title: Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: a systematic review.
abstract: OBJECTIVE
  To systematically evaluate the efficacy of chlorhexidine (CHX) mouthrinses on plaque, gingival inflammation and staining in gingivitis patients.
  
  
  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.
authors.affiliation: Department of Periodontology, Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands. d.v.strydonck@telenet.be
authors.forename: Daniëlle A C
authors.initials: DA
authors.lastname: Van Strydonck
authors.forename: Dagmar E
authors.initials: DE
authors.lastname: Slot
authors.forename: Ubele
authors.initials: U
authors.lastname: Van der Velden
authors.forename: Fridus
authors.initials: F
authors.lastname: Van der Weijden
mesh_terms: D002710:Chlorhexidine / Q000009:adverse effects / Q000627:therapeutic use*; D003773:Dental Plaque / Q000517:prevention & control*; D005891:Gingivitis / Q000188:drug therapy*; D006801:Humans; D009067:Mouthwashes / Q000009:adverse effects / Q000627:therapeutic use*; D009910:Oral Hygiene; D017063:Outcome Assessment, Health Care; D014075:Tooth Discoloration / Q000209:etiology*
chemical_list: D009067:Mouthwashes; D002710:Chlorhexidine