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.

Abstract

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.

• Authors: Gerson Pedro José Langa, Francisco Wilker Mustafa Gomes Muniz, Ricardo Dos Santos Araújo Costa, Taciane Menezes da Silveira, Cassiano Kuchenbecker Rösing
• Journal: Clinical oral investigations (Clin Oral Investig) Vol. 25 Issue 2 Pg. 745-757 (Feb 2021) ISSN: 1436-3771 [Electronic] Germany
• PMID: 33185736 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Chemical References

• Anti-Infective Agents, Local
• Mouthwashes
• Cetylpyridinium

Topics

• Anti-Infective Agents, Local
• Cetylpyridinium (therapeutic use)
• Dental Plaque Index
• Gingivitis (prevention & control)
• Humans
• Inflammation
• Mouthwashes
• Toothbrushing