Pizzo Giuseppe, Guiglia Rosario, La Cara Monica, Giuliana Giovanna, D'Angelo Matteo
Department of Oral Sciences, Section of Periodontology, University of Palermo, Palermo, Italy.
J Periodontol. 2004 Jun;75(6):852-7. doi: 10.1902/jop.2004.756852.
Chlorhexidine (CHX)-containing mouthrinses are recommended as adjuncts to mechanical oral hygiene. The problem associated with side effects, however, has stimulated the search for alternative antiplaque agents. The aim of this study was to investigate the plaque inhibitory effects of two mouthrinses containing amine fluoride/stannous fluoride (ASF) and antimicrobial host proteins (lactoperoxidase, lysozyme and lactoferrin; LLL), respectively.
The study was an observer-masked, randomized 4x4 Latin square cross-over design balanced for carryover effects, involving 12 healthy volunteers in a 4-day plaque regrowth model. A 0.12% CHX mouthrinse and a saline solution served as positive and negative controls, respectively. On day 1, subjects received professional prophylaxis, suspended oral hygiene measures, and commenced rinsing with their allocated rinses. On day 5, subjects were scored for disclosed plaque.
The ASF rinse showed a significant inhibition of plaque regrowth in comparison to both saline and LLL solutions, but the lowest plaque indices were obtained with the CHX formulation (P<0.01). There were no significant differences between LLL rinse and saline (P>0.05). Such pattern of efficacy was the same in anterior and posterior teeth and in vestibular and lingual surfaces as well, with the exception of the lingual anterior surfaces. In these sites, differences between the CHX and ASF rinses were not significant (P>0.05). A significantly higher prevalence of side effects was found in subjects using the CHX product (P<0.0042).
Although the effect on plaque regrowth observed with 0.12% CHX rinsing was superior to that with ASF, the ASF rinse was not associated with side effects. These findings, together with those from long-term trials, suggest that the ASF rinse may represent an effective alternative to CHX rinse as an adjunct to oral hygiene. On the contrary, the LLL rinse did not significantly inhibit plaque regrowth.
含氯己定(CHX)的漱口水被推荐作为机械口腔卫生措施的辅助手段。然而,与副作用相关的问题促使人们寻找替代的抗牙菌斑剂。本研究的目的是调查分别含有胺氟化物/氟化亚锡(ASF)和抗菌宿主蛋白(乳过氧化物酶、溶菌酶和乳铁蛋白;LLL)的两种漱口水对牙菌斑的抑制作用。
本研究采用观察者盲法、随机4×4拉丁方交叉设计,平衡残留效应,在4天的牙菌斑再生长模型中纳入12名健康志愿者。0.12%的CHX漱口水和生理盐水分别作为阳性和阴性对照。第1天,受试者接受专业洁治,暂停口腔卫生措施,并开始使用分配的漱口水漱口。第5天,对受试者的牙菌斑进行染色评分。
与生理盐水和LLL溶液相比,ASF漱口水对牙菌斑再生长有显著抑制作用,但CHX制剂的牙菌斑指数最低(P<0.01)。LLL漱口水和生理盐水之间无显著差异(P>0.05)。除舌侧前牙表面外,这种疗效模式在前牙和后牙以及前庭和舌侧表面均相同。在这些部位,CHX和ASF漱口水之间的差异不显著(P>0.05)。使用CHX产品的受试者出现副作用的患病率显著更高(P<0.0042)。
尽管观察到0.12%的CHX漱口水对牙菌斑再生长的效果优于ASF漱口水,但ASF漱口水无副作用。这些发现与长期试验的结果一起表明,ASF漱口水可能是CHX漱口水作为口腔卫生辅助手段的有效替代品。相反,LLL漱口水对牙菌斑再生长没有显著抑制作用。