Effects of two different post-surgical protocols including either 0.05 % chlorhexidine herbal extract or 0.1 % chlorhexidine on post-surgical plaque control, early wound healing and patient acceptance following standard periodontal surgery and implant placement

Laugisch, Oliver; Ramseier, Christoph A.; Salvi, Giovanni E.; Hägi, Tobias T.; Bürgin, Walter; Eick, Sigrun; Sculean, Anton

doi:10.1007/s00784-016-1713-7

Cited by 23 publications

(26 citation statements)

References 41 publications

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“…In recent years, research and development has focused on developing different methods to reduce staining while maintaining CHX efficacy. Recently mouth-rinses with lower concentrations and/or in combination with other ingredients such as herbal extracts or hyaluronic acid have been assessed in order to decrease such side effects [28][29][30]. A so-called anti-discoloration system (ADS) has also been implemented [31][32][33][34].…”

Section: Introductionmentioning

confidence: 99%

Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review

et al. 2018

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BACKGROUND: Biofilm management and infection control are essential after periodontal and implant surgery. In this context, chlorhexidine (CHX) mouth-rinses are frequently recommended post-surgically. Despite its common use and many studies in this field, a systematic evaluation of the benefits after periodontal or implant surgery is-surprisingly-still missing. OBJECTIVES: To evaluate the benefits of chlorhexidine rinsing after periodontal or implant surgery in terms of plaque and inflammation reduction potential. Furthermore, to screen whether the concentration changes or additives in CHX solutions reduce side effects associated with its use. MATERIALS AND METHODS: A systematic literature search was performed for clinical trials, which compared CHX rinsing after periodontal or implant surgery with rinsing using placebo, non-staining formulations, or solutions with reduced concentrations of the active compound. Four databases (Medline, PubMed, Embase, Cochrane) were searched up to June 2018. Two reviewers independently identified and screened the literature. RESULTS: From 691 titles identified, only eleven publications met the inclusion criteria and were finally included. Mainly early publications assessed the benefits of CHX over placebo rinsing, whereas more recent publications focused more on the evaluation of new formulations with regard to effectiveness and side effects. The use of CHX after surgery showed in general significant reduction in plaque (means of 29-86% after 1 week) and bleeding (up to 73%) as compared to placebo. No consensus, however, was found regarding the most beneficial CHX formulation avoiding side effects. CONCLUSION: Chlorhexidine rinsing helps to reduce biofilm formation and gingival inflammation after surgery. However, no additional reduction of periodontal probing depth over any given placebo or control solution could be found irrespective of whether CHX was used or not. The use of additives such as antidiscoloration systems (ADS) or herbal extracts may reduce side effects while retaining efficacy. CLINICAL RELEVANCE: Within the limitations of this review, it can be concluded that CHX may represent a valuable chemo-preventive tool immediately after surgery, during the time period in which oral hygiene capacity is compromised. To reduce the side effects of CHX and maintain comparable clinical effects, rinsing with less concentrated formulations (e.g., 0.12%) showed the most promising results so far.

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Section: Introductionmentioning

confidence: 99%

Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review

et al. 2018

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“…It is a safe technique, which diminishes bacterial load, thus reducing inflammation in periodontitis treatment [20][21][22]. Likewise, other studies propose herbal chlorhexidine in post-surgery protocols, as biofilm inhibitors, providing comfort to the patient after surgery [23]. Other studies demonstrate good outcomes in periodontitis treatment using a combination of diode laser therapy with scaling and SRP [24].…”

Section: Introductionmentioning

confidence: 99%

Preliminary Phytochemical Analysis of Berberis goudotii Triana & Planch. ex Wedd. (Berberidaceae) with Anticariogenic and Antiperiodontal Activities

et al. 2019

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Berberis goudotii is an endemic Colombian plant found in the paramo ecosystem. It has been used in food preparation and as a medicinal plant for diverse treatments. Additionally, it is used as a mouthwash to strengthen the gums and combat throat irritations and periodontitis. The present research evaluated Berberis goudotii aerial parts extract and fractions antimicrobial activities. Ultrasonic-assisted extraction was used to attain total ethanol-water extract. Solid-liquid fractionation was used to obtain hexane fraction. The residue was dispersed in water and liquid-liquid fractionation was carried-out to acquire dichloromethane, butanol and water fractions. Preliminary phytochemical analysis was performed on total extract and phenol, polyphenol, flavonoid, and proanthocyanidin, while tannin content was quantified. Antimicrobial activity assessment was performed by agar diffusion method using disks and wells employing Ceftazidime as a positive control against Streptococcus mutans, Streptococcus sobrinus, Lactobacillus acidophilus, Lactobacillus casei, Porphyromonas gingivalis, Prevotella intermedia and Fusobacterium nucleatum. Antimicrobial activity was determined as relative percentage inhibition (RPI), minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC). Phenols (92.5 ± 7.7 mg GA/10 g), polyphenols (87.7 ± 8.1 mg PG/10 g) and tannins (44.1 ± 4.3 mg PG/10 g) were among the highest secondary metabolites observed. Total extract presented an MBC of 1.0 µg/µL against cariogenic bacteria (Streptococcus mutans and Streptococcus sobrinus) and 0.12 µg/µL against bacteria associated with periodontal disease (Porphyromonas gingivalis, Prevotella intermedia and Fusobacterium nucleatum). Butanol and hexane fractions showed antiperiodontal activity with MBC of 0.12 and 1.0 µg/µL, respectively. In conclusion, Berberis goudotii total extract demonstrated antimicrobial activity against cariogenic and periodontal microorganisms, on the other hand, hexane and butanol fractions displayed antiperiodontal activity.

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“…This might have impacted on the study results. Laugish et al observed a similar healing profile after 2‐week rinsing period with a 0.05% CHX/extract herbal combination mouthrinse or a 0.1% CHX solution as adjunct to mechanical plaque control with a soft toothbrush starting on the third day after surgery.…”

Section: Discussionmentioning

confidence: 88%

“…This was accompanied by a different pattern in the early post‐operative healing phase. The healing after regenerative procedures and flap surgeries has been addressed in previous clinical studies by using the EHI . This index was designed to monitor periodontal wound healing by primary intention .…”

Section: Discussionmentioning

confidence: 99%

“…Extensive research has demonstrated the beneficial clinical effects of chemical control of supragingival plaque formation in any type of surgery, with chlorhexidine (CHX) being considered as the gold standard for this purpose . In contrast, only a limited number of studies described timing, frequency and detailed technique of mechanical plaque removal during the first days after periodontal and implant flap surgery . This is likely due to toothbrush trauma, and subsequent discomfort and sensitivity perceived by the patient in the surgical area.…”

Section: Introductionmentioning

confidence: 99%

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Effect of two post‐surgical cleansing protocols on early periodontal wound healing and cytokine levels following osseous resective surgery: A randomized controlled study

Sijari

Romano

Ciardo

et al. 2019

Int J Dental Hygiene

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Objectives:The aim of this RCT study was to compare early wound healing and gingival crevicular fluid cytokine levels of patients treated with two different post-surgical cleansing protocols. Methods:A total of 30 chronic periodontitis patients scheduled for osseous resective surgery with fibre retention technique were randomly assigned to follow one of two post-surgical protocols. Patients assigned to the test protocol (n = 15) were instructed to brush the surgical area with a sonic toothbrush starting the day after surgery in addition to 0.12% chlorhexidine (CHX) rinsing, while patients following the control protocol (n = 15) rinsed only with 0.12% CHX solution and resumed mechanical cleansing with a manual toothbrush on day 14 after surgery. Interleukin (IL)-1β and IL-8 levels were assessed before and 14 days post-operatively in gingival crevicular fluid. Patients were recalled on day 7, 14, 21 and 28 after surgery for clinical assessment. Pain was self-reported by a visual analogue scale.

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Effects of two different post-surgical protocols including either 0.05 % chlorhexidine herbal extract or 0.1 % chlorhexidine on post-surgical plaque control, early wound healing and patient acceptance following standard periodontal surgery and implant placement

Abstract: A post-operative protocol including 0.05 % CHX/herbal extract may have the potential to improve patient compliance during post-operative maintenance.

Cited by 23 publications

References 41 publications

Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review

Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review

Preliminary Phytochemical Analysis of Berberis goudotii Triana & Planch. ex Wedd. (Berberidaceae) with Anticariogenic and Antiperiodontal Activities

Effect of two post‐surgical cleansing protocols on early periodontal wound healing and cytokine levels following osseous resective surgery: A randomized controlled study

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