Department of Periodontology, School of Dental Medicine, National and Kapodistrian University of Athens, 2 Thivon Str, 115 27, Athens, Greece.
Institute of Biosciences and Applications, National Center for Scientific Research "Demokritos", Athens, Greece.
Clin Oral Investig. 2018 Sep;22(7):2581-2591. doi: 10.1007/s00784-018-2357-6. Epub 2018 Feb 2.
The use of chlorhexidine (CHX) with or without alcohol has been recommended for a number of clinical applications. On the other hand, there is a plethora of widely subscribed antiseptics, such as agent C31G (alkyl dimethyl glycine/alkyl dimethyl amine oxide), which has not yet been evaluated postsurgically. The effectiveness of three different mouthrinses (CHX with and without alcohol, C31G) in plaque control and early wound healing was compared postoperatively.
In this, randomized, double-blind, controlled clinical trial 42 patients were allocated to three groups assigned to 2 weeks rinsing after non-regenerative periodontal flap surgery with or without osseous surgery with C31G (group A), alcohol-free CHX 0.12% (group B) or alcohol-based CHX 0.12% (group C). At days 7 and 14, plaque and early wound healing indices were recorded. At day 14, total bacterial counts were estimated utilizing real-time quantitative polymerase chain reaction (qPCR). Statistics included linear and generalized linear mixed models.
At day 7, healing response was not significantly different among groups. At day 14, group A revealed the highest while group C demonstrated the lowest plaque index values (B vs A, odds ratio-OR = 0.18, p = 0.012; C vs A, OR = 0.01, p < 0.001; C vs B, OR = 0.06, p < 0.001). Group C demonstrated the lowest bacterial counts levels at day 14 (38.470 × 10, 48.190 × 10, and 3.020 × 10 for groups A, B, and C, respectively). At day 14, healing was significantly better in group C compared to B (p = 0.007). Group A showed no significant differences compared to other groups.
(1) The presence of alcohol may increase the effectiveness of CHX in early wound healing, (2) C31G might be an alternative solution prescribed during early postoperative period after non-regenerative periodontal flap surgery.
The present study found that active agent C31G displayed no significant differences to CHX formulations regarding periodontal wound healing improvement and might be used alternatively after non-regenerative periodontal flap surgery. In addition, an alcohol based 0.12% CHX mouthwash was more effective than an alcohol-free 0.12% CHX and C31G mouthrinse on plaque control in the absence of mechanical oral hygiene.
氯己定（CHX）与酒精联合使用或单独使用已被推荐用于许多临床应用。另一方面，有大量广泛使用的防腐剂，如 C31G（烷基二甲基甘氨酸/烷基二甲基氧化胺），但尚未在术后进行评估。本研究比较了三种不同漱口液（含酒精和不含酒精的 CHX、C31G）在控制菌斑和早期伤口愈合方面的效果。
在这项随机、双盲、对照临床试验中，42 名患者被分配到三组：非再生性牙周翻瓣手术后 2 周内分别使用 C31G（A 组）、不含酒精的 0.12%CHX（B 组）或含酒精的 0.12%CHX（C 组）漱口。在第 7 天和第 14 天，记录菌斑和早期伤口愈合指数。在第 14 天，利用实时定量聚合酶链反应（qPCR）估计总细菌计数。统计分析包括线性和广义线性混合模型。
第 7 天，各组之间的愈合反应无显著差异。第 14 天，A 组的菌斑指数值最高，而 C 组的菌斑指数值最低（B 与 A 相比，比值比-OR=0.18，p=0.012；C 与 A 相比，OR=0.01，p<0.001；C 与 B 相比，OR=0.06，p<0.001）。C 组第 14 天的细菌计数水平最低（A、B、C 组分别为 3.020×10、48.190×10 和 38.470×10）。第 14 天，C 组的愈合情况明显优于 B 组（p=0.007）。A 组与其他组之间无显著差异。
（1）酒精的存在可能会增加 CHX 在早期伤口愈合中的效果；（2）C31G 可能是一种替代方案，可在非再生性牙周翻瓣手术后的早期术后阶段使用。
本研究发现，活性成分 C31G 在改善牙周伤口愈合方面与 CHX 制剂无显著差异，在非再生性牙周翻瓣手术后可替代使用。此外，与不含酒精的 0.12%CHX 和 C31G 漱口水相比，含酒精的 0.12%CHX 漱口水在不进行机械口腔卫生的情况下对菌斑控制更有效。
