Use of chlorhexidine as a plaque control measure following surgical treatment of periodontal disease

Abstract

Chlorhexidine mouth rinsing was compared with regularly performed professional tooth cleaning as a plaque control measure during healing following periodontal surgery. Patients (14) were selected for the study. A baseline examination included assessment of oral hygiene status, gingival condition, probing depth and attachment level. In each patient, scaling and root planing was carried out in conjunction with the modified Widman flap procedure including recontouring of alveolar bone irregularities in 2 jaw quadrants. The same procedures without osseous surgery were performed in contralateral jaw quadrants. Seven patients rinsed their mouth with a solution of 0.2% chlorhexidine digluconate twice a day, 2 min each time, for the first 6 mo. after therapy (healing phase). During the same period the remaining 7 patients were recalled every 2 wk for professional tooth cleaning ad modum Axelsson and Lindhe (1974). Following reexamination after 6 mo., all 14 patients were placed on a maintenance care program which included mechanical prophylaxis once every 3 mo. for 18 mo. (maintenance phase). Reexaminations were performed 6, 12 and 24 mo. after completion of initial therapy. Professional tooth cleaning was somewhat more effective as a plaque control measure during healing following surgery than chlorhexidine mouth rinsing. At the end of the healing phase there was a higher frequency of sites with pockets deeper than 4 mm in the patients who rinsed with chlorhexidine, less gain of attachment occurred following chlorhexidine rinsing in pockets with an initial probing depth of > 4 mm and attachment loss in initially shallow pockets was somewhat more pronounced in the patients who rinsed with chlorhexidine. The differences in the effect of the 2 methods of plaque control, however, were small and in most respects diminished in the course of the maintenance phase. Mouth rinsing with chlorhexidine is a proper alternative to plaque control during healing following periodontal surgery.