Galván M, Gonzalez S, Cohen C L, Alonaizan F A, Chen C T-L, Rich S K, Slots J
Graduate Periodontology Clinic, Ostrow School of Dentistry of USC, Los Angeles, CA, USA.
J Periodontal Res. 2014 Dec;49(6):696-702. doi: 10.1111/jre.12151. Epub 2013 Dec 14.
The study aimed to evaluate the effect of 0.25% sodium hypochlorite twice-weekly oral rinse on plaque and gingivitis in patients with minimally treated periodontitis.
The study included 30 patients with periodontitis, it lasted 3 mo, and it was performed as a randomized, controlled, single-blinded, clinical trial in parallel groups. Fifteen patients rinsed for 30 s with 15 mL of a fresh solution of 0.25% sodium hypochlorite (test) and 15 patients rinsed with 15 mL of water (control). Clorox(®) regular bleach was the source of the sodium hypochlorite. At baseline and at 2 wk, the study patients received professional subgingival irrigation for 5 min with either 0.25% sodium hypochlorite or water, but no subgingival or supragingival scaling. The presence or absence of supragingival plaque on facial and lingual surfaces was determined by visual inspection; each tooth was dried with air and mouth mirror rotation was used to provide light reflection to identify plaque on smooth surfaces and at the tooth line angles. Gingival bleeding within 30 s after probing to full pocket depth was assessed in six sites of each tooth. Adverse events were evaluated by questionnaire and visual examination.
All 30 patients in the study completed the baseline and the 2 wk parts of the study and a subset of 12 participants completed the 3 mo part of the study. The sodium hypochlorite rinse group and the water rinse group, respectively, showed increases from baseline to 3 mo of 94% and 29% (3.2-fold difference) in plaque-free facial surfaces, of 195% and 30% (6.5-fold difference) in plaque-free lingual surfaces, and of 421% and 29% (14.5-fold difference) in number of teeth with no bleeding on probing. The differences in clinical improvement between the sodium hypochlorite rinse group and the water rinse group were statistically significant. No adverse events were identified in any of the study patients, except for minor complaints about the taste of bleach.
A twice-weekly oral rinse with 0.25% sodium hypochlorite produced marked decreases in dental plaque level and bleeding on probing and may constitute a promising new approach to the management of periodontal disease. Long-term controlled studies on the effectiveness of sodium hypochlorite oral rinse are needed and encouraged.
本研究旨在评估每周两次使用0.25%次氯酸钠进行口腔冲洗对轻度牙周炎患者牙菌斑和牙龈炎的影响。
本研究纳入30例牙周炎患者，为期3个月，采用随机、对照、单盲、平行组临床试验。15例患者用15mL新鲜的0.25%次氯酸钠溶液（试验组）冲洗30秒，15例患者用15mL水（对照组）冲洗。次氯酸钠的来源为高乐氏（®）普通漂白剂。在基线期和2周时，研究患者接受用0.25%次氯酸钠或水进行5分钟的专业龈下冲洗，但不进行龈下或龈上洁治。通过视觉检查确定面部和舌面龈上菌斑的有无；每颗牙齿用气吹干，使用口镜旋转提供光反射以识别光滑表面和牙线角处的菌斑。在每颗牙齿的六个部位评估探诊至牙周袋深度后30秒内的牙龈出血情况。通过问卷和视觉检查评估不良事件。
本研究中的所有30例患者均完成了研究的基线期和2周部分，12名参与者的一个子集完成了研究的3个月部分。次氯酸钠冲洗组和水冲洗组从基线到3个月，无菌斑面部表面分别增加了94%和29%（相差3.2倍），无菌斑舌面分别增加了195%和30%（相差6.5倍），探诊时无出血的牙齿数量分别增加了421%和29%（相差14.5倍）。次氯酸钠冲洗组和水冲洗组在临床改善方面的差异具有统计学意义。除了对漂白剂味道的轻微抱怨外，在任何研究患者中均未发现不良事件。
每周两次用0.25%次氯酸钠进行口腔冲洗可显著降低牙菌斑水平和探诊出血，可能构成一种有前景的牙周疾病管理新方法。需要并鼓励对次氯酸钠口腔冲洗效果进行长期对照研究。
