Chemical Control Protocols of Supragingival Biofilm in the Periodontal Treatment

Objectives: Studies have suggested that strict supragingival biofilm control by means of chlorhexidine (CHX) rinsing improves the outcomes of different periodontal treatments. Cetylpyridinium chloride (CPC) is an effective antibacterial agent and generates less side effects than CHX but has never been tested as an adjunct in the treatment of periodontitis. The aim of this study was to evaluate the clinical effects of two oral hygiene protocols containing CHX and/or CPC, used at different phases of periodontal treatment.
Methods: 102 subjects with periodontitis were randomly assigned to receive one of the following treatment protocols: scaling and root planning (SRP) combined with (1) 0.075% CPC + Zinc + Fluoride (for 6 months); (2): 0.12% CHX (for 2 months) and 0.075% CPC + Zinc + Fluoride (for up to 6 months); and (3) Control: Placebo solution (for 6 months). Subjects received SRP in 14 days and rinsed with 20 ml of the solutions for 1 minute, 2 times/day, starting at the first SRP session. Subjects were clinically monitored at baseline, 2 and 6 months post-therapy.
Results: Both groups rinsing with antimicrobials demonstrated greater reduction in the number of sites woth probing depth (PD) ≧ 4 mm than the control group at 6 months (p<0.05). Subjects rinsing with CHX followed by CPC showed a tendency for deeper reductions in PD in sites with initial PD ≧ 5 mm (primary outcome variable, p>0.05) in comparison with the other two groups, at 6 months.
Conclusions: Subjects with periodontitis benefited from the adjunctive use of antimicrobial rinses up to 6 months post-treatment. The group rinsing CHX during the active phase of treatment and CPC during the maintenance phase showed a tendency to achieve the best clinical outcomes.