Cetypiridinium Chloride as Adjunct to toothbrushing: Systematic Review and Meta-Analyses

Objectives: The aim of the present study was to systematically review the literature about the interproximal anti-plaque and anti-gingivitis efficacy of Cetylpyrydinium Chloride (CPC) mouthrinse compared to a placebo solution without the use of dental floss.
Methods: Three databases were searched for randomized clinical trials to compare results of the interproximal plaque and gingivitis after a minimum of 6 weeks use of the cetylpyridinium chloride (CPC) and a placebo mouthrinses in adjunct to toothbrushing. Two meta-analyses were performed for the Quigley-Hein Plaque Index Turesky modification and Löe & Silness Gingival Index. For both analyses, the mean differences (MD) between baseline and 6 weeks were calculated. In all analyses, random effect models were used.
Results: Twenty-one studies were included. All included studies showed significant improvement, in at least one of the parameters, to the CPC mouthrinses tested when compared to the placebo. In Tthe meta-analysis, it found was showed that the groups that used CPC showed a significantly greater reduction in the plaque index score (MD; 95% confidence interval 95%CI: -0.74; -0.81 -0.67) and greater reduction in the gingival index (MD; 95%CI: -0.38; -0.47 -0.28) when compared to the control group. This difference was statistically significant (p<0,001). Even thoughAlthough, high heterogeneity was observed in both analyses.
Conclusions: When considering only the interproximal surfaces, better results may be expected for the CPC mouthwash groups when compared to a placebo solution in non dental floss users.