Effect of 0.12% Chlorhexidine on Bacterial Recolonization Following Periodontal Surgery

Abstract

Bacterial plaque accumulation following periodontal surgery has been directly associated with delayed and altered surgical wound healing. Successful antimicrobial treatment following periodontal surgery depends upon the elimination and suppression of wound associated microorganisms. Highly effective antimicrobials should also prevent recolonization of periodontopathogens. In this investigation, the antimicrobial effect of a 0.12% Chlorhexidine gluconate mouthrinse (Peridex) on bacterial recolonization after periodontal surgery was determined. A double–blind, randomized, placebo‐controlled study was carried out on 40 patients for 6 weeks. Patients with moderate Periodontitis (AAP Class III) underwent osseous periodontal flap surgery in one quadrant. Subgingival and marginal plaque samples from the surgery area were taken prior to surgery and 2 and 6 weeks postoperatively. General descriptive bacteriological cultural analysis and assays for specific microbial populations were carried out. During the 6 weeks of mouthrinse use, patients using Chlorhexidine had significant reductions over placebo (P < 0.05) in the number of total Gram–positive facultative cocci, streptococci (85.8%); Gram–positive facultative rods, primarily Actinomyces (91.7%); Capnocytophaga (97.6%) and Gram–negative anaerobic rods (94.5%). Few black pigmented Bacteriodes or Actinobacillus actinomycetemcomitans were found prior to surgery or any time postoperatively. In the Chlorhexidine group, 6 weeks post surgery, streptococci were the predominant bacterial group in the sampled plaque. Quantitatively, the distribution of bacteria, after 2 and 6 weeks of mouthrinse use, was consistent with a young, less mature plaque. A previous study demonstrated that this plaque was associated with clinical health. (J Periodontol 1989; 60:577–581)

A randomized, controlled clinical trial on the clinical, microbiological, and staining effects of a novel 0.05% chlorhexidine/herbal extract and a 0.1% chlorhexidine mouthrinse adjunct to periodontal surgery

“…In the present study, we demonstrated a decrease of bacterial counts between baseline and week 4. The findings from the present study that rinsing with CHX resulted in a temporary reduction of bacteria in periodontal pockets are consistent with findings by others (Newman et al 1989, Tuan et al 2000, Levy et al 2002, Ioannou et al 2009).…”

Effect of Essential Oil and Chlorhexidine Mouthwashes on Gingival Fibroblast Survival and Migration

“…Off‐label use of CHX after periodontal surgery is preferred by most periodontists mainly because of its substantivity. Both CHX‐ and EO‐containing mouthwashes are proven to reduce oral bacterial survival 6‐8 and inhibit gingival inflammation and plaque accumulation 1 . In a recent in vitro study, multiple dilutions of the EO mouthwash were tested to determine its minimum inhibitory concentration against 40 different oral bacteria 16 .…”

“…Previous studies have demonstrated the effectiveness of CHX 6,7 and EO 8 against bacterial species in the oral cavity. However, there is concern that both of these mouthwashes can have deleterious effects on gingival fibroblasts (GFs), affecting cell morphology, viability, and function.…”

Effect of Autogenous Cortical Bone Particulate in Conjunction With Enamel Matrix Derivative in the Treatment of Periodontal Intraosseous Defects

“…The patients received systemic antibiotic therapy, †† 2 g/day for 6 days, and 0.12% chlorhexidine mouthrinses, 28 twice a day for 6 weeks. Mechanical tooth cleaning was not allowed in the surgical area for the first 6 postoperative weeks.…”