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Randomized Controlled Trial
. 2024 Jun 4;28(6):354.
doi: 10.1007/s00784-024-05643-0.

Early periodontal wound healing after chlorhexidine rinsing: a randomized clinical trial

Filippo Graziani  1 , Rossana Izzetti  2 , Marina Perić  2   3 , Urška Marhl  2   4 , Marco Nisi  2 , Stefano Gennai  2
Affiliations
Randomized Controlled Trial

Early periodontal wound healing after chlorhexidine rinsing: a randomized clinical trial

Filippo Graziani et al. Clin Oral Investig. .

Abstract

Objectives: This single-center randomized, parallel design, clinical trial with a 2-week follow-up involved patients affected by periodontitis undergoing periodontal surgery. The aim was to evaluate periodontal surgical wound healing with the use of chlorhexidine-based mouth rinses versus an untreated control group.

Materials and methods: Periodontal surgery was performed following a standardized protocol. Patients were randomly prescribed i) chlorhexidine (CHX) + anti-discoloration system (ADS) + hyaluronic acid (HA), ii) CHX + ADS or iii) no treatment (control group). Plaque score, gingival inflammation, and Early Healing Index (EHI), assessing the degree of wound closure and the presence of fibrin and necrosis, were evaluated at 3, 7 and 14 days after surgery.

Results: In total, 33 patients were enrolled. Patients were comparable at baseline for all measured clinical parameters. At 3-days wound healing was significantly improved in all patients treated with CHX + ADS-based mouth rinses with a lower EHI score at the interdental papillae compared with control group (p < 0.01). CHX + ADS + HA group presented improved healing across all time points in terms of EHI, plaque containment, and gingival inflammation when compared to control group (p < 0.01).

Conclusions: The usage of CHX-ADS following periodontal surgery improved early wound healing, reduced plaque accumulation and gingival inflammation. During the early post-operative period the adjunct of HA further improved soft tissue closure.

Clinical relevance: This study aims at evaluating the response of gingival tissues to mouth rinsing with chlorhexidine and anti-discoloration system (CHX + ADS) or CHX + ADS + hyaluronic acid (CHX + ADS + HA) versus no rinse in terms of healing of the periodontal surgical wound. CHX + ADS mouth rinses enhanced early soft tissue closure after periodontal surgery and contributed to the reduction in plaque accumulation and gingival inflammation. The adjunct of HA may be beneficial especially in the early post-operative period. CHX + ADS administration following periodontal surgery may improve soft tissue healing in the first two post-operative weeks.

Keywords: Chlorhexidine; Hyaluronic acid; Periodontal surgery; Wound healing.

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Conflict of interest statement

Professor Filippo Graziani received consultancy fees from Curasept SPA whose products are tested in this study. Dr. Izzetti has a research position funded with a grant from Curasept SPA. The remaining authors report no conflict of interest for this study.

Figures

Fig. 1
Fig. 1
Study flowchart
Fig. 2
Fig. 2
Clinical photographs of the wound healing progression in the three study groups
Fig. 3
Fig. 3
Variation between timepoints of the Early Healing Index (EHI) assessed at the interdental papilla
Fig. 4
Fig. 4
Variation between timepoints of the Early Healing Index (EHI) assessed at the experimental incision
See this image and copyright information in PMC

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