Adjunctive Use of 0.05% Chlorhexidine Mouth-rinse in Supportive Periodontal Care

Objective: To evaluate the clinical and microbiological efficacy of mouth rinse, used as an adjunct to mechanical hygiene in patients following supportive periodontal care. Methods: This was a placebo-controlled randomized clinical trial evaluating the adjunctive efficacy of rinsing twice daily with the test product, containing 0.05% chlorhexidine and 0.05% cetylpyridinium chloride, when compared with a placebo rinse on both clinical and microbiological outcomes. The sample population consisted on treated chronic periodontitis patients undergoing a regular periodontal maintenance program. They were followed during 6 months. Clinical outcome variables included plaque and gingival indices, together with probing measurements. Subgingival samples were collected and processed by culturing. Patient-based variables and adverse effects were also assessed. Outcome variables were compared by t-test, chi-square, and Mann-Whitney test. Results: Results belonged to 39 patients (intent-to-treat) and 28 final patients (per-protocol). Full-mouth indices and probing showed small improvements after 3 months, and no intergroup differences were detected. The same was true after 6 months, although plaque indices demonstrated significant intragroup changes in the placebo group (p<0.05). Total anaerobic counts showed a significant reduction after 3 months in the test group (p=0.001), and the difference in this change was statistically significant between both groups (p=0.02). No significant differences were observed after 6 months. Minor changes were observed in the frequency of detection or counts of periodontal pathogens, and no overgrowth of opportunistic species was detected. Adverse effects were scarce, with the exception of staining, which affected 95% of test patients. Conclusion: No significant benefits of the adjunctive use of the tested mouth-rinse were demonstrated in patients in supportive periodontal therapy. The tested mouth-rinse demonstrated its safety, and a relevant side effect, namely tooth staining. Supported by LRU grant by Dentaid.