Mechanical control of biofilm by the dental clinic practitioner, as well as by the patient, together with an adjunctive chlorhexidine and cetylpyridinium chloride-based mouthwash, may improve clinical outcomes in patients with peri-implant mucositis. 

Pulcini A, Bollaín J, Sanz-Sánchez I, Figuero E, Alonso B, Sanz M, Herrera D. Clinical effects of the adjunctive use of a 0.03% chlorhexidine and 0.05% cetylpyridinium chloride mouth rinse in the management of peri-implant diseases: a randomized clinical trial. J Clin Periodontol 2019 Mar; 46 (3): 342-353. 

INTRODUCTION 

Peri-implant Mucositis (PiM) is very common and there is published evidence of its treatment through mechanical control of biofilm and adjuvant chemical antimicrobials. 

The use of low concentration chlorhexidine (CHX) mouthwashes, combined with cetylpyridinium chloride (CPC) has not been previously tested in PiM management. 

AIM 

To evaluate the efficacy in the treatment of PiM of a 0.03% CHX and 0.05% CPC mouthrinse as a complement to the mechanical removal of plaque performed by both the professional during maintenance visits and by the patient daily. 

MATERIAL & METHODS 

This randomised, double-blind clinical trial included patients who showed PiM in at least one implant. 

The subjects received professional prophylaxis at the beginning of the trial and after six months and were instructed on regular oral hygiene and rinsing practices with the test product or with placebo mouthwash, twice a day and for one year. 

Clinical, radiographic and microbiological results were evaluated at the beginning of the study, after six months and after twelve months. The resolution of the disease was defined as the absence of Bleeding on Probing (BOP). 

Data were analysed applying repeated measures ANOVA (Analysis of Variance), Student's t and chi-square test. 

RESULTS & DISCUSSION 

The trial included 54 patients, of which 46 attended the final visit (22 in the control group and 24 in the test group). The test group showed a 24.49% greater reduction in BOP at the vestibular sites (95% confidence interval [3.65-45.34%]; p = 0.002) than the controls. 58.3% of the implants in the test group and 50% of those in the control group showed healthy peri-implant tissues at the final visit (p> 0.05). 

CONCLUSION 

The use of the test mouthwash showed some additional benefits in the treatment of PiM. The complete resolution of the disease could not be achieved in all cases.