Efficacy of Different Chlorhexidine Concentrations

Summary

Chlorhexidine is the gold standard of dental plaque prevention, but which concentration is the most effective is not known. The aim of the present study was to compare the plaque and gingivitis inhibiting effect of commercial products containing 0.2%, 0.12% and 0.06% chlorhexidine in a modified experimental gingivitis model. In three groups of healthy volunteers, experimental gingivitis was induced and monitored over 21days, simultaneously treated with the commercial solutions containing 0.2%, 0.12% and 0.06% chlorhexidine. The maxillary right quadrant of each individual received mouthwash only, whereas the maxillary left quadrant was subject to both rinsing and mechanical oral hygiene. Compliance and side effects were monitored at days 7, 14, and 21. Plaque and gingivitis scores were obtained at baseline and day 21. The commercial mouthwash containing 0.2% chlorhexidine resulted in statistically significantly lower plaque scores than the 0.12 and 0.06% mouthwashes after 21 days use, whereas no statistically significant difference was found between the effect of the two latter mouthrinses. A commercial available mouthwash containing 0.2% chlorhexidine proved statistically significant better effect in preventing dental plaque than 0.12% and 0.06% solutions.

Timeline

Start

2016-11

Primary completion

2016-11

Completion

2016-12

Publications

• Background Denton, G. W. Disinfection, Sterilization and Preservation, 4th ed, pp. 274-89.
• Background Loe H, Schiott CR. The effect of mouthrinses and topical application of chlorhexidine on the development of dental plaque and gingivitis in man. J Periodontal Res. 1970;5(2):79-83. doi: 10.1111/j.1600-0765.1970.tb00696.x. No abstract available.
• Background Altman DG. Clinical trials. Practical statistics for medical research. London: Chapman & Hall/CRC; 1991. p 456.
• Results Davies A. The mode of action of chlorhexidine. J Periodontal Res Suppl. 1973;12:68-75. doi: 10.1111/j.1600-0765.1973.tb02167.x. No abstract available.
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• Results Owens J, Addy M, Faulkner J, Lockwood C, Adair R. A short-term clinical study design to investigate the chemical plaque inhibitory properties of mouthrinses when used as adjuncts to toothpastes: applied to chlorhexidine. J Clin Periodontol. 1997 Oct;24(10):732-7. doi: 10.1111/j.1600-051x.1997.tb00190.x.
• Results Gjermo P, Rolla G, Arskaug L. Effect on dental plaque formation and some in vitro properties of 12 bis-biguanides. J Periodontal Res Suppl. 1973;12:81-92. doi: 10.1111/j.1600-0765.1973.tb02169.x. No abstract available.
• Results Berchier CE, Slot DE, Van der Weijden GA. The efficacy of 0.12% chlorhexidine mouthrinse compared with 0.2% on plaque accumulation and periodontal parameters: a systematic review. J Clin Periodontol. 2010 Sep;37(9):829-39. doi: 10.1111/j.1600-051X.2010.01575.x. Epub 2010 Jul 7.
• Results QUIGLEY GA, HEIN JW. Comparative cleansing efficiency of manual and power brushing. J Am Dent Assoc. 1962 Jul;65:26-9. doi: 10.14219/jada.archive.1962.0184. No abstract available.
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• Results Loe H. The Gingival Index, the Plaque Index and the Retention Index Systems. J Periodontol. 1967 Nov-Dec;38(6):Suppl:610-6. doi: 10.1902/jop.1967.38.6.610. No abstract available.
• Results LOE H, THEILADE E, JENSEN SB. EXPERIMENTAL GINGIVITIS IN MAN. J Periodontol (1930). 1965 May-Jun;36:177-87. doi: 10.1902/jop.1965.36.3.177. No abstract available.
• Results Preus HR, Aass AM, Hansen BF, Moe B, Gjermo P. A randomized, single-blind, parallel-group clinical study to evaluate the effect of soluble beta-1,3/1,6-glucan on experimental gingivitis in man. J Clin Periodontol. 2008 Mar;35(3):236-41. doi: 10.1111/j.1600-051X.2007.01183.x.
• Results Preus HR, Koldsland OC, Aass AM, Sandvik L, Hansen BF. The plaque- and gingivitis-inhibiting capacity of a commercially available essential oil product. A parallel, split-mouth, single blind, randomized, placebo-controlled clinical study. Acta Odontol Scand. 2013 Nov;71(6):1613-9. doi: 10.3109/00016357.2013.782506. Epub 2013 May 3.
• Results Harper PR, Milsom S, Wade W, Addy M, Moran J, Newcombe RG. An approach to efficacy screening of mouthrinses: studies on a group of French products (II). Inhibition of salivary bacteria and plaque in vivo. J Clin Periodontol. 1995 Sep;22(9):723-7. doi: 10.1111/j.1600-051x.1995.tb00833.x.
• Results Keijser JA, Verkade H, Timmerman MF, Van der Weijden FA. Comparison of 2 commercially available chlorhexidine mouthrinses. J Periodontol. 2003 Feb;74(2):214-8. doi: 10.1902/jop.2003.74.2.214.
• Results Franco Neto CA, Parolo CC, Rosing CK, Maltz M. Comparative analysis of the effect of two chlorhexidine mouthrinses on plaque accumulation and gingival bleeding. Braz Oral Res. 2008 Apr-Jun;22(2):139-44. doi: 10.1590/s1806-83242008000200008.
• Results Pizzo G, Guiglia R, Imburgia M, Pizzo I, D'Angelo M, Giuliana G. The effects of antimicrobial sprays and mouthrinses on supragingival plaque regrowth: a comparative study. J Periodontol. 2006 Feb;77(2):248-56. doi: 10.1902/jop.2006.050116.
• Results Quirynen M, Avontroodt P, Peeters W, Pauwels M, Coucke W, van Steenberghe D. Effect of different chlorhexidine formulations in mouthrinses on de novo plaque formation. J Clin Periodontol. 2001 Dec;28(12):1127-36. doi: 10.1034/j.1600-051x.2001.281207.x.
• Results Smith RG, Moran J, Addy M, Doherty F, Newcombe RG. Comparative staining in vitro and plaque inhibitory properties in vivo of 0.12% and 0.2% chlorhexidine mouthrinses. J Clin Periodontol. 1995 Aug;22(8):613-7. doi: 10.1111/j.1600-051x.1995.tb00814.x.
• Results Van Strydonck DA, Timmerman MF, van der Velden U, van der Weijden GA. Plaque inhibition of two commercially available chlorhexidine mouthrinses. J Clin Periodontol. 2005 Mar;32(3):305-9. doi: 10.1111/j.1600-051X.2005.00681.x.
• Results 26. Valør LO, Norton IKR, Koldsland OC, Aass AM, Sandvik L, Preus HR. The plaque- and gingivitis inhibiting capacity of a commercially available mouthwash containing essential oils and ethyl lauroyl arginate. A parallel, split-mouth, double blind, randomized, placebo-controlled clinical study. In press
• Results Preus HR, Dahlen G, Gjermo P, Baelum V. Microbiologic Observations After Four Treatment Strategies Among Patients With Periodontitis Maintaining a High Standard of Oral Hygiene: Secondary Analysis of a Randomized Controlled Clinical Trial. J Periodontol. 2015 Jul;86(7):856-65. doi: 10.1902/jop.2015.140620. Epub 2015 Mar 12.
• Results Vatne JF, Gjermo P, Sandvik L, Preus HR. Patients' perception of own efforts versus clinically observed outcomes of non-surgical periodontal therapy in a Norwegian population: an observational study. BMC Oral Health. 2015 May 17;15:61. doi: 10.1186/s12903-015-0037-3.
• Haydari M, Bardakci AG, Koldsland OC, Aass AM, Sandvik L, Preus HR. Comparing the effect of 0.06% -, 0.12% and 0.2% Chlorhexidine on plaque, bleeding and side effects in an experimental gingivitis model: a parallel group, double masked randomized clinical trial. BMC Oral Health. 2017 Aug 18;17(1):118. doi: 10.1186/s12903-017-0400-7.

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