Comparison of the postoperative anti-inflammatory efficacy of chlorhexidine, saline rinses and herbal mouthwashes after mechanical debridement in patients with peri-implant mucositis: A randomized controlled trial

Comparison of the Clinical Efficacy of Herbal, Chlorhexidine, and Normal Saline Mouthwash in the Management of Chronic Gingivitis

BACKGROUND

The incidence of chronic gingivitis, a widespread inflammatory condition of the gums, is considerable across the demographic spectrum, with potential progression to advanced periodontal pathology in the absence of intervention. The objective of this investigation was to conduct a comparative analysis of the clinical effectiveness of various oral rinses in mitigating the symptoms of chronic gingivitis.

METHODS

This empirical study was conducted within the confines of the Department of Oral Medicine and Radiology. A cohort of 60 individuals diagnosed with chronic gingivitis, ranging from 18 to 45 years of age and inclusive of all sexes, was systematically selected for participation.

RESULTS

Quantitative analysis yielded data indicating that the mean score on the gingival index was minimally recorded for participants utilizing herbal mouthwash (HO), in contrast to those administered with normal saline (NS), which displayed the highest mean score. A corresponding trend was observed with the plaque index, where the HO users exhibited the lowest mean values, as opposed to the NS cohort, which demonstrated the highest.

CONCLUSION

Employing post-hoc statistical evaluations, a pronounced disparity in the mean gingival index was discerned favoring the chlorhexidine (CHX) and HO groups over the NS group. No statistical significance was detected in the comparative mean gingival index between the CHX and HO cohorts. This pattern of findings was paralleled in the plaque index assessments, where the NS group's values were significantly elevated relative to those of both the CHX and HO groups.

Novel Flowchart Guiding the Non-Surgical and Surgical Management of Peri-Implant Complications: A Narrative Review

Peri-implant diseases, such as peri-implant mucositis and peri-implantitis, are induced by dysbiotic microbiota resulting in the inflammatory destruction of peri-implant tissue. Nonetheless, there has yet to be an established protocol for the treatment of these diseases in a predictable manner, although many clinicians and researchers have proposed various treatment modalities for their management. With the increase in the number of reports evaluating the efficacy of various treatment modalities and new materials, the use of multiple decontamination methods to clean infected implant surfaces is recommended; moreover, the use of hard tissue laser and/or air abrasion techniques may prove advantageous in the future. Limited evidence supports additional effects on clinical improvement in antimicrobial administration for treating peri-implantitis. Implantoplasty may be justified for decontaminating the implant surfaces in the supracrestal area. Surgical treatment is employed for advanced peri-implantitis, and appropriate surgical methods, such as resection therapy or combination therapy, should be selected based on bone defect configuration. This review presents recent clinical advances in debridement methods for contaminated implant surfaces and regenerative materials for treating peri-implant bone defects. It also proposes a new flowchart to guide the treatment decisions for peri-implant disease.

Assessment of salivary alpha amylase and mucin-4 before and after non-surgical treatment of peri-implant mucositis

BACKGROUND

The present study was based on the null hypothesis that there is no difference in clinicoradiographic parameters and whole salivary alpha amylase (AA) and mucin-4 levels before and after non-surgical mechanical debridement (NSMD) of patients with peri-implant mucositis (PM). The aim was to assess whole salivary AA and mucin-4 levels before and after treatment of PM.

METHODS

Patients with PM (Group-1) and individuals without peri-implant diseases (Group-2) were included. Demographic data was collected and peri-implant modified plaque and bleeding indices (mPI and mBI, respectively), probing depth (PD) and crestal bone loss were measured at baseline. Levels of AA and mucin-4 were assessed in unstimulated whole saliva samples. All patients underwent full-mouth non-surgical periodontal therapy (NSPT) and NSMD; and clinical parameters and salivary biomarkers were re-assessed after 3 months. Level of significance was set at P < 0.01.

RESULTS

Twenty-six and 32 individuals were included in groups 1 and 2, respectively. None of the participants had periodontitis. At baseline clinical periodontal parameters (PI [P < 0.001], GI [P < 0.001], clinical AL [P < 0.001] and PD [P < 0.001]) were significantly high in Group-1 than Group-2. At 3-month follow-up, there was a statistically significant reduction in clinical periodontal and peri-implant parameters (PI [P < 0.01], GI [P < 0.01], and PD [P < 0.01]) in Group-1 compared with their baseline values. At baseline, salivary AA levels were significantly high in Group-1 than Group-2 (P < 0.01). At 3-month follow-up, there was no significant difference in whole salivary AA levels among patients in groups 1 and 2.

CONCLUSIONS

The AA and mucin-4 levels are potential biomarkers for evaluation of peri-implant diseases including PM. Mechanical instrumentation continues to be the most predictable treatment option for the management of peri-implant diseases.