Windhorst Emmy Rowan, Joosstens Maud, van der Sluijs Eveline, Slot Dagmar Else
Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
Int J Dent Hyg. 2025 Jun 18. doi: 10.1111/idh.12916.
To evaluate the effectiveness of cetylpyridinium chloride (CPC) and chlorhexidine (CHX) mouthwashes (MW) on plaque and gingivitis scores for patients with gingivitis, in brushing as well as non-brushing situations.
A comprehensive search of MEDLINE-PubMed and Cochrane-CENTRAL was conducted to identify clinical and randomised controlled trials comparing CPC and CHX mouthwashes on plaque and gingivitis scores. The staining index was evaluated as a secondary outcome. In addition, the risk of bias was assessed. The data was summarised using a descriptive approach, and whenever possible, a meta-analysis was conducted. The results for brushing and non-brushing studies were presented separately. Grading was applied using the GRADE approach to rate the certainty of evidence.
The search resulted in 424 unique papers, from which 14 full-text papers providing 18 comparisons were selected. Different concentrations of CPC-MW (0.1%, 0.075%, 0.05%) and CHX-MW (0.2%, 0.12%) were used. The risk of bias was estimated to be low, moderate or high for each study. A meta-analysis for non-brushing models showed a significant favour for CHX-MW in plaque index scores (0.55 [95% CI: 0.19; 0.91], p = 0.003). For brushing, no significant differences were found between CPC-MW and CHX-MW. The descriptive analysis supports these findings. CHX-MW tends to stain more than CPC-MW.
There is moderate certainty for a small statistically significant favourable effect of CHX-MW over CPC-MW for plaque control in non-brushing situations, but no difference between them for plaque and gingivitis prevention in brushing situations.
评估十六烷基氯化吡啶（CPC）和氯己定（CHX）漱口水对牙龈炎患者在刷牙和不刷牙情况下牙菌斑及牙龈炎评分的效果。
全面检索MEDLINE - PubMed和Cochrane - CENTRAL，以确定比较CPC和CHX漱口水对牙菌斑及牙龈炎评分的临床和随机对照试验。将染色指数作为次要结果进行评估。此外，评估偏倚风险。采用描述性方法汇总数据，并尽可能进行荟萃分析。分别呈现刷牙和不刷牙研究的结果。使用GRADE方法进行分级以评估证据的确定性。
检索得到424篇独特论文，从中选择了14篇全文论文，提供了18项比较。使用了不同浓度的CPC漱口水（0.1%、0.075%、0.05%）和CHX漱口水（0.2%、0.12%）。估计每项研究的偏倚风险为低、中或高。对不刷牙模型的荟萃分析显示，CHX漱口水在牙菌斑指数评分方面显著优于CPC漱口水（0.55 [95%CI：0.19；0.91]，p = 0.003）。对于刷牙情况，CPC漱口水和CHX漱口水之间未发现显著差异。描述性分析支持这些结果。CHX漱口水比CPC漱口水更容易导致染色。
对于在不刷牙情况下控制牙菌斑，CHX漱口水比CPC漱口水有小的统计学显著有利效果，证据具有中等确定性，但在刷牙情况下预防牙菌斑和牙龈炎方面两者无差异。
