Prospective clinical study evaluating the long‐time adjunctive use of chlorhexidine after one‐stage full‐mouth SRP

Stratul, Ştefan‐Ioan; Rusu, Darian; Didilescu, Andreea Cristiana; Mesaros-Anghel, M; Lala, C; Tion, L; Sculean, Anton; Jentsch, Holger

doi:10.1111/j.1601-5037.2009.00390.x

Cited by 9 publications

(4 citation statements)

References 40 publications

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“…Therefore, this systematic review aimed for the first time to evaluate the benefit of CHX after periodontal or implant surgery compared to rinsing with a placebo and second to discern the influence of different concentrations and formulations in terms of efficacy, side effects and patient acceptance. We hypothesized, as shown for gingivitis prophylaxis and non-surgical periodontal therapy [37,[38][39][40][41][42][43][44], that rinsing with CHX 1) Results in less plaque formation and bleeding as compared to placebo control 2) Novel formulations are able to reduce side effects while still being effective, i.e. are as effective in plaque and bleeding reduction as the respective control (standard CHX-formulation).…”

Section: Despite the Aforementioned Disadvantages Chemical Plaque Comentioning

confidence: 99%

Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review

et al. 2018

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BACKGROUND: Biofilm management and infection control are essential after periodontal and implant surgery. In this context, chlorhexidine (CHX) mouth-rinses are frequently recommended post-surgically. Despite its common use and many studies in this field, a systematic evaluation of the benefits after periodontal or implant surgery is-surprisingly-still missing. OBJECTIVES: To evaluate the benefits of chlorhexidine rinsing after periodontal or implant surgery in terms of plaque and inflammation reduction potential. Furthermore, to screen whether the concentration changes or additives in CHX solutions reduce side effects associated with its use. MATERIALS AND METHODS: A systematic literature search was performed for clinical trials, which compared CHX rinsing after periodontal or implant surgery with rinsing using placebo, non-staining formulations, or solutions with reduced concentrations of the active compound. Four databases (Medline, PubMed, Embase, Cochrane) were searched up to June 2018. Two reviewers independently identified and screened the literature. RESULTS: From 691 titles identified, only eleven publications met the inclusion criteria and were finally included. Mainly early publications assessed the benefits of CHX over placebo rinsing, whereas more recent publications focused more on the evaluation of new formulations with regard to effectiveness and side effects. The use of CHX after surgery showed in general significant reduction in plaque (means of 29-86% after 1 week) and bleeding (up to 73%) as compared to placebo. No consensus, however, was found regarding the most beneficial CHX formulation avoiding side effects. CONCLUSION: Chlorhexidine rinsing helps to reduce biofilm formation and gingival inflammation after surgery. However, no additional reduction of periodontal probing depth over any given placebo or control solution could be found irrespective of whether CHX was used or not. The use of additives such as antidiscoloration systems (ADS) or herbal extracts may reduce side effects while retaining efficacy. CLINICAL RELEVANCE: Within the limitations of this review, it can be concluded that CHX may represent a valuable chemo-preventive tool immediately after surgery, during the time period in which oral hygiene capacity is compromised. To reduce the side effects of CHX and maintain comparable clinical effects, rinsing with less concentrated formulations (e.g., 0.12%) showed the most promising results so far.

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Section: Despite the Aforementioned Disadvantages Chemical Plaque Comentioning

confidence: 99%

Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review

et al. 2018

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“…Nevertheless, a prospective clinical study on patient undergoing one-stage full-mouth scaling and root planing has demonstrated a statistical significant benefit in probing depth and clinical attachment gain after 3 months of extensive use of CHX mouth rinse. [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Influence of different post-interventional maintenance concepts on periodontal outcomes: an evaluation of three systematic reviews

et al. 2016

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BackgroundTo selectively review the existing literature on post-interventional maintenance protocols in patients with periodontal disease receiving either non-surgical or surgical periodontal treatment.MethodsThree systematic reviews with different periodontal interventions, i.e. scaling and root planing (SRP), SRP with adjunctive antibiotics or regenerative periodontal surgery were evaluated focusing on their post-interventional maintenance care. Due to the early publication of one review an additional literature search update was undertaken. The search was executed for studies published from January 2001 till March 2015 through an electronic database to ensure the inclusion of resent studies on SRP. Two reviewers guided the study selection and assessed the validity of the three reviews found.ResultsWithin the group of scaling and root planing alone there have been nine studies with more than three appointments for maintenance care and five studies with more than two appointments in the first 2 months after the intervention. Chlorhexidine was the most frequently used antiseptic agent used for 2 weeks after non-surgical intervention. Scaling and root planing with adjunctive antibiotics showed a similar number of visits with professional biofilm debridement, whereas regenerative studies displayed more studies with more than three visits in the intervention group. In addition, the use of antiseptics was longer and lasted 4 to 8 weeks after the regenerative intervention. The latter studies also showed more stringent maintenance protocols.ConclusionsWith increased interventional effort there was a greater tendency to increase frequency and duration of the maintenance care program and antiseptic agents.

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“…To improve the outcome of SRP antibiotics are used in severe forms of periodontitis [ 15 , 16 ] and mostly chlorhexidine rinsing is executed in the first days after SRP [ 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

Adjunctive use of essential oils following scaling and root planing –a randomized clinical trial

Azad

Schwiertz²,

Jentsch

2016

BMC Complement Altern Med

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BackgroundHitherto no study has been published on the effect of the adjunctive administration of essential oils following scaling and root planing (SRP). This study describes the effect of a mouthrinse consisting of essential oils (Cymbopogon flexuosus, Thymus zygis and Rosmarinus officinalis) following SRP by clinical and microbiological variables in patients with generalized moderate chronic periodontitis.MethodsForty-six patients (aged 40–65 years) with moderate chronic periodontitis were randomized in a double-blind study and rinsed their oral cavity following SRP with an essential oil mouthrinse (n = 23) or placebo (n = 23) for 14 days. Probing depth (PD), attachment level (AL), bleeding on probing (BOP) and modified sulcus bleeding index (SBI) were recorded at baseline and after 3 and 6 months. Subgingival plaque was taken for assessment of major bacteria associated with periodontitis.ResultsAL, PD, BOP and SBI were significantly improved in both groups after three (p < 0.001) and 6 months (p ≤ 0.015). AL improved significantly better in the test than in the control group after 3 and 6 months (p < 0.001), so did PD after three months in the tendency (p = 0.1). BOP improved better in the test group after 3 months (p = 0.065). Numbers of Treponema denticola (p = 0.044) and Fusobacterium nucleatum (p = 0.029) decreased more in the test than in the control group after 3 months, those of Tannerella forsythia after 6 months (p = 0.039). Prevotella micra (p < 0.001, p = 0.035) and Campylobacter rectus (p = 0.002 , p = 0.012) decreased significantly in both groups after 3 months.ConclusionsThe adjunctive use of a mouthrinse containing essential oils following SRP has a positive effect on clinical variables and on bacterial levels in the subgingival biofilm.Trial registration332-12-24092012, DRKS 00009387, German Clinical Trials Register, Freiburg i. Br., 16.09.2015Electronic supplementary materialThe online version of this article (doi:10.1186/s12906-016-1117-x) contains supplementary material, which is available to authorized users.

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Prospective clinical study evaluating the long‐time adjunctive use of chlorhexidine after one‐stage full‐mouth SRP

Abstract: Over 3 months of extended use of CHX mouth rinse after SRP showed slightly but statistically significant better results.

Cited by 9 publications

References 40 publications

Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review

Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review

Influence of different post-interventional maintenance concepts on periodontal outcomes: an evaluation of three systematic reviews

Adjunctive use of essential oils following scaling and root planing –a randomized clinical trial

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