Dental plaque, gingival inflammation and tooth -discolouration with different commercial -formulations of 0.2% chlorhexidine rinse: a double-blind randomised controlled clinical trial

Abstract

Purpose: To investigate the efficacy of various formulations of chlorhexidine 0.2% (CHX) in terms of plaque and gingival bleeding control compared to each other and to saline rinse (CTRL) over a 35-day rinsing period.

Materials and methods: Seventy subjects were randomly allocated to one of 4 groups rinsing twice daily for 35 days. The different groups used CHX 0.2% rinse with alcohol (CHX1) and without alcohol (CHX2), with an antidiscolouration system (CHX3) or saline rinse (CTRL). Clinical examinations to evaluate full-mouth plaque scores (FMPS) and periodontal parameters were performed at baseline, 7, 21 and 35 days. Tooth discolouration (TD) was measured at each time point using digital photographs and spectrophotometric analysis.

Results: At 35 days, CTRL showed the highest levels of plaque. The mean changes in FMPS from baseline were 69.8% ± 6.8 for CHX1, 57.5% ± 9.8 for CHX2, 43.7% ± 9.8 for CHX3 and 25.8% ± 7.7 for CTRL. Statistically significant differences were demonstrated between CHX1 and CHX3 (p = 0.02), CHX2 vs CHX3 (p ≤ 0.05) and CHX1/CHX2 vs CHX3 (p < 0.05). In contrast, CHX3 appeared more effective in reducing inflammatory indexes. TD increased over time in 60% to 70% of participants, although lighter staining was found in the CHX3 group. Greater FMPS reduction was observed in participants with staining vs without staining (26.0% ± 12.3, p = 0.04).

Conclusion: Conventional CHX appeared more effective in terms of plaque reduction. Interestingly, the newest formulation showed a higher control of gingival inflammation. Staining was associated with lower plaque levels.