Comparison of the Effects of Mucosa Tissue Healing with Chlorhexidine Digluconate and Choline Salicylate in Patients Wearing a Removable Prosthetic Restoration-A RCT

Overview

Journal Clin Pract

Publisher MDPI

Specialty General Medicine

Date 2024 Nov 25

PMID 39585012

Authors

Barbara Sekula-Kaminska

Aleksandra Nitecka-Buchta

Mateusz Wojciechowski

Malgorzata Skucha-Nowak

Malgorzata Rymarczyk

Stefan Baron

Affiliations

Soon will be listed here.

Abstract

Background And Objectives: A randomized, double-blind clinical trial was conducted based on the CONSORT study protocol for randomized clinical trials (NCT06531720) to compare the effectiveness of oral mucosa healing properties of 0.2% chlorhexidine digluconate (CHX) and 8.7% choline salicylate (CHS), as well as a control group (CON) with no intervention, in patients with delivered partial removable dentures (PRDs).

Materials And Methods: Patients (n = 27) who were enrolled in the study were healthy subjects according to the inclusion/exclusion criteria, and they received new PRDs to complement Kennedy's class III and IV deficiencies. During the process of adaptation to new prosthetic restorations, OMLs were formed and treated with one of two selected preparations, either CHX = 0.2% or CHS = 8.7%, in relation to the control group (CON). The wound surface area (WSA) (mm) was measured on repeatable intraoral images taken in accordance with the examination protocol on the first control visit on day 1, day 3, day 7, day 10, and day 14 with the assistance of computer software.

Results: There were no statistically significant differences between groups. The fastest effect of WSA complete reduction was observed in the CHX group after 7 days (WAS = 0.78, SD = 1.18) in comparison to CHS = 10 days (WAS = 0.44, SD = 0.90) and CON = 14 days (WAS = 0.22, SD = 0.67). The decrease in the WSA after 7 days of observation was 85.1% in the CHX group, 70.1% in the CHS group, and 59.2% in the CON group.

Conclusions: The WSA decreased most rapidly after 7 days of treatment with 0.2% chlorhexidine digluconate (CHX), slightly more slowly after 10 days of treatment with 8.7% choline salicylate (CHS), and relatively most slowly in the CON group, who were not treated with any topical medication after 14 days. Oral mucosa lesions (OMLs) therapy during the process of adaptation to new removable prosthetic restorations is a very important element supporting the whole process. Topical medications containing 0.2% chlorhexidine digluconate are indicated as adjunctive therapy in the process of the supportive treatment and disinfection of oral mucosa lesions. However, this does not release the dentist from liability for the careful adjustment of the removable prosthetic restoration.

References

Pilloni A, Ceccarelli S, Bosco D, Gerini G, Marchese C, Marini L . Effect of Chlorhexidine Digluconate in Early Wound Healing of Human Gingival Tissues. A Histological, Immunohistochemical and Biomolecular Analysis. Antibiotics (Basel). 2021; 10(10). PMC: 8532903. DOI: 10.3390/antibiotics10101192. View

Graziani F, Izzetti R, Peric M, Marhl U, Nisi M, Gennai S . Early periodontal wound healing after chlorhexidine rinsing: a randomized clinical trial. Clin Oral Investig. 2024; 28(6):354. PMC: 11150287. DOI: 10.1007/s00784-024-05643-0. View

Schulz K, Altman D, Moher D . CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. BMJ. 2010; 340:c332. PMC: 2844940. DOI: 10.1136/bmj.c332. View

Toma A, Fuller J, Willett N, Goudy S . Oral wound healing models and emerging regenerative therapies. Transl Res. 2021; 236:17-34. PMC: 8380729. DOI: 10.1016/j.trsl.2021.06.003. View

Gurav N, Husukale P . Development and Evaluation of Gel Formation for Treatment of Mouth Ulcer. Turk J Pharm Sci. 2023; 20(3):185-197. PMC: 10337022. DOI: 10.4274/tjps.galenos.2022.25968. View

Panchanadikar N, Balasubramanian S, Nirmal L, Haridoss S, Muthu M . Management of oral mucosal lesions in salicylate sensitive stevens-Johnson syndrome - A case report. Indian J Dent Res. 2022; 32(4):537-540. DOI: 10.4103/ijdr.IJDR_322_20. View

Wyganowska-Swiatkowska M, Kotwicka M, Urbaniak P, Nowak A, Skrzypczak-Jankun E, Jankun J . Clinical implications of the growth-suppressive effects of chlorhexidine at low and high concentrations on human gingival fibroblasts and changes in morphology. Int J Mol Med. 2016; 37(6):1594-600. DOI: 10.3892/ijmm.2016.2550. View

Sun H, Chen S, Yang C, Kuang H, Huang Y, He X . Advances in the use of chlorhexidine for periodontitis treatment in diabetic patients: A review. Medicine (Baltimore). 2024; 103(36):e39627. PMC: 11383263. DOI: 10.1097/MD.0000000000039627. View

Berchier C, Slot D, Van der Weijden G . The efficacy of 0.12% chlorhexidine mouthrinse compared with 0.2% on plaque accumulation and periodontal parameters: a systematic review. J Clin Periodontol. 2010; 37(9):829-39. DOI: 10.1111/j.1600-051X.2010.01575.x. View

10.

Wroblewska K, Plewa S, Derezinski P, Muszalska-Kolos I . Choline Salicylate Analysis: Chemical Stability and Degradation Product Identification. Molecules. 2019; 25(1). PMC: 6983192. DOI: 10.3390/molecules25010051. View

11.

Baus-Dominguez M, Aguilera F, Vivancos-Cuadras F, Ferra-Domingo L, Torres-Lagares D, Gutierrez-Perez J . Mucoadhesive Pharmacology: Latest Clinical Technology in Antiseptic Gels. Gels. 2024; 10(1). PMC: 10815608. DOI: 10.3390/gels10010023. View

12.

Khoury Z, Brooks J, Bashirelahi N . What every dentist should know about oral mucosal wound healing. Gen Dent. 2020; 68(6):24-26. View

13.

Hamp S, Rosling B, Lindhe J . Effect of chlorhexidine on gingival wound healing in the dog. A histometric study. J Clin Periodontol. 1975; 2(3):143-52. DOI: 10.1111/j.1600-051x.1975.tb01736.x. View

14.

Madrazo-Jimenez M, Rodriguez-Caballero A, Serrera-Figallo M, Garrido-Serrano R, Gutierrez-Corrales A, Gutierrez-Perez J . The effects of a topical gel containing chitosan, 0,2% chlorhexidine, allantoin and despanthenol on the wound healing process subsequent to impacted lower third molar extraction. Med Oral Patol Oral Cir Bucal. 2016; 21(6):e696-e702. PMC: 5116111. DOI: 10.4317/medoral.21281. View

15.

Gurgan C, Zaim E, Bakirsoy I, Soykan E . Short-term side effects of 0.2% alcohol-free chlorhexidine mouthrinse used as an adjunct to non-surgical periodontal treatment: a double-blind clinical study. J Periodontol. 2006; 77(3):370-84. DOI: 10.1902/jop.2006.050141. View

16.

James P, Worthington H, Parnell C, Harding M, Lamont T, Cheung A . Chlorhexidine mouthrinse as an adjunctive treatment for gingival health. Cochrane Database Syst Rev. 2017; 3:CD008676. PMC: 6464488. DOI: 10.1002/14651858.CD008676.pub2. View

17.

Jadad A, Moore R, Carroll D, Jenkinson C, Reynolds D, Gavaghan D . Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials. 1996; 17(1):1-12. DOI: 10.1016/0197-2456(95)00134-4. View

18.

Solderer A, Kaufmann M, Hofer D, Wiedemeier D, Attin T, Schmidlin P . Efficacy of chlorhexidine rinses after periodontal or implant surgery: a systematic review. Clin Oral Investig. 2018; 23(1):21-32. DOI: 10.1007/s00784-018-2761-y. View

19.

Gkatzonis A, Vassilopoulos S, Karoussis I, Kaminari A, Madianos P, Vrotsos I . A randomized controlled clinical trial on the effectiveness of three different mouthrinses (chlorhexidine with or without alcohol and C31G), adjunct to periodontal surgery, in early wound healing. Clin Oral Investig. 2018; 22(7):2581-2591. DOI: 10.1007/s00784-018-2357-6. View

20.

Kalyani N, Upadya V, Sequeira J . Does Topical Metronidazole-Chlorhexidine Combination Gel Improve Healing of Intraoral Incisions ? A Split-Mouth Comparative Study. J Maxillofac Oral Surg. 2023; 22(1):159-164. PMC: 9871198. DOI: 10.1007/s12663-022-01706-5. View