The effect of cetylpyridinium chloride mouthrinse as adjunct to toothbrushing compared to placebo on interproximal plaque and gingival inflammation—a systematic review with meta-analyses.

Objectives: The present study aimed to systematically review the literature about the interproximal anti-plaque and anti-gingivitis efficacy of cetylpyrydinium chloride (CPC) mouthrinse compared to placebo solution. Materials and methods: Three databases (PUBMED, SCOPUS, and EMBASE) were searched for randomized clinical trials that compared the interproximal anti-plaque and anti-gingivitis effect of CPC and placebo mouthrinses as an adjunct to toothbrushing, after a minimum of 6 weeks. Individuals with any periodontal diagnosis were considered. Two meta-analyses were performed for the Turesky modification of the Quigley-Hein plaque index and the Löe and Silness gingival index. For both analyses, the mean differences (MD) between baseline and 6-weeks were calculated using a random-effect model. Results: Eight studies were included. All included studies showed significant improvement in at least one of the parameters, favoring the CPC mouthrinse when compared to placebo. The meta-analysis demonstrated that groups that used CPC displayed a significantly greater reduction in the plaque index score (MD; 95% confidence interval [95%CI]: − 0.70; − 0.83 to − 0.57) and in the gingival index (MD; 95%CI: − 0.38; − 0.47 to − 0.28) when compared to placebo. However, high heterogeneity was observed in both analyses (I2 = 89% and I2 = 98%, respectively). Conclusions: When considering interproximal surfaces, CPC is efficacious both in plaque and gingival inflammatory parameters, demonstrating the potential to compensate for the limitations of interproximal plaque control. Clinical relevance: CPC may be a good alternative to compensate interproximal plaque removal, improving interproximal gingivitis [ABSTRACT FROM AUTHOR]