Effectiveness of 0.50% and 0.75% chlorhexidine dentifrices in orthodontic patients: a double-blind and randomized controlled trial.
BACKGROUND
In this double-blind and randomized controlled trial, we analyzed whether a lower concentration of chlorhexidine in dentifrices could reduce the risk of tooth staining without compromising its effectiveness in controlling gingivitis, bleeding, and dental plaque.


METHODS
Volunteers with fixed orthodontic appliances were randomly divided into 3 groups: control, 1100 ppm F, NaF (n = 27); experimental, chlorhexidine 0.50% (n = 27); and experimental, chlorhexidine 0.75% (n = 27). At baseline, and after 6 and 12 weeks, clinical examinations were carried out. Staining, calculus, gingivitis, bleeding, and dental plaque data were analyzed with Friedman tests to evaluate intragroup changes over time. To detect intergroup differences after 12 months, the data were evaluated with Kruskal-Wallis tests. Dunn tests were used in both situations for necessary post-hoc analyses.


RESULTS
The groups were statistically similar for the stain, calculus, and plaque indexes, but there were statistically significant differences for the gingival and bleeding indexes. During the experimental periods, gingivitis and bleeding scores improved in all 3 groups. Only the 0.75% chlorhexidine dentifrice significantly increased the stain index, although most patients did not notice the stains. The intergroup comparison showed a statistically significant better performance of the experimental groups regarding the gingival and bleeding indexes.


CONCLUSIONS
This study suggests that the use of dentifrices with lower concentration of chlorhexidine can reduce the risk of tooth staining without compromising its effectiveness in controlling gingivitis and bleeding in orthodontic patients.
Oltramari-Navarro
Paula Vanessa Pedron
PV
Department of Orthodontics, University of North Paraná, Londrina, Paraná, Brazil. pvoltramari@hotmail.com
Titarelli
Juliana Mára
JM
Marsicano
Juliane Avansini
JA
Henriques
José Fernando Castanha
JF
Janson
Guilherme
G
Lauris
José Roberto Pereira
JR
Buzalaf
Marília Afonso Rabelo
MA
D000293:Adolescent; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000009:adverse effects; D002710:Chlorhexidine / Q000008:administration & dosage / Q000009:adverse effects*; D003773:Dental Plaque / Q000209:etiology / Q000517:prevention & control; D003802:Dentifrices / Q000008:administration & dosage / Q000009:adverse effects* / Q000737:chemistry; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000209:etiology / Q000517:prevention & control; D005891:Gingivitis / Q000209:etiology / Q000517:prevention & control*; D006801:Humans; D009967:Orthodontic Appliances / Q000009:adverse effects*; D009971:Orthodontics, Corrective; D010512:Periodontal Index; D018709:Statistics, Nonparametric; D014075:Tooth Discoloration / Q000139:chemically induced*; D016896:Treatment Outcome; D055815:Young Adult
D000891:Anti-Infective Agents, Local; D003802:Dentifrices; D002710:Chlorhexidine