The clinical evaluation of Vi-one chlorhexidine mouthwash on plaque-induced gingivitis

A double-blind randomized clinical trial

Authors

  • Marzyeh Omidbakhsh Dental Student, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran

Keywords:

Mouthwashes, Chlorhexidine, Gingivitis, Periodontal index, Thymol

Abstract

Background: Chlorhexidine (CHX) is the most effective antiseptic mouthwash to date. Essential oil such as thymol, have inhibitory and biocidal effects a range of bacteria. 

Objective: To determine the effect of mouthwash containing CHX and thymol on plaque induced gingivitis.

Methods: This double-blind randomized clinical trial study was performed on 60 patients with plaque induced gingivitis who were randomly divided into two groups: Group I (CHX/thymol mouthwash-Vi-one) and Group II (CHX mouthwash-Behsa). Patients in each group underwent scaling and root planning and polishing, then were educated about BASS-Method brushing, and were recommended Oral-B toothbrushes and Pooneh toothpaste. The two groups were asked to rinse their mouths for 60 seconds twice a day, once in the morning and once at night, after brushing their teeth. Plaque index, gingival index, bleeding index and stain index were evaluated at baseline and 14 days later in Ramfjord teeth. Data analysis was conducted using SPSS version 21. Independent-samples t-test and paired-samples t-test were used for data analysis. 

Results: The results showed that plaque index and gingival index significantly reduced in two groups (p<0.001). However, group I was significantly more efficient than group II (p<0.001, p=0.021 respectively). Similar results were observed in terms of bleeding index with the difference that the two groups did not differ significantly from each other (p=0.879). Both groups significantly increased the stain index. No remarkable difference was also observed between the two groups (p=0.754).

Conclusion: Based on the results of this study, we can conclude that the CHX/thymol mouthwash can be offered to patients with dental plaque-induced gingivitis, because it appears to be more effective in controlling dental plaque and gingivitis.

Trial registration: The trial was registered at the Iranian Registry of Clinical Trials (http://www.irct.ir) with the

Irct ID: IRCT201602231760N45.

Funding: This study was part of a thesis and research project (Grant No: 9440921) supported and funded by Babol University of Medical Sciences. The authors received no financial support from Behsa pharmaceutical company (Behsa mouthwash manufacturer) or Rojin cosmetic laboratory (Vi-one mouthwash manufacturer) for this study.

References

Jose A, Butler A, Payne D, Maclure R, Rimmer P, Bosma ML. A randomised clinical study to evaluate the

efficacy of alcohol-free or alcohol-containing mouthrinses with chlorhexidine on gingival bleeding. British

dental journal. 2015;219(3):125-30. Doi: 10.1038/sj.bdj.2015.592, PMID:26271869.

Kumar S, Patel S, Tadakamadla J, Tibdewal H, Duraiswamy P, Kulkarni S. Effectiveness of a mouthrinse

containing active ingredients in addition to chlorhexidine and triclosan compared with chlorhexidine and

triclosan rinses on plaque, gingivitis, supragingival calculus and extrinsic staining. Int J Dent Hyg.

;11(1):35-40. Doi: 10.1111/j.1601-5037.2012.00560.x, PMID:22672130.

Aspalli S, Shetty VS, Devarathnamma MV, Nagappa G, Archana D, Parab P. Evaluation of antiplaque and

antigingivitis effect of herbal mouthwash in treatment of plaque induced gingivitis: A randomized, clinical

trial. Journal of Indian Society of Periodontology. 2014;18(1):48-52. Doi: 10.4103/0972-124X.128208,

PMID: 24744544.

Bhate D, Jain S, Kale R, Muglikar S. The comparative effects of 0.12% chlorhexidine and herbal oral rinse

on dental plaque-induced gingivitis: A randomized clinical trial. Journal of Indian Society of

Periodontology. 2015;19(4):393-5. Doi: 10.4103/0972-124X.153478, PMID: 26392686.

Najafi MH, Taheri M, Mokhtari MR, Forouzanfar A, Farazi F, Mirzaee M, et al. Comparative study of

2% and 0.12% digluconate chlorhexidine mouth rinses on the level of dental staining and gingival

indices. Dental research journal. 2012;9(3):305-8. PMID: 23087736.

Leyes Borrajo JL, Garcia VL, Lopez CG, Rodriguez-Nunez I, Garcia FM, Gallas TM. Efficacy of

chlorhexidine mouthrinses with and without alcohol: a clinical study. J Periodontol. 2002;73(3):317-21.

Doi: 10.1902/jop.2002.73.3.317, PMID: 11924590.

Quirynen M, Avontroodt P, Peeters W, Pauwels M, Coucke W, van Steenberghe D. Effect of different

chlorhexidine formulations in mouthrinses on de novo plaque formation. Journal of clinical periodontology.

;28(12):1127-36. PMID: 11737510.

Van Strydonck DA, Slot DE, Van der Velden U, Van der Weijden F. Effect of a chlorhexidine mouthrinse

on plaque, gingival inflammation and staining in gingivitis patients: a systematic review. Journal of clinical

periodontology. 2012;39(11):1042-55. Doi: 10.1111/j.1600-051X.2012.01883.x, PMID: 22957711.

Mor-Reinoso C, Pascual A, Nart J, Quirynen M. Inhibition of de novo plaque growth by a new 0.03 %

chlorhexidine mouth rinse formulation applying a non-brushing model: a randomized, double blind clinical

trial. Clinical oral investigations. 2016;20(7):1459-67. Doi: 10.1007/s00784-015-1625-y, PMID: 26475499.

Zanatta FB, Antoniazzi RP, Rosing CK. Staining and calculus formation after 0.12% chlorhexidine rinses

in plaque-free and plaque covered surfaces: a randomized trial. Journal of applied oral science : revista

FOB. 2010;18(5):515-21. PMID: 21085810.

Charles CH, Mostler KM, Bartels LL, Mankodi SM. Comparative antiplaque and antigingivitis

effectiveness of a chlorhexidine and an essential oil mouthrinse: 6-month clinical trial. Journal of clinical

periodontology. 2004;31(10):878-84. Doi: 10.1111/j.1600-051X.2004.00578.x, PMID:15367192.

Osso D, Kanani N. Antiseptic mouth rinses: an update on comparative effectiveness, risks and

recommendations. Journal of dental hygiene : JDH / American Dental Hygienists' Association.

;87(1):10-8. PMID: 23433693.

Pan PC, Harper S, Ricci-Nittel D, Lux R, Shi W. In-vitro evidence for efficacy of antimicrobial

mouthrinses. Journal of dentistry. 2010;38 Suppl 1:S16-20. Doi: 10.1016/S0300-5712(10)70006-3, PMID:

Parikh-Das AM, Sharma NC, Du Q, Charles CA. Superiority of essential oils versus 0.075% CPC- containing mouthrinse: a two-week randomized clinical trial. The Journal of clinical dentistry.

;24(3):94-9. PMID: 24660271.

www.rojin-cosmetic.ir

Ghasemi M, Janab H, Valaei N. Anti-Plaque Efficacy of Chlorhexidine Mouthrinses With and without

Alcohol. Res Dent Sci. 2014;10(4):211-7.

Papaioannou W, Vassilopoulos S, Vrotsos I, Margaritis V, Panis V. A comparison of a new alcohol-free

2% chlorhexidine oral rinse to an established 0.2% chlorhexidine rinse with alcohol for the control of

dental plaque accumulation. Int J Dent Hyg. 2015. Doi: 10.1111/idh.12182, PMID: 26449740.

Todkar R, Sheikh S, Byakod G, Muglikar S. Efficacy of chlorhexidine mouthrinses with and without

alcohol - a clinical study. Oral health & preventive dentistry. 2012;10(3):291-6. PMID: 23094273.

Neely AL. Essential oil mouthwash (EOMW) may be equivalent to chlorhexidine (CHX) for long-term

control of gingival inflammation but CHX appears to perform better than EOMW in plaque control. The

journal of evidence-based dental practice. 2012;12(3 Suppl):69-72. Doi: 10.1016/S1532-3382(12)70017-9,

PMID: 23253835.

Shu C, Sun L, Zhang W. Thymol has antifungal activity against Candida albicans during infection and

maintains the innate immune response required for function of the p38 MAPK signaling pathway in

Caenorhabditis elegans. Immunologic research. 2016;64(4):1013-24. Doi: 10.1007/s12026-016-8785-y,

PMID: 26783030.

Cosyn J, Wyn I, De Rouck T, Moradi Sabzevar M. Clinical benefits of subgingival chlorhexidine varnish

application as an adjunct to same-day full-mouth root planing: a pilot study. J Periodontol.

;77(6):1074-9. Doi: 10.1902/jop.2006.050220, PMID: 16734584.

Marchese A, Orhan IE, Daglia M, Barbieri R, Di Lorenzo A, Nabavi SF, et al. Antibacterial and antifungal

activities of thymol: A brief review of the literature. Food chemistry. 2016;210:402-14. Doi:

1016/j.foodchem.2016.04.111, PMID: 27211664.

Walsh SE, Maillard JY, Russell AD, Catrenich CE, Charbonneau DL, Bartolo RG. Activity and

mechanisms of action of selected biocidal agents on Gram-positive and -negative bacteria. Journal of

applied microbiology. 2003;94(2):240-7. PMID: 12534815.

Botelho MA, Nogueira NA, Bastos GM, Fonseca SG, Lemos TL, Matos FJ, et al. Antimicrobial activity of

the essential oil from Lippia sidoides, carvacrol and thymol against oral pathogens. Brazilian journal of

medical and biological research = Revista brasileira de pesquisas medicas e biologicas / Sociedade

Brasileira de Biofisica [et al]. 2007;40(3):349-56. PMID: 17334532.

Didry N, Dubreuil L, Pinkas M. Activity of thymol, carvacrol, cinnamaldehyde and eugenol on oral

bacteria. Pharmaceutica acta Helvetiae. 1994;69(1):25-8. PMID: 7938073.

Takeuchi Y, Guggenheim B, Filieri A, Baehni P. Effect of chlorhexidine/thymol and fluoride varnishes on

dental biofilm formation in vitro. European journal of oral sciences. 2007;115(6):468-72. Doi:

1111/j.1600-0722.2007.00493.x, PMID: 18028054.

Yucel-Lindberg T, Twetman S, Skold-Larsson K, Modeer T. Effect of an antibacterial dental varnish on the

levels of prostanoids, leukotriene B4, and interleukin-1 beta in gingival crevicular fluid. Acta odontologica

Scandinavica. 1999;57(1):23-7. PMID: 10207532.

Filoche SK, Soma K, Sissons CH. Antimicrobial effects of essential oils in combination with chlorhexidine

digluconate. Oral microbiology and immunology. 2005;20(4):221-5. Doi: 10.1111/j.1399- 302X.2005.00216.x, PMID: 15943766

Published

2022-02-12