A Randomized Clinical Trial on the Clinical and Immunological Efficacy of a Mouth Rinse Containing Hydrogen Peroxide and Hyaluronic Acid in Patients with Gingivitis.

Abstract

OBJECTIVE: The present study aimed to investigate the impact of HA/H2O2 (Hyaluronic Acid/Hydrogen Peroxide) mouthwash on pro-inflammatory cytokines, specifically IL-1β and IL-6, in individuals diagnosed with gingivitis. Furthermore, a comparison was made between the effects of HA/H2O2 and those of CHX (Chlorhexidine) and placebo.MATERIALS AND METHODS: This clinical trial was randomized, double-blinded, and parallel. Fifty-four students with biofilm-induced gingivitis (18 to 23 years old) were randomly assigned to three mouthwash groups: HA/H2O2, CHX, and placebo. Unidentified bottles were delivered to participants. For 14 days, 10 millilitres of HA/H2O2 mouthwash formulation, CHX (0.12%), and placebo were used twice a day. All subjects were assessed twice, once at baseline and once after 14 days. Before and after each participant's mouthwash usage, bleeding on probing was measured as a clinical parameter for inflammation, Salivary IL-1β and IL-6 were also assessed by ELISA. Changes in salivary interleukins and bleeding between baseline and after treatment were determined and compared by the t test with an alpha of 0.05.RESULTS: There was a statistically significant decrease in salivary interleukin-1β and IL-6 in all three groups. However, intergroup comparisons at second visits showed no significant difference between HA/H2O2 and CHX groups (P>0.05) for the interleukins tested. Furthermore, all treatments considerably reduced bleeding on probing, although mouthwash with hyaluronic acid (HA) and hydrogen peroxide (H2O2) had a greater impact than the other two treatments.CONCLUSION: Mouthwash containing HA/H2O2 demonstrated an anti-inflammatory effect, suggesting they are immunomodulatory agents. These findings may be beneficial and encouraging for the use of HA/H2O2 in the treatment of gingivitis; thus, HA/H2O2 rinse has the potential to serve as an appropriate replacement for chlorhexidine (CHX).