Clinical efficacy of a chlorhexidine-based mouthrinse containing hyaluronic acid and an antidiscoloration system in patients undergoing flap surgery: A triple-blind, parallel-arm, randomized controlled trial

Int J Dent Hyg. 2018 Nov;16(4):541-552. doi: 10.1111/idh.12361. Epub 2018 Aug 12.

Abstract

Objectives: To evaluate the postsurgery gingival healing as well as plaque, gingival inflammation and staining levels following the use of a 0.2% chlorhexidine (CHX) solution with or without antidiscoloration system (ADS) and 0.2% hyaluronic acid (HA).

Methods: Patients undergoing flap surgery at sites with an intact or reduced but healthy periodontium participated in a parallel-arm RCT. After surgery, patients used the assigned mouthrinse (CHX + HA + ADS or CHX) for 21 days. At days 7 and 21, the healing process was evaluated at experimental teeth using a composite index, namely the Gingival Healing Index (GHI). GHI score was obtained as the sum of the scores related to the severity of wound dehiscence (score 1-3) and the profile of the buccal and oral aspects of the papilla (score 1-3). Therefore, GHI ranged from 2 (worst quality of healing) to 6 (optimal quality of healing). Plaque Index (PlI), Gingival Index (GI), angulated bleeding score (AngBS), and tooth and tongue staining were also assessed.

Results: In both groups, GHI assumed values of 5 or 6 at both days 7 and 21 in ≥50% of patients, and low median values of PlI, GI, AngBS and staining were observed during the 21-day period. Except for a significantly lower GI in CHX group at day 7, no other significant intergroup differences were found.

Conclusions: Postsurgery plaque control based on either CHX or CHX + HA + ADS mouthrinses results in optimal plaque control and quality of early gingival healing along with limited tooth and tongue staining.

Keywords: chlorhexidine; gingiva; hyaluronic acid; surgical flaps; tooth discoloration; wound healing.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Dental Plaque / prevention & control*
  • Dental Plaque Index
  • Epidemiologic Research Design
  • Female
  • Gingiva / physiology*
  • Humans
  • Hyaluronic Acid / administration & dosage*
  • Male
  • Middle Aged
  • Mouthwashes / administration & dosage*
  • Mouthwashes / chemistry
  • Oral Surgical Procedures*
  • Periodontal Index
  • Postoperative Complications / prevention & control*
  • Postoperative Period
  • Surgical Flaps*
  • Time Factors
  • Tooth Discoloration / prevention & control*
  • Treatment Outcome
  • Wound Healing*

Substances

  • Mouthwashes
  • Hyaluronic Acid