Post-operative care by 0.1% chlorhexidine mouthwash after periodontal surgery

Objectives: the aim of our study was to assess the efficacy of 0.1% chlorhexidine(CHX) mouthwash(Eludril®) on controlling plaque accumulation in surgical areas during the first week following periodontal surgery.

Methods: a total of 199 non-smoker patients were included in a multicentre,randomized,placebo-controlled,blind study on two parallel groups. Patients were recruited at the time of planning periodontal surgery and instructed to use either 0.1%CHX or placebo twice a day for 7 days after surgery. Plaque index(PlI) measurements were performed at 6 sites per tooth in the surgical area plus 2 distal sites for the mesial tooth and 2 mesial sites for the distal tooth at Day1 at end of surgery and in the morning of Day8. Discoloration index was used to evaluate the commonly described adverse staining of CHX. Healing was measured using the 3-point epithelialisation score(Sanz,1989) and investigator's judgement was assessed regarding the cleanness and coalescence of sutures. The changes in PlI between Day1 and Day8 were analyzed by a non-parametric ANOVA adjusted on baseline value and stratified by centre.

Results: the increase in PlI from Day1 to Day8 was significantly(p=0.017) lower in the CHX group(0.42±0.48) than in the placebo group(0.58±0.64).Changes in Discoloration index were very slight without any difference between CHX and placebo groups. A significant effect(p=0.018) of CHX mouthwash was observed on suture cleanness and more patients in the CHX group exhibited complete healing and good epithelialisation.

Conclusion: 0.1% CHX mouthwash was effective in reducing plaque accumulation in patients undergoing periodontal surgery with favourable effects on suture cleanness, healing and epithelialisation and without adverse staining.

The study was funded by Pierre Fabre Medicament, Castres, France