Alcohol-free mouthrinse solutions to reduce supragingival plaque regrowth and vitality. A controlled clinical study.
BACKGROUND
The aim of this study was to evaluate the clinical and antibacterial properties of alcohol-free mouthrinses, an amine fluoride/stannous fluoride mouthrinse (ASF) and two triclosan solutions in comparison with a chlorhexidine and a placebo rinse.


METHODS
In a double-blind, randomised 5-cell cross-over 4-day plaque regrowth study, 19 volunteers rinsed 2 x a day with 15 ml of each of the distributed solutions. Each test cycle was followed by a 10 days wash-out period. On day 0 of each test week, volunteers received a dental prophylaxis. Thereafter they refrained from all mechanical oral hygiene procedures for the next four days. Plaque regrowth was assessed daily by the plaque index and on day 4 by calculating the plaque area with a computer program after disclosure and photography of the front teeth. The vitality of the plaque was examined on days 1 to 4 by the vital fluorescence technique.


RESULTS
19 participants completed the study. Compared to the placebo the ASF solution showed 15.7% (p>0.5), 30.6% (p<0.001), 40.5% (p<0.001) and 44.7% (p<0.001) reductions on the consecutive days 14 in plaque index and a reduction of 61.9% in plaque area. The decrease of vitality of supragingival plaque was highly significant compared to placebo on every test day ranging between 30.9% and 36.6%. A reduction in plaque index from 19.4% (p<0.01) on day 2, 34.9% (p<0.001) on day 3 and 40.4% (p<0.001) on day 4 concommitant with a reduction in plaque area of 48.9% (p<0.001) was noted for alcohol-free chlorhexidine. Concerning the vitality chlorhexidine reduced the percentage of vital bacteria significantly on every day (16.0% to 24.9%). The reductions in mean plaque index for the 0.15% triclosan solution during the test period were 6.3%, 22.4%, 24.6% and 36% and in plaque area 41.8%. Vitality was significantly reduced at every day compared to placebo. Plaque Index reduction with the 0.02% triclosan increased from 15.3% (day 2) to 31.0% (day 4) and a reduction of 23.6% was seen in plaque area. A significant effect concerning the vitality of the plaque was only found at the first and the last day of the test cycle.


CONCLUSIONS
Alcohol-free mouthrinse solutions were shown to be effective in reducing both plaque accumulation and plaque biofilm vitality compared to a placebo solution.
Arweiler
N B
NB
Department of Periodontology and Conservative Dentistry, University of the Saarland, Homburg, Germany. zmknarw@med-rz.uni-sb.de
Netuschil
L
L
Reich
E
E
D000328:Adult; D000704:Analysis of Variance; D018441:Biofilms / Q000187:drug effects; D002327:Cariostatic Agents / Q000627:therapeutic use; D002710:Chlorhexidine / Q000627:therapeutic use; D018592:Cross-Over Studies; D003773:Dental Plaque / Q000517:prevention & control*; D004311:Double-Blind Method; D004338:Drug Combinations; D000431:Ethanol; D005260:Female; D005460:Fluorides, Topical / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000737:chemistry* / Q000494:pharmacology / Q000627:therapeutic use*; D018709:Statistics, Nonparametric; D014002:Tin Fluorides / Q000627:therapeutic use; D014260:Triclosan / Q000627:therapeutic use
D002327:Cariostatic Agents; D004338:Drug Combinations; D005460:Fluorides, Topical; D009067:Mouthwashes; D014002:Tin Fluorides; C094808:amine fluoride solution; D000431:Ethanol; D014260:Triclosan; D002710:Chlorhexidine