Impact of 0.12% Chlorhexidine Gluconate Mouthwash on Peri-Implant Mucositis and Gingivitis After Nonsurgical Treatment: A Multilevel Analysis

• Autores: Karyna M. Menezes, Ângelo da Costa Oliveira, Bruno César de Vasconcelos Gurgel
• Localización: The International Journal of Oral & Maxillofacial Implants, ISSN-e 0882-2786, Vol. 36, Nº. 6, 2021, págs. 1188-1197
• Idioma: inglés
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• Resumen

  • Purpose: This study investigated the impact of 0.12% chlorhexidine gluconate mouthwash on dental implants with periimplant mucositis and contralateral teeth with gingivitis at 6 months of follow-up after nonsurgical treatment. Materials and methods: This was a secondary analysis of data from a previous controlled, randomized, double-blinded clinical trial of 30 patients diagnosed with peri-implant mucositis and gingivitis in contralateral teeth, at 6 months following treatment. Patients were randomly assigned into a test group (basic periodontal therapy + 0.12% chlorhexidine mouthwash) or a control group (basic periodontal therapy + placebo). Therapy consisted of an adaptation of the full-mouth scaling and root planing protocol. The clinical parameters of visible Plaque Index, Gingival Bleeding Index, probing depth, bleeding on probing, keratinized mucosa width, and gingival and peri-implant phenotype were evaluated at baseline and at 1, 3, and 6 months posttherapy. Data were analyzed using Poisson multilevel regression analysis with a significance level of .05. Results: The study analyzed 47 implants and contralateral teeth (376 sites) in the test group and 49 implants and contralateral teeth (392 sites) in the control group. No differences were found between the groups at the patient level. At the site level, the teeth and implants presented statistical differences in bleeding on probing, probing depth, and keratinized mucosa width at 3 months for both treatment groups. However, no difference was observed in bleeding on probing in the test group (P = .484) at 6 months, whereas the control group demonstrated increased bleeding on probing (indicating more inflammation) at implant sites than at teeth sites (P = .039). Additionally, implant sites with a thin peri-implant phenotype (P < .001) and located posteriorly (P = .002) presented greater inflammation. Conclusion: Use of a 0.12% chlorhexidine mouthwash for 14 days was beneficial for implant sites with peri-implant mucositis, compared to contralateral teeth sites with gingivitis, as indicated by the reduced percentage of teeth with bleeding on probing.