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A randomized controlled clinical trial on the effectiveness of three different mouthrinses (chlorhexidine with or without alcohol and C31G), adjunct to periodontal surgery, in early wound healing

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Abstract

Objectives

The use of chlorhexidine (CHX) with or without alcohol has been recommended for a number of clinical applications. On the other hand, there is a plethora of widely subscribed antiseptics, such as agent C31G (alkyl dimethyl glycine/alkyl dimethyl amine oxide), which has not yet been evaluated postsurgically. The effectiveness of three different mouthrinses (CHX with and without alcohol, C31G) in plaque control and early wound healing was compared postoperatively.

Materials and methods

In this, randomized, double-blind, controlled clinical trial 42 patients were allocated to three groups assigned to 2 weeks rinsing after non-regenerative periodontal flap surgery with or without osseous surgery with C31G (group A), alcohol-free CHX 0.12% (group B) or alcohol-based CHX 0.12% (group C). At days 7 and 14, plaque and early wound healing indices were recorded. At day 14, total bacterial counts were estimated utilizing real-time quantitative polymerase chain reaction (qPCR). Statistics included linear and generalized linear mixed models.

Results

At day 7, healing response was not significantly different among groups. At day 14, group A revealed the highest while group C demonstrated the lowest plaque index values (B vs A, odds ratio—OR = 0.18, p = 0.012; C vs A, OR = 0.01, p < 0.001; C vs B, OR = 0.06, p < 0.001). Group C demonstrated the lowest bacterial counts levels at day 14 (38.470 × 106, 48.190 × 106, and 3.020 × 106 for groups A, B, and C, respectively). At day 14, healing was significantly better in group C compared to B (p = 0.007). Group A showed no significant differences compared to other groups.

Conclusions

(1) The presence of alcohol may increase the effectiveness of CHX in early wound healing, (2) C31G might be an alternative solution prescribed during early postoperative period after non-regenerative periodontal flap surgery.

Clinical relevance

The present study found that active agent C31G displayed no significant differences to CHX formulations regarding periodontal wound healing improvement and might be used alternatively after non-regenerative periodontal flap surgery. In addition, an alcohol based 0.12% CHX mouthwash was more effective than an alcohol-free 0.12% CHX and C31G mouthrinse on plaque control in the absence of mechanical oral hygiene.

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Acknowledgements

The laboratory support provided by Dr. Effie C. Tsilibary (Head of Institute of Biosciences and Applications, National Center for Scientific Research “Demokritos”, Athens, Greece) and Christina Gkolfinopoulou is highly appreciated.

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Authors and Affiliations

  1. Department of Periodontology, School of Dental Medicine, National and Kapodistrian University of Athens, 2 Thivon Str, 115 27, Athens, Greece

    Anastasios M. Gkatzonis, Spyridon I. Vassilopoulos, Ioannis K. Karoussis, Phoebus N. Madianos & Ioannis A. Vrotsos

  2. Institute of Biosciences and Applications, National Center for Scientific Research “Demokritos”, Athens, Greece

    Archontia Kaminari

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  1. Anastasios M. Gkatzonis
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  2. Spyridon I. Vassilopoulos
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Gkatzonis, A.M., Vassilopoulos, S.I., Karoussis, I.K. et al. A randomized controlled clinical trial on the effectiveness of three different mouthrinses (chlorhexidine with or without alcohol and C31G), adjunct to periodontal surgery, in early wound healing. Clin Oral Invest 22, 2581–2591 (2018). https://doi.org/10.1007/s00784-018-2357-6

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