Clinical efficacy of nanosilver and chlorhexidine in the treatment of plaque-induced gingivitis: a randomized controlled clinical trial.

  • Amani Al-sharani Department of Biological and Preventive Sciences, College of Dentistry, University of Sciences and Technology, Yemen.
  • Waddah Al-Hajj Department of Biological and Preventive Sciences, College of Dentistry, University of Sciences and Technology, Yemen.
  • Ahmed Madfa Department of Conservative Dentistry, Faculty of Dentistry, Thamar University, Yemen. Department Restorative and Prostho-dontic, College of Dentistry, University of Science and Technology, Yemen.

Abstract

Aim: The present study aimed to assess the clinical efficacy of nanosilver (NS) mouthwash and compared with chlorhexidine (CHX) mouthwash for the treatment of plaque-induced gingivitis. Materials and methods: Sixty-two (28 males and 34 females) plaque-induced gingivitis patients were allocated into two groups and asked to rinse with 10ml of NS or CHX, immediately after brushing, for 1 min, in the morning and evening. The plaque, gingival, and papilla bleeding indices were taken at baseline, two weeks, and finally at four weeks for each patient. The statistical analysis between and within groups were performed using Mann-Whitney U-test and Wilcoxon signed rank test respectively. Result: Intergroup comparison by Mann-Whitney U-test showed no statistically significant differences in the investigated groups at the baseline for all studied parameters. At 2 and 4 weeks follow up, the CHX group showed statistically significant lower plaque scores than the NS group (p<0.05). However, there is no statistically significant difference between NS and CHX groups for gingival and papilla bleeding scores (p>0.05). Both groups showed statistically significant reductions in plaque, gingival and papilla bleeding scores after 2 weeks and 4 weeks of product use when compared to baseline (p<0.001). Conclusion: Both mouthwashes decreased plaque, gingival and papilla bleeding scores, however the reduction in plaque scores was higher for the CHX group compared to the NS group.

Author Biography

Amani Al-sharani, Department of Biological and Preventive Sciences, College of Dentistry, University of Sciences and Technology, Yemen.
Interim Editor -in- Chief

References

1. Marcotte H, Lavoie MC. Oral microbial ecology and the role of salivary immunoglobulin A. Microbiol Mol Biol Rev. 1998;62(1):71–109.
2. Aruni AW, Dou Y, Mishra A, Fletcher HM. The Biofilm Community-Rebels with a Cause. Curr Oral Health Rep. 2015;2(1):48–56.
3. 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. J Indian Soc Periodontol. 2014;18(1):48–52.
4. Hojo K, Nagaoka S, Ohshima T, Maeda N. Bacterial interactions in dental biofilm development. J Dent Res. 2009;88(11):982–90.
5. Hajishengallis G. Immunomicrobial pathogenesis of periodon-titis: keystones, pathobionts, and host response. Trends Immunol. 2014;35(1):3–11.
6. Priya BM, Galgali SR. Comparison of amine fluoride and chlorhexidine mouth rinses in the control of plaque and gingivitis--a randomized controlled clinical trial. Indian J Dent Res. 2015;26(1):57–62.
7. Mahajan R, Khinda PK, Gill AS, Kaur J, Saravanan SP, Shewale A, Taneja M, Joshi V. Comparison of Efficacy of 0.2% Chlorhexidine Gluconate and Herbal Mouthrinses on Dental Plaque: An in vitro Comparative Study . Eur J Med Plant. 2016;13(2):1–11.
8. Balagopal S, Arjunkumar R. Chlorhexidine: The Gold Standard Antiplaque Agent. J Pharm Sci Res. 2013;5(12):270–4.
9. Graziani F, Gabriele M, D'Aiuto F, Suvan J, Tonelli M, Cei S. Dental plaque, gingival inflammation and tooth -discolouration with different commercial -formulations of 0.2% chlorhexidine rinse: a double-blind randomised controlled clinical trial. Oral Health Prev Dent. 2015;13(2):101–11.
10. Kariminik A, Motaghi MM. Evaluation of Antimicrobial susceptibility pattern of Streptococcus mutans isolated from dental plaques to chlorhexidine, nanosil and common antibiotics. Int J Life Scien. 2015;9(2):18–21.
11. Besinis A, De Peralta T, Handy RD. The antibacterial effects of silver, titanium dioxide and silica dioxide nanoparticles compared to the dental disinfectant chlorhexidine on Streptococcus mutans using a suite of bioassays. Nanotoxicology. 2014;8(1):1–16.
12. Esfahanian V, Mohamadi F, Amini SH. An In Vitro Comparison of Antimicrobial Effect of Nanosil and ChlorhexidineMouthrinses. J Islam Dent Assoc Iran. 2012;24(3):188–92.
13. Mozayeni MA, Hadian A, Bakhshaei P, Dianat O. Comparison of Antifungal Activity of 2% Chlorhexidine, Calcium Hydroxide, and Nanosilver gels against Candida Albicans. J Dent. 2015;12(2):109–17.
14. Ahrari F, Eslami N, Rajabi O, Ghazvini K, Barati S. The antimicrobial sensitivity of Streptococcus mutans and Streptococcus sangius to colloidal solutions of different nanoparticles applied as mouthwashes. Dent Res J. 2015;12(1):44–9.
15. Kripal K, Chandrasekaran K, Rajan S, Reddy SS, Kumar PA, Ajit P, Kotha M, Bhavanam SR. Evaluation of a Herbal Mouthwash (BefreshTM) Versus Chlorhexidine Mouthwash (Clohex Plus): A Prospective Clinical and Microbiological Study. EC Microbiology. 2017;7(6):209–18.
16. Loe H, Silness J. Periodontal disease in pregnancy. I. Prevalence and severity. Acta Odontol Scand. 1963;21:533–51.
17. Farah CS, McIntosh L, McCullough MJ. Mouthwashes. Aust Prescr. 2009;32(6):162–4.
18. Chatterjee A, Debnath K, Rao NKH. A comparative evaluation of the efficacy of curcumin and chlorhexidine mouthrinses on clinical inflammatory parameters of gingivitis: A double-blinded randomized controlled clinical study. J Indian Soc Periodontol. 2017;21(2):132–7.
19. Arora V, Tangade P, TLR, Tirth , Pal S, Tandon V. Efficacy of dental floss and chlorhexidine mouth rinse as an adjunct to toothbrushing in removing plaque and gingival inflammation - a three way cross over trial. J Clin Diagn Res. 2014;8(10):ZC01–4.
20. 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. J Clin Periodontol. 2004;31(10):878–84.
21. Osso D, Kanani N. Antiseptic mouth rinses: an update on comparative effectiveness, risks and recommendations. J Dent Hyg. 2013;87(1):10–8.
22. Jain A, Bhaskar DJ, Gupta D, Agali C, Gupta V, Gupta RK, Yadav P, Lavate AB, Chaturvedi M. Comparative evaluation of honey, chlorhexidine gluconate (0.2%) and combination of xylitol and chlorhexidine mouthwash (0.2%) on the clinical level of dental plaque: A 30 days randomized control trial. Perspect Clin Res. 2015;6(1):53–7.
23. Herrera D. Chlorhexidine mouthwash reduces plaque and gingivitis. Evid Based Dent. 2013;14(1):17–8.
24. Halkai KR, Mudda JA, Shivanna V, Rathod V, Halkai RS. Biosynthesis, Characterization and Antibacterial Efficacy of Silver Nanoparticles Derived from Endophytic Fungi against P. gingivalis. J Clin Diagn Res. 2017;11(9):ZC92–6.
25. Shawky HA, Basha SM, EL Batouti GA, Kassem AA. Evaluation of Clinical and Antimicrobial Efficacy of Silver Nanoparticles and Tetracycline Films in the Treatment of Periodontal Pockets . J Dent Med Sci. 2015;14(7):113–23.
26. Lu Z, Rong K, Li J, Yang H, Chen R. Size-dependent antibacterial activities of silver nanoparticles against oral anaerobic pathogenic bacteria. J Mater Sci Mater Med. 2013;24(6):1465–71.
27. Freire PLL, Albuquerque AJR, Sampaio FC, Galembeck A, Flores MAP, Stamford TCM, Rosenblatt A. AgNPs: The New Allies Against S. Mutans Biofilm - A Pilot Clinical Trial and Microbiological Assay. Braz Dent J. 2017;28(4):417–22.
28. Sadeghi R, Owlia P, Yaraee R, Sharif F, Taleghani F. An in vitro assessment of antimicrobial and cytotoxic effects of nanosilver. J Med Microbiol. 2015;3(4):44–52.
Published
2018-09-19
How to Cite
AL-SHARANI, Amani; AL-HAJJ, Waddah; MADFA, Ahmed. Clinical efficacy of nanosilver and chlorhexidine in the treatment of plaque-induced gingivitis: a randomized controlled clinical trial.. Journal of Oral Research, [S.l.], v. 7, n. 7, p. 238-244, sep. 2018. ISSN 0719-2479. Available at: <http://www.joralres.com/index.php/JOR/article/view/joralres.2018.064>. Date accessed: 15 july 2019. doi: https://doi.org/10.17126/joralres.2018.064.
Section
Articles

Keywords

dental plaque; gingivitis; antimicrobial mouthwash; nanosilver; chlorhexidine.