Efficacy of Chlorhexidine Rinses After Periodontal or Implant Surgery: A Systematic Review
Many hygienists have a distaste for chlorhexidine, no pun intended. The stain, the taste, the increase in calculus accumulation, and the well-documented interactions with healing are all reasons to loathe this mouth rinse. However, what about short term use after periodontal or implant surgery? Are there hidden benefits we may be overlooking? A systematic review published in Clinical Oral Investigations evaluates the possibility of benefits in terms of plaque and inflammation reduction after periodontal and implant surgery.
This review focuses on the use of CHX in patients with restricted ability to mechanically control plaque after periodontal or implant surgery. Plaque control is imperative for healing and reduced inflammation after surgical dental treatment. The review does emphasize the use of CHX should be on a short-term basis.
Rinsing with CHX reduced plaque accumulation by 29% after one week of use, after two weeks it was reduced by 50.9% to 82%. That reduction is significant for a patient that is unable to properly brush after surgery. However, after patients can properly remove plaque mechanically, there was no significant difference in gingival inflammation with or without CHX use. No benefit was found in the reduction of pocket depths with the use of CHX. Therefore, the use of CHX for pocket depth reduction is not recommended.
Different CHX formulations were also evaluated for the best efficacy. There was no significant difference in wound healing when comparing CHX with alcohol and alcohol-free CHX. The same was true when CHX was compared with CHX with the additional anti-discoloration system, CHX plus hyaluronic acid, and CHX enhanced with herbal extracts/essential oils. However, CHX plus hyaluronic acid showed a significant reduction in edema when compared to standard CHX.
This systematic review indicates there are benefits, such as reduced plaque accumulation and gingival inflammation, with short term use of CHX after periodontal and implant surgery. If you previously were against the use of CHX, does this make you re-evaluate your beliefs regarding CHX use when patients are unable to mechanically control plaque accumulation?
- Alex Solderer, Manuala Kaufmann, Deborah Hofer, Daniel Wiedemeier, Thmas Attin, Patrick R. Schmidlin. Efficacy of Chlorhexidine Rinses After Periodontal or Implant Surgery: A Systematic Review. Clin Oral Invest (2019) 23:21-32.
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