十六烷基氯化吡啶和精油漱口水在减少牙菌斑和牙龈炎方面疗效的比较评价：一项系统评价和荟萃分析
Comparative evaluation of the efficacy of cetylpyridinium chloride and essential oil mouthwashes in reducing plaque and gingivitis: a systematic review and meta-analysis.
作者信息
Mohapatra Subhashree, Mohandas Rahul
机构信息
Department of Public Health Dentistry, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India.
Department of Oral and Maxillofacial Pathology and Oral Microbiology, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, 411018, India.
出版信息
Evid Based Dent. 2025 May 24. doi: 10.1038/s41432-025-01163-2.
BACKGROUND
Despite being the gold standard for chemical plaque treatment, chlorhexidine digluconate (CHX) mouthwash has adverse effects that make it necessary to use alternatives. Essential oil (EO) and cetylpyridinium chloride (CPC) mouthwashes effectively reduce plaque and gingivitis. Hence, the aim of this review is to assess and compare the available data on the efficacy of CPC and EO mouthwashes in reducing plaque and gingivitis.
METHODS
Scopus, PubMed, Cochrane, Science Direct, EBSCOhost, Lilacs, Science Direct, Web of Science, and Google Scholar were searched from the earliest available year (1990) till January 10, 2025. PICO Strategy: P: Individuals with plaque and gingivitis; I: CPC mouthwash; C: EO mouthwash; O: Reduction in plaque and gingivitis. The review only comprised randomised controlled trials. The risk of bias assessment and quality of evidence were assessed using the RoB-2 Tool and GRADE Tool respectively.
RESULTS
After meeting the eligibility requirements, seven full-text publications were assessed for qualitative synthesis and six articles for quantitative synthesis. Overall, there was no significant difference in the reduction of plaque and gingivitis between CPC and EO mouthwashes. At two weeks, however, EO demonstrated a greater reduction in gingivitis (SMD: 4.67 [4.08, 5.26]; p < 0.00001; I² = 0%). Both mouthwashes were equally effective at reducing plaque and gingivitis at one, three, and six months.
CONCLUSION
While CPC mouthwash matched EO mouthwash's long-term efficacy, EO mouthwash demonstrated superior short-term anti-gingivitis effects. Both were equally successful in reducing plaque. Depending on the needs of the patient, either can be utilized because of their distinct mechanism of action. Additional research should be done to reduce bias and enhance the methodology.
PROSPERO REGISTRATION NO
CRD42025638243.
背景
尽管葡萄糖酸氯己定（CHX）漱口水是化学菌斑治疗的金标准，但其存在不良反应，因此有必要使用替代品。精油（EO）漱口水和西吡氯铵（CPC）漱口水能有效减少菌斑和牙龈炎。因此，本综述的目的是评估和比较CPC漱口水和EO漱口水在减少菌斑和牙龈炎方面的现有数据。
方法
检索了Scopus、PubMed、Cochrane、Science Direct、EBSCOhost、Lilacs、Science Direct、Web of Science和谷歌学术，检索时间从最早可获取年份（1990年）至2025年1月10日。PICO策略：P：患有菌斑和牙龈炎的个体；I：CPC漱口水；C：EO漱口水；O：减少菌斑和牙龈炎。本综述仅纳入随机对照试验。分别使用RoB-2工具和GRADE工具评估偏倚风险和证据质量。
结果
在满足纳入标准后，对7篇全文出版物进行了定性综合评估，对6篇文章进行了定量综合评估。总体而言，CPC漱口水和EO漱口水在减少菌斑和牙龈炎方面无显著差异。然而，在两周时，EO漱口水在减少牙龈炎方面效果更显著（标准化均数差：4.67[4.08,5.26]；p<0.00001；I²=0%）。在1个月、3个月和6个月时，两种漱口水在减少菌斑和牙龈炎方面效果相当。
结论
虽然CPC漱口水在长期疗效上与EO漱口水相当，但EO漱口水在短期抗牙龈炎方面效果更佳。两者在减少菌斑方面同样成功。根据患者需求，由于其作用机制不同，两者均可使用。应开展更多研究以减少偏倚并改进方法。
PROSPERO注册号：CRD420256
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