Supragingival Irrigation with 0.06% Chlorhexidine in Naturally Occurring Gingivitis I. 6 Month Clinical Observations

Abstract

The purpose of this study was to assess the efficacy of supragingival irrigation with 0.06% chlorhexidine gluconate (CHX) on naturally occurring gingivitis. The relative benefit of CHX irrigation in comparison with CHX rinsing, water irrigation, and normal oral hygiene was evaluated. In a blind, placebo-controlled 6-month study 222 patients were assigned to one of four groups: Group 1: Once daily irrigation with 300 ml water followed by irrigation with 200 ml 0.06% chlorhexidine gluconate (experimental); Group 2: Twice daily rinsing with 15 ml 0.12% chlorhexidine (positive control); Group 3: Once daily irrigation with 500 ml water (irrigation control) and Group 4: Sodium fluoride dentifrice for normal oral hygiene only (negative control). All groups used the same sodium fluoride dentifrice for tooth brushing. At baseline, 3 months, and 6 months patients were examined for Gingival Index (GI), Bleeding on Probing (BOP), Plaque Index (PLI), Pocket probing depth (PD), Calculus Index (CI), and stain. After the baseline visit all patients received a supra- and subgingival oral prophylaxis. At 6 months GI and BOP were significantly (P less than or equal to 0.05) reduced by adjunctive CHX irrigation (42.5% and 35.4%, respectively), CHX rinse (24.1% and 15.0%), and water irrigation (23.1% and 24.0%) compared to tooth brushing alone. Plaque was significantly (P less than or equal to 0.05) reduced only by CHX irrigation (53.2%) and CHX rinse (43.3%) while calculus and staining were significantly (P less than or equal to 0.05) increased in the two chlorhexidine groups (276.4% (irrigation) and 273.2% (rinse)). Although significant (P less than or equal to 0.05), pocket probing depth reduction was minimal after CHX irrigation (4.6%).(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical and Microbiological Effects of Subgingival and Gingival Marginal Irrigation With Chlorhexidine Gluconate

“…Patients who had clinical/radiographic evidence of pulpitis, periapical radiolucencies, impacted teeth, or retained root fragments. 5. Patients receiving medications such as anti-inflammatory, cardiac, epilepsy, or other medications which could affect periodontal health.…”

“…All home irrigation was performed at the lowest power setting of the oral irrigator. 5. Minnesota Daily Use Cards12 were used to assess compliance.…”

Treatment modalities and evaluation models for periodontitis

“…Several studies indicated the impact of subgingival irrigation as a monotherapy and in combination with root planning and revealed that subgingival irrigation with a variety of agents reduced the amount of gingival microbial load. [2526] Subgingival irrigation helps to diminish gingival inflammation despite unchanged plaque levels[27–29] by diluting plaque toxicity, interference with subgingival plaque maturation, or possibly by washing away unattached plaque. [2930] Pocket irrigation is able to reduce microbial load in the pocket and offers some better clinical parameters like pocket depth, bleeding of gum etc, but is associated with a major drawback of showing erratic results which is probably attributed to short residence time of the drug in the periodontal pocket.…”

“…[2526] Subgingival irrigation helps to diminish gingival inflammation despite unchanged plaque levels[27–29] by diluting plaque toxicity, interference with subgingival plaque maturation, or possibly by washing away unattached plaque. [2930] Pocket irrigation is able to reduce microbial load in the pocket and offers some better clinical parameters like pocket depth, bleeding of gum etc, but is associated with a major drawback of showing erratic results which is probably attributed to short residence time of the drug in the periodontal pocket. [31] The biologic rationale for performing subgingival irrigation is to nonspecifically reduce microbial deposits that may induce periodontal diseases.…”

¿Existen realmente diferencias clínicas entre las distintas concentraciones de clorhexidina?: Comparación de colutorios

“…Así en el estudio de Mc Bain, la clorhexidina a concentracio- 24 realizaron un estudio prospectivo randomizado a doble ciego de seis meses de duración en 222 pacientes, en los que se comparaban los efectos de: 1) una irrigación diaria con clorhexidina 0,06%, 2) dos enjuagues al día con colutorio de clorhexidina al 0,12 % y 3) una irrigación diaria con placebo (agua) sobre la placa. Encontraron que la irrigación con clorhexidina 0,06% producía una disminución en el número de unidades formadoras de colonias y en el porcentaje de bacterias Gram-anaerobias y una mejoría en la gingivitis.…”