Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: a systematic review.

Aim To systematically evaluate the efficacy of chlorhexidine ( CHX) mouthrinses on plaque, gingival inflammation and staining in gingivitis patients. Material & Methods Medline, EMBASE and Cochrane Central Register of Controlled Trials were searched through April 2011. Randomized controlled clinical trials comparing CHX to placebo/control mouthrinses or oral hygiene ( OH) ≥4 weeks were included. Results Among 1355 titles, 30 publications fulfilled the selection criteria. Meta-analysis ( MA) showed significant weighted mean differences ( WMD) favouring CHX. This was −0.39 [95% CI: −0.70; −0.08] for the Plaque Index Silness & Löe, −0.67 [95% CI: −0.82; −0.52] for the Plaque-Index Quigley & Hein ( PIQH), −0.32 [95% CI: −0.42; −0.23] for the Gingival Index ( GI), −0.08 [95% CI: −0.10; −0.05] for the bleeding aspect of the GI, −0.21 [95% CI: −0.37; −0.04] for the Papillary BIeeding Index, −0.16 [95% CI: −0.26; −0.07] for Bleeding on Marginal Probing and 0.91 [95% CI: 0.12;1.70] for the Lobene Stain Index. MA of studies with a low risk of author-estimated bias showed a WMD of −0.68 [95% CI: −0.85; −0.51] for the PIQH and −0.24 [95% CI: −0.29; −0.20] for the GI in favour of CHX. Relative to control, the reduction with CHX for plaque was 33% and for gingivitis 26%. CHX rinsing groups demonstrated significantly more staining. Conclusions In gingivitis patients, CHX mouthrinses together with OH versus placebo- or control mouthrinse provide significant reductions in plaque and gingivitis scores, but a significant increase in staining score. [ABSTRACT FROM AUTHOR]