Comparative evaluation of antiplaque and antigingivitis effects of an herbal and chlorine dioxide mouthwashes: A clinicomicrobiological study

Siddeshappa, Srinivasa Tenkasale; Bhatnagar, Shruti; Yeltiwar, Ramreddy K; Parvez, Humera; Singh, Asmita; Banchhor, Saket

doi:10.4103/ijdr.ijdr_391_16

Cited by 10 publications

(12 citation statements)

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“…Furthermore, out of the six selected studies, we had to exclude one more article as it was not an RCT and some crucial data were missing from that article [74]. Finally, five articles were eligible for systematic review and meta-analysis [75][76][77][78][79] (Fig. 1).…”

Section: Study Selectionmentioning

confidence: 99%

“…One work was placebo controlled [78], another one used physiological saline as control [79] (i.e. having negative controls) and two other studies used herbal mouthwash [75], aloe vera and chlorhexidine [76] as positive controls. One investigation had a parallel design of which we only used the chlorine dioxide group in our work [77].…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…Randomization was only described partially; therefore, this article has a low risk of bias. In two studies [75,77], there was no information about allocation concealment, yielding unclear risks of bias. Two studies were singleblinded trials: one had an unclear risk of performance bias [76], the other had a high risk of performance bias [77], because the patients knew which group they belonged to.…”

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

“…Yeturu and coinvestigators lost 5 participants in the follow-up period due to noncompliance of high risk [76], while Pham and coworkers lost only one patient so the attrition bias was unclear [79]. One paper was judged to have unclear risk as it did not have a registration number as a clinical trial [75]. Finally, another study had a high risk of reporting bias because some participants noted side effects in their diaries [78].…”

Section: Risk Of Bias Within Studiesmentioning

confidence: 99%

“…Risk of bias summary: review authors' judgements about each risk of bias item for each included study Our primary outcome was PI, the secondary outcome was GI, and tertiary outcome was tongue-coating index modified by Winkel. For the description of oral hygiene, the Silness-Löe PI and Löe-Silness GI were used in four articles [75,76,78,79], Aung et al applied the debris index of the Oral Hygiene Index and, for the description of gingival inflammation, bleeding on probing index [77]. Because bleeding on probing index is not comparable with GI, we could not calculate on these results as secondary outcomes.…”

Section: Fig (3) Risk Of Bias Summarymentioning

confidence: 99%

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Effects of Chlorine Dioxide on Oral Hygiene - A Systematic Review and Meta-analysis

Kerémi

Korbonits

Farkas

et al. 2020

CPD

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Background: Effective and selective oral rinses are required in the daily medical and dental practice. Currently used mouthwashes have substantial side effects. Objectives: Our aim was to evaluate the efficacy of chlorine dioxide-containing mouthwashes in comparison with other previously established mouth rinses in healthy adults using oral hygiene indices. Methods: This work was registered in PROSPERO (CRD42018099059) and carried out using multiple databases and reported according to the PRISMA statement. The following search terms were used “chlorine dioxide” AND “oral”, only randomised controlled trials (RCTs) were included. The primary outcome was the alteration of the plaque index (PI), while the secondary outcomes were the gingival index (GI) and bacterial counts. For the risk of bias assessment, the Cochrane Risk of Bias Tool was used. Statistical analysis for data heterogeneity was performed by Q-value and I2 -tests. Results: 364 articles were found in the databases. After the selection process, only five RCTs were eligible for meta-analysis. Data heterogeneity was low. There were no statistical differences in effectiveness between chlorine dioxide and the other effective mouth rinses in PI (0.720±0.119 vs 0.745±0.131; 95%; confidence intervals (CIs): 0.487–0.952 vs 0.489– 1.001, respectively) and GI (0.712±0.130 vs 0.745±0.131; 95% CIs: 0.457–0.967 vs 0.489– 1.001, respectively) and also in bacterial counts. Conclusion: Chlorine dioxide reduces both plaque and gingival indices and bacterial counts in the oral cavity similar to other routinely used oral rinses, however, the evidence supporting this is very limited. Therefore, further large scale RCTs are needed to decrease the risk of bias.

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