2014 Volume 57 Issue 3 Pages 219-228
Purpose: Mouth rinse with chlorhexidine gluconate (CHG) has been reported to be effective as a chemical plaque control. However, undesirable side effects such as allergy are known problems. Therefore, we developed a new mouth rinse formulated with both chlorhexidine hydrochloride (CHH) and cetylpyridinium chloride (CPC) as anti-microbial constituents and tested its effects on oral bacteria in patients with chronic periodontitis.
Methods: This was a short-term, randomized, controlled clinical trial. Systemically healthy 30 patients with ≥20 teeth were enrolled if they had 1 to 7 sites of residual pockets ≥5 mm after initial periodontal therapy with scaling and root planing. Patients were assigned to three groups and used placebo (control group), or rinse with 0.05% CHG (CHG group), or rinse with 0.05% CHH and 0.05% CPC (CHH+CPC group), for 4 weeks. In each patient, saliva, tongue coating and supragingival plaque were collected and microbiological parameters were measured with real-time PCR. Terminal restriction fragment length polymorphism (T-RFLP) analyses were also performed.
Results: No adverse event was observed. At the baseline, no difference was found in age, sex, number of teeth, or clinical periodontal parameters between the groups. Comparing the data at baseline and after 4 weeks, total bacterial counts and S. mutans in saliva, total bacterial counts in tongue coating and total streptococci in supragingival plaque were significantly decreased in the CHH+CPC group. In the CHG group, total bacterial counts in supragingival plaque were significantly decreased. Significant decreases of total bacterial counts and streptococci in tongue coating were detected in the control group. As the results from T-RFLP analyses, saliva from the CHH+CPC group showed significant reductions of presumed numbers of Streptococcus group in the digested fragments by Msp I, and Streptococcus, Eubacterium group, Parvimonas group and Porphyromonas, Prevotella group in the digested fragments by Hha I. Additionally, in supragingival plaque obtained from the CHG group after 4 weeks, presumed Streptococcus, Veillonella group from Hha I digests were significantly reduced. No change was observed between baseline and after 4 weeks in the other bacterial data.
Conclusion: The new mouth rinse formulated with CHH and CPC might be used safely and have equal to greater effects reducing oral bacteria than existing mouth rinse formulated with CHG alone.
