCLUSIONS: None vehicle allowed the complete paste removal and cleaning of the dentinal tubule from the root canal and despite the use of PUI. Distilled water or macrogol plus propylene glycol as vehicle favored smaller remnant of TAP in the apical and middle thirds / Doutor

Indiana University-Purdue University Indianapolis (IUPUI) / Introduction: One of the main objectives of endodontic therapy is to reduce microbes and remove inflamed pulpal tissue within the root canal system (RCS). This is accomplished through chemomechanical debridement of the RCS using hand and rotary instrumentation along with an antimicrobial irrigant. Today, the most commonly used irrigant is sodium hypochlorite (NaOCl), often at concentrations toxic to human cells. The use of ozone as an endodontic irrigant is a novel technique that has been proven to be antimicrobial against several microorganisms. However, independent research is lacking on ozone’s efficacy against an established endodontic biofilm. If ozone’s efficacy against biofilms is confirmed, the use of toxic and potentially dangerous sodium hypochlorite could be replaced in some clinical situations (i.e., regeneration, immature teeth, resorption) with a safer and effective alternative. Objective: The aim of the current study was to evaluate the anti-biofilm activity of different concentrations of ozonated water compared to various concentrations of NaOCl against an established endodontic biofilm of Enterococcus faecalis in root canal treated teeth in vitro. Materials and Methods: The crowns of similarly sized, maxillary anterior teeth were removed, and the roots cut to a standard length (12 mm). All root canals were instrumented to a standard size. Specimens were sterilized and then inoculated with E. faecalis, which were allowed to grow for two weeks to form an established biofilm. There were six treatment groups: 1) 6% NaOCl; 2) 1.5% NaOCl; 3) 16µg/mL ozonated water; 4) 25µg/mL ozonated water; 5) 50µg/mL ozonated water, and 6) saline. Following treatment, samples were collected, plated, and incubated for two days. The number of CFU/mL were determined, and samples visualized using confocal imaging. The effect of treatment group on bacterial counts was made using one-way ANOVA followed by pair-wise comparisons. Null Hypothesis: Endodontically treated teeth irrigated with ozonated water will not demonstrate a statistically significant decrease in the E. faecalis biofilm compared to those treated with sodium hypochlorite Results: CFUs were converted to log10 and compared using Fisher’s Exact tests or one-way ANOVA followed by pair-wise tests. In all observations utilizing NaOCl irrigation, no colonies formed following treatment. The two NaOCl groups, with 0 CFU/mL, were significantly different than the other four groups (p=0.009). Saline showed a trend towards higher CFU/mL than 50 µg/ml O3 (p=0.068). None of the other comparisons approached statistical significance (p=0.453 25 µg/ml O3, p=0.606 16 µg/ml O3, p=0.999 25 µg/ml O3 vs 50 µg/ml O3, p=0.990 16 µg/ml O3 vs 50 µg/ml O3, p=1.000 16 µg/ml O3 vs 25 µg/ml O3). Confocal imaging helped illustrate effects of irrigation and confirm CFU findings. Conclusion: The results of this study failed to reject the null hypothesis. There was a statistically significant difference in the E. faecalis biofilm remaining in the groups treated with ozonated water compared to those treated with NaOCl. However, there was a trend towards higher CFU/mL in the saline group compared to the 50µg/mL ozonated water group. According to this finding, future studies should evaluate the effects of higher concentrations of ozonated water against an established E. faecalis biofilm. In addition, other follow-up studies might include ozonated water’s effect on human cells, such as the stem cells of the apical papilla that are so critical to the success of regenerative endodontic procedures. Due to university and laboratory closures caused by the COVID-19 pandemic, this project was stopped short and an insufficient sample size did not allow for proper statistical power. Additional occasions should be run upon the university’s re-opening to allow for proper statistical power.

<p>Intraoperativna kontaminacija autokalema tokom rekonstrukcije prednjeg ukr&scaron;tenog ligamenta je i dalje tema koja je predmet stalne debate među ortpedskim hirurzima, a koja se preteţno odnosi na potrebu i način njenog tretmana. Ona nastaje kao posledica naseljavanja uzročnika kontaminacije iz vazduha, sa koţe i sluznica kako pacijenata tako i osoblja, kao i preko nesterilisanih ili nedovoljno sterilisanih instrumenata. Patogeni koji je izazivaju su identični uzročnicima koji izazivaju septični arthritis, pa se smatra jednim od faktora rizika za njegov nastanak. Septični arthritis predstavlja najče&scaron;ću komplikaciju u artroskopskoj hirurgiji uop&scaron;te, a njegove posledice mogu bitno uticati na funkcionalni i mentalni status pacijenata. Zbog toga se smatra da je tretman intraoperativne kontaminacije autokalema tokom rekonstrukcije prednjeg ukr&scaron;tenog ligamenta kolena mandatoran. Najče&scaron;će primenjivani agensi u tretmanu intraoperativne kontaminacije alokalema predstavljaju različite vrste antiseptičnih i antibiotskih solucija. I pored toga &scaron;to intraoperativna irigacija fiziolo&scaron;kim rastvorom predstavlja jednu od najče&scaron;če primenjivanih procedura tokom hirur&scaron;kih operacija, u savremenoj literaturi je objavljen mali broj radova na temu primene ove procedure u tretmanu intraoperativne kontamninacije. Cilj ove studije je bio da pokaţe da se dekontaminacija autoklema tokom rekonstrukcije prednjeg ukr&scaron;tenog ligamenta kolena moţe uspe&scaron;no tretirati intraoperativnom mehaničkom irigacijom čistim fiziolo&scaron;kim rastvorom, kao i da odredi koja je količina fiziolo&scaron;kog rastvora dovoljna da izvr&scaron;i potpunu dekontaminaciju autokalema. Jedan od ciljeva se odnosio na utvrđivanje uticaja faktora okruţenja na pojavu intraoperativne kontaminacije. Studija se sastojala iz dva dela- eksperimentalnog i kliničkog. Eksperimentalni deo studije je bio sproveden na Odeljenju za kliničku bakteriologiju Centra za mikrobiologiju Instituta za javno zdravlje Vojvodine i sastojao se iz pravljenja eksperimentalnog modela koji je imao za cilj da u in vitro uslovima obezbedi iste ili pribliţno iste uslove kao i operacionoj sali. On se sastojao od pedeset ispreparisanih i sterilisanih svinjskih tetiva dubokih pregibača prstiju koje su po svojim dimenzijama pribliţno odgovarale humanom prednjem ukr&scaron;tenom ligamentu kolena. Tetive su potom bile kontaminirane unapred određenom koncetracijom najče&scaron;ćeg uzročnika kontaminacije, a to je koagulaza negativan stafilokok ( ATCC 12228 Staphylococcus epidermidis). One su se potom mehanički ispirale sa 500 ml, 1000 ml, i 1500 ml fiziolo&scaron;kog rastvora, a nakon svakog ispiranja uzimao se bris. Brisevi su nakon toga bili zasejavani na krvni agar, a nakon 24h inkubacije su očitavane vrednosti brojanjem kolonija uzročnika. Rezultati eksperimentalnog dela pokazuju da je količina od 1500 ml fiziolo&scaron;kog rastvora dovoljna da izazove potpunu dekontaminaciju tetive. Rezultati eksperimentalnog dela su potom bili primenjivani u kliničkom delu studije koji je obuhvatao 200 ispitanika starosne dobi između 15-50 godina i koje je je bilo sprovedeno na Klinici za ortopedsku hirurgiju i traumatologiju Kliničkog centra Vojvodine. Kontrolnu grupu su činili onih 100 pacijenata kod kojih je mehaničko intraoperativno ispiranje autokalema neposredno pred njegovu implantaciju vr&scaron;eno pomoću 500 ml fiziolo&scaron;kog rastvora, a ispitivanu grupu su činili drugih sto pacijenata kod kojih je isto to ispiranje izvr&scaron;eno sa 1500 ml fiziolo&scaron;kog rastvora. Rezultati kliničkog dela studije jasno ukazuju da je količina od 1500 ml fiziolo&scaron;kog rastvora kojim se vr&scaron;i intraoperativna mehanička irigacija dovoljna da izvr&scaron;i potpunu dekonaminaciju autokalema kao i da stepen kontaminacije autokalema raste sa povećanjem vremena koje kalem provodi na vazduhu tokom obrade, &scaron;to je u direktnoj vezi sa vremenskim trajanjem operacije i vrstom kalema koji se koristi za rekonstrukciju. Rezultati pokazuju da je rizik za nastanak kontaminacije autokalema u direktnoj vezi sa faktorima okruţenja, odnosno da se porastom broja ljudi u operacionoj sali, kao i redosledom operativnih procedura u toku jednog operativnog dana u smislu da operacije koje počinju kasnije na operativnom programu, povećava i procenat kontaminacije. Intraoperativna mehanička irigacija kontaminiranog autokalema se pokazala kao metoda koja se uspe&scaron;no moţe koristiti u intaoperativnoj dekontaminaciji autokalema tokom rekonstrukcije prednje ukr&scaron;tene veze kolena. Rezultati ove studije se mogu se primeniti i na druge asetne hirurgije i mogu posluţiti i daljim kliničkim istraţivanjima.</p> / <p>Intraoperative contamination of autograft during anterior cruciate ligament reconstruction still remains a topic for debate among orthopaedic surgeons mainly concerning the need and the way of its treatment. Graft contamination arises after pathogen settlement from the surrounding air, from skin and mucoses of patient and staff, as well as not enough sterilized instruments. Pathogens found in graft contamination are the same ones who are causes of septic arthritis, which is the most common complication in arthroscopic surgery in general. Consequences of septic arthritis usually leave a huge impact on patient&rsquo;s mental and physical status. In modern surgery, it is mandatory to prevent potential auto-graft contamination by irrigation (during anterior cruciate ligament reconstruction in knee). Most commonly used agents for intraoperative auto-graft irrigation are variety of antiseptic and antibiotic solutions. Even though intraoperative irrigation with saline solution presents one of the most commonly used procedures during different surgical interventions in general, little is said in literature about its usage in auto-graft contamination. The aim of this study was to show that decontamination of auto-graft during anterior cruciate ligament reconstruction of the knee can be successfully done by mechanical irrigation with saline (0,9%) solution and also to define a precise quantity of saline for complete decontamination. Furthermore, effects of different factors in surroundings were inspected. The study consisted of two parts: experimental and clinical. Experimental part was conducted at the Department for clinical bacteriology, at Microbiology Centre at the Institute for public health of Vojvodina. It consisted in making the experimental model with in vitro conditions similar to or as the same as in the operating theatre. Experimental model was made of 50 preparated and sterilized pig tendons of deep finger flexors, which are similar dimensions as human anterior cruciate ligament of the knee. Then, the tendons were contaminated with previously defined concentration of most common cause of contamination which is coagulase negative staphylococcus (ATCC 12228 Staphylococcus epidermidis). Contaminated tendons were mechanicaly irrigated with 500ml, 1000ml and 1500ml saline solution. After each irrigation a swab was taken and put in blood agar to grow. Following 24h of incubation, bacterial colonies were counted. Results of experimental model show that 1500ml of saline solution is required for decontamination of tendon. Results of experimental model were used in clinical part of the study which was conducted at the Clinic for orthopaedic surgery and traumatology in Clinical Centre of Vojvodina. It comprised of 200 patients, who were 15-50 years old. Patients were divided in two equal groups: tested and control group. In control group mechanical irrigation of auto-graft was done prior to its implementation with 500ml saline solution, while in tested group 1500ml of saline was used for irrigation. Results of clinical part of the study show that intraoperative irrigation with 1500ml of saline solution is enough for complete decontamination of auto-graft. Furthermore, degree of auto-graft contamination rises with prolonged exposure time on surrounding air, with incrised number of people in the operating theatre and also with number and sequence of operations during the day. Intraoperative mechanical irrigation proved to be a sufficient method that can be used in intraoperative autograft decontamination during anterior cruciate ligament reconstruction. The results of this study can be applied to other aspects of the surgery and could be used and further clinical<br />studies.</p>

<p>Najče&scaron;ća komplikacija nakon ugradnje silikonskih implantata za dojku je kontraktura fibrozne kapsule (KK), koja se normalno stvara oko implantata u sklopu reakcije oko stranog tela. Najozbiljnija komplikacija nakon ugradnje silikonskih implantata za dojku je anaplastični krupnoćelijski limfom koji se javlja isključivo kod pacijentkinja koje imaju ugraĎene implantate (eng. Breast-implant associated anaplastic large cell lymphoma &ndash; BIA ALCL). Uzrok nastanka ovih komplikacija ostaje nepoznat. Ustanovljeno je da se KK manje javlja kod implantata koji imaju makroteksturisanu povr&scaron;inu i kod onih koji su presvučeni poliuretanskom penom. S druge strane, BIA-ALCL se če&scaron;će dijagnostikuje kod pacijentkinja kojima su ugraĎeni upravo makroteksturisani implantati. Subklinička infekcija koja predstavlja odgovor organizma na postojanje biofilma na ugraĎenim implantatima, predstavlja jedan od najznačajnijih etiolo&scaron;kih faktora za nastanak KK i BIA-ALCL. Biofilm je konglomerat mirkoorganizama uronjenih u matriks koji ih &scaron;titi od dejstva antibiotika i antiseptika. Kako je nemoguće delovati medikamentozno na eradikaciju biofilma, brojni autori daju razne preporuke u cilju izbegavanja kontaminacije implantata tokom operativnog zahvata, a time i formiranja biofilma. Pored brojnih mera, savetuje se i ispiranje džepa u koji će se plasirati proteza kao i same proteze, nekim od antiseptičkih ili antibiotskih rastvora. Do sada ne postoje prihvaćene jasne preporuke o načinu ispiranja različitih implantata, objavljena su samo lična iskustva raznih autora. Ciljevi ovog istraživanja su bili da se ustanovi mogućnost formiranja biofilma četiri različite bakterije (Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa i Ralstonia pickettii) na tri različito teksturisana silikonska implantata za dojku (sa porama veličine 70-150 &mu;m, 50&ndash;900 &mu;m i 13 &mu;m) u in vitro uslovima; da se ispita da li ispiranje antisepticima (oktenidindihidrohloridom i povidon jodom), ili antibiotikom (cefuroksimom) ili istovremeno me&scaron;avinom povidon joda i antibiotika pre bakterijske kontaminacije sa četiri različite bakterije ima uticaja na formiranje biofilma na tri različito teksturisana implantata za dojke u in vitro uslovima; i da se ispita efekat antiseptika u odnosu na efekat antibiotika na formiranje bakterijskog biofilma na tri različito teksturisana silikonska implantata za dojku. Istraživanje je koncipirano kao prospektivna studija u vidu eksperimenta koji je izveden u Laboratoriji za mikrobiologiju, Instituta za javno zdravlje Vojvodine u Novom Sadu. Za izvoĎenje eksperimenta kori&scaron;ćeni su uzorci tri vrste silikonskih implantata za dojku sa različito teksturisanom povr&scaron;inom, odnosno porama različite veličine: 70-150 &mu;m, 50&ndash;900 &mu;m, i 13 &mu;m. Od svakog od navedenih implantata su pravljeni uzorci, sečenjem kapsula implantata na komadiće veličine 1x1 cm. Ukupno je bilo 1440 uzoraka. Na osnovu teksture uzorci su podeljeni u tri grupe: Grupa 1 (pore veličine 70-150 &mu;m), Grupa 2 (pore veličine 50&ndash;900 &mu;m) i Grupa 3 (pore veličine 13 &mu;m). Svaka od ovih grupa je dalje podeljena u jednu kontrolnu grupu i po četiri ispitivane grupe. Nakon sterilizacije uzoraka svaka kontrolna grupa je kontaminirana sa po 100&mu;l bakterijskog bujona Staphylococcus epidermidis (n=30), Staphylococcus aureus (n=30), Pseudomonas aeruginosa (n=30) i Ralstonia pickettii (n=30). Ispitivane grupe se bile podeljene prema načinima ispiranja na one u kojima su uzorci prvo ispirani: oktenidin &ndash; dihidrohloridom ili povidon jodom ili cefuroksimom ili kombinacijom povidon joda i dva antibiotika, pa potom kontaminirani sa po 100&mu;l bakterijskog bujona Staphylococcus epidermidis (n=30), Staphylococcus aureus (n=30), Pseudomonas aeruginosa (n=30) i Ralstonia pickettii (n=30). Po zavr&scaron;enoj kontaminaciji, uzorci su se inkubirali na temperaturi od 37&deg;C u trajanju od 96h, čime su stvoreni uslovi za formiranje biofilma. Nakon inkubacije, svaki pojedinačni uzorak je uronjen u sterilan tripton soja bujon, izlagan soničnoj energiji u trajanju od 1minuta i zatim vorteksiran 1 minut, čime je omogućeno odvajanje nastalog biofilma od implantata. Za ispitivanje sposobnosti formiranja biofilma kori&scaron;ćena je modifikovana tehnika sa mikrotitar pločom po Stepanoviću. Rezultati su pokazali da sve četiri ispitivane bakterije S. epidermidis, S. aureus, P. aeruginosa i Ralstonia pickettii statistički značajno vi&scaron;e stvaraju biofilm na implantatima sa porama veličine 50&ndash;900 &mu;m u odnosu na pore 70-150 &mu;m i u odnosu na pore veličine 13 &mu;m. Biofilm se statistički značajno vi&scaron;e stvara na porama veličine 70-150 &mu;m u odnosu na pore 13 &mu;m. Jedini izuzetak je Pseudomonas aeruginosa kod kojeg ne postoji statistični značajna razlika u produkciji biofilma na teksturisanim implantatima sa porama veličine 70-150 &mu;m u odnosu na one sa porama 13 &mu;m. TakoĎe, sve četiri ispitivane bakterije statistički značajano manje stvaraju biofilm nakon ispiranja povidon jodom, oktenidin-dihidrohloridom ili rastvorom antibiotika u sve tri grupe implantata, u odnosu na povr&scaron;ine koje nisu ispirane. Izuzetak je S. epidermidis u Grupi 3 kod kojeg nije utvrĎeno statistički značajno manje formiranje biofilma nakon ispiranja oktenidin dihidrohloridom u odnosu na neispiranje. Cefuroksim je bio efikasniji u sprečavanju formiranja biofilma sve četiri ispitivane bakterije u odnosu na neispiranje u Grupi 1, kao i za S. epidermidis i Ralstoniu Pickettii u Grupi 2. Cefuroksim se nije pokazao statistički značajno efikasnim u sprečavanju formiranja biofilma S. aureus i P. aeruginosa u Grupi 2, kao ni kod jedne bakterije u Grupi 3. Dalje je dokazano da su antiseptici (oktenidin-dihirohlorid i povidon jod) kao i me&scaron;avina povidon joda i dva antibiotika (cefuroksim i gentamicin), statistički značajno efikasnji od ispiranja samo antibiotikomcefuroksimom u smanjenju formiranja biofilma sve četiri ispitivane bakterije kod sva tri ispitivana, različito teksturisana silikonska implantata. Rezultati su pokazali da je ispiranje povidon jodom statistički značajno efikasnije u prevenciji stvaranja biofilma kod skoro svih ispitivanih bakterija od ispiranja oktenidin- dihidrohloridom u sve tri grupe implantata. Statistički značajna razlika nije utvrĎena u prevenciji stvaranja biofilma Staphylococcus aureusa kod sve tri grupe implantata prilikom ispiranja povidon jodom u odnosu na oktenidin- dihidrohlorid, kao i kod Ralsotnia pickettii u Grupi 2. Na osnovu rezultata ove studije, preporuka je da se koriste mikroteksturisani implantati kao i da se oni, pre ugradnje isperu povidon jodom ili me&scaron;avinom povidon jod i dva antibiotika (cefuroksim i gentamicin), u cilju prevencije stvaranja biofilma, a time i postoperativnih komplikacija koje mogu nastati nakon ugradnje implantata.</p> / <p>The most common complication after breast implant surgery is contracture of capsule, which is normally formed around implants as part of foreign body reaction. The most sincere complication after this kind of surgery is breast implant associated anaplastic large cell lymphoma (BIA-ALCL). The cause of these complications is still unknown. It is evident that capsular contracture (CC) is seen less frequently in patients with macro-textured implants and in those with implants covered with polyurethane foam. On the other hand, BIA-ALCL is diagnosed more frequently in patients with those, macro-textured implants. Subclinical infection, defined as an response of organism on presence of biofilm on the implant, is considered to be one of the most important etiologic factors for CC and BIA-ALCL. Biofilm is a conglomerate of microorganisms immersed into matrix, which protects them from influence of antibiotics and antiseptics. As it is impossible to eradicate biofilms with medicaments, many authors suggest different steps in order to avoid contamination of the implant during the operation and therefore, prevent the formation of biofilm. Among many tips, it is recommended to irrigate the pocket for breast implant and the implant itself, with some antiseptic or antibiotic solution. Up till now, there is no agreed consensus on the type of irrigation for different implants. Only personal experiences of a few authors have been published. Aims of this research were: to establish the possibility of biofilm formation of four different bacteria (Staphylococcus epidermidis, Staphylococcus aureus, Pseudomonas aeruginosa and Ralstonia pickettii) on three differently textured breast implants (with pore diameter of 70-150 &mu;m, 50&ndash;900 &mu;m and 13 &mu;m) in vitro; to examine whether the irrigation of implant with antiseptics (povidone iodine and octenidine dihydrochloride), antibiotics (cefuroxime) or mixture of povidone iodine and two antibiotics, before the contamination with bacteria, has an influence on the incidence on biofilm formation on three differently textured implants; and to examine the effect of antiseptics in contrast to the effect of antibiotics on biofilm formation on three differently textured breast implants. The study was conducted as a prospective research that took place at the Laboratory for microbiology, at the Institute of public health of Vojvodina in Novi Sad. For the experiment, three types of silicone breast implants were used with different pore sizes: 70-150 &mu;m, 50&ndash;900 &mu;m and 13 &mu;m. Samples were made by cutting each of these types of implants into pieces sized 1x1cm. There were 1440 samples in total. According to texture, samples were divided it three groups: Group 1 (pore size 70-150 &mu;m), Group 2 (pore size 50&ndash;900 &mu;m) and Group 3 (pore size 13 &mu;m). Furthermore, each of these groups was divided in one control and four test groups. After sterilisation of samples, every control group was contaminated with 100&mu;l of bacterial broth of Staphylococcus epidermidis (n=30), Staphylococcus aureus (n=30), Pseudomonas aeruginosa (n=30) and Ralstonia pickettii (n=30). Tested groups were divided according to type of irrigation into those where samples were firstly irrigated with either: octenidine dihydrochloride of povidone iodine or cefuroxime of mixture of povidone iodine with two antibiotics, and after the irrigation, contaminated with 100&mu;l bacterial broth of Staphylococcus epidermidis (n=30), Staphylococcus aureus (n=30), Pseudomonas aeruginosa (n=30) and Ralstonia pickettii (n=30). After contamination, samples were incubated on 37&deg;C for 96h, which created excellent conditions for biofilm formation. After incubation, each sample was dipped into sterile tripton soy broth, and then exposed to sonic energy for 1 minute and vortexed for 1 minute, which made biofilm separate from the implant. For testing the capability of biofilm formation, modified technique with microtitar plates described by Stepanović was used. Results show that all four examined bacteria S. epidermidis, S. aureus, P. aeruginosa and Ralstonia pickettii form more biofilm on implants with pore sizes 50&ndash;900 &mu;m compared to implants with pore size 70-150 &mu;m and those with 13 &mu;m. Statistical significance was found in biofilm formation on implants with pores 70-150 &mu;m compared to implants with pores 13 &mu;m. Furthermore, all four examined bacteria form statistically less biofilm after the irrigation with any of used solutions: povidone iodine, octenidine dihydrochloride, antibiotic solution of mixture of povidone iodine and two antibiotics, in all three groups of implants compared to surfaces that were not irrigated. The exception is S. epidermidis in Group 3, where no statistical significance was found on biofilm formation after the irrigation with octenidine dihydrochloride compared to non-irrigation. Cefuroxime was more efficient in biofilm prevention for all four tested bacteria compared to non-irrigation in Group 1 and for S. epidermidis and Ralstonia pickettii in Group 2. There was no statistical significance found in prevention of S. aureus i P. aeruginosa biofilms when irrigating with cefuroxime in Group 2, as well as for all tested bacteria in Group 3. Furthermore, it was verified that antiseptics (octenidin dihydrochloride and povidone iodine) and mixture of povidone iodine and two antibiotics (cefuroxime and gentamycin), were statistically more efficient in biofilm prevention of all four examined bacteria in all groups of implants, compared to irrigation with antibiotic-cefuroxime alone. Results show that irrigation with povidone iodine is statistically more efficient in biofilm prevention of almost all examined bacteria compared to irrigation with octenidine dihydrochloride in all groups of implants. There was not found any statistical significance in prevention of Staphylococcus aureus biofilm when irrigating with povidone iodine compared to octenidine dihydrochloride in all groups of implants, and also in biofilm prevention of Ralsotnia pickettii in Group 2. According to results of this research, it is recommended to use micro-textured implants and to irrigate them with povidone iodine or mixture of povidone iodine and two antibiotics (cefuroxime and gentamycin) prior the implementation, in order to prevent biofilm formation which is most probable cause of postoperative complications after implant surgery.</p>