Comparative evaluation of hydrogen peroxide and Chlorhexidine mouthwash on salivary interleukin-1ß levels in patients with type 2 diabetes mellitus and chronic periodontitis: a randomized controlled clinical trial
Abstract
Introduction: Periodontal inflammation causes dysbiosis and change in the microbiota. Nonsurgical periodontal therapy (NSPT) helps in removal of plaque and restoring periodontal health. Various adjunctive therapy like use of mouthwash helps in maintenance of periodontal health and reducing inflammatory load.
Materials and Methods: A total of 108 subjects diagnosed with type 2 diabetes mellitus and periodontitis were divided into three groups: Group 1 received NSPT and rinsing with 0.2% chlorhexidine mouthwash for 3 months, Group 2 received NSPT and rinsing with 1.5% hydrogen peroxide mouthwash for 3 months, Group 3- received NSPT only (control group). The clinical parameters measured included Plaque Index (PI), Gingival Index (GI), Bleeding on probing (BOP) and probing (PD) at baseline, 1, 2, 3 months follow up. Salivary interleukin 1βlevels were measured at baseline and 3 months interval.
Results: Group 1, 2 and 3 showed significant reduction in PI, GI, BOP and PD at 1 and 3 months follow up (p<0.05). However, Intergroup comparison of clinical parameters showed significant reduction in group 1 and 2 when compared with group 3 (p<0.05). Salivary interleukin 1-β levels showed significant reduction from baseline to 3 months in all the three groups and intergroup comparison didn’t show any significant changes, (p>0.05).
Conclusions: Hydrogen peroxide mouthwash as an adjunct to NSPT can be considered as a safe and effective measure to reduce periodontal inflammation in type 2 diabetes mellitus patients with chronic periodontitis.
References
Petrescu SM, Tuculina MJ, Popa DL, Du A, S?lan AI, Voinea Georgescu R, Diaconu OA, Turcu AA, Mocanu H, Nicola AG, Dasculu IT. Modeling and Simulating an Orthodontic System Using Virtual Methods. Diagnostics (Basel). 2022;12(5):1296. https://doi.org/10.3390/diagnostics12051296. PMID: 35626452; PMCID: PMC9141121.
Tepedino M, Cornelis MA, Chimenti C, Cattaneo PM. Correlation between tooth size-arch length discrepancy and interradicular distances measured on CBCT and panoramic radiograph: an evaluation for miniscrew insertion. Dent Press J Orthodont. 2018;23:39. e1-. e13. https://doi.org/10.1590/2177-6709.23.5.39.e1-13.onl
Kumar KA, Gupta S, Sandhu H. Determination of mesiodistal width of maxillary anterior teeth using inner canthal distance. Medical J Armed Forces India. 2015;71:S376-S81. https://doi.org/10.1016/j.mjafi.2014.08.002
Julyan J, Julyan J, De Lange J. Comparison of three different instruments for orthodontic study model analysis. South African Dental J. 2020;75(6):298-302. https://doi.org/10.17159/2519-0105/2020/v75no6a2
Kasparova M, Grafova L, Dvorak P, Dostalova T, Prochazka A, Eliasova H, Prusa J, Kakawand S. Possibility of reconstruction of dental plaster cast from 3D digital study models. Biomed Eng Online. 2013;12:49. https://doi.org/10.1186/1475-925X-12-49. PMID: 23721330; PMCID: PMC3686614.
Pachêco-Pereira C, De Luca Canto G, Major PW, Flores-Mir C. Variation of orthodontic treatment decision-making based on dental model type: A systematic review. The Angle Orthodontist. 2014;85(3):501-9. https://doi.org/10.2319/051214-343.1
Rebong RE, Stewart KT, Utreja A, Ghoneima AA. Accuracy of three-dimensional dental resin models created by fused deposition modeling, stereolithography, and Polyjet prototype technologies: A comparative study. The Angle Orthodont. 2018;88(3):363-9. https://doi.org/10.2319/071117-460.1
Cantín M, Muñoz M, Olate S. Generation of 3D tooth models based on three-dimensional scanning to study the morphology of permanent teeth. Int J Morphol. 2015;33(2):782-7. https://doi.org/10.4067/S0717-95022015000200057
De Luca Canto G, Pachêco?Pereira C, Lagravere M, Flores?Mir C, Major P. Intra?arch dimensional measurement validity of laser?scanned digital dental models compared with the original plaster models: a systematic review. Orthod Craniofacial Res. 2015;18(2):65-76. https://doi.org/10.1111/ocr.12068
Erten O, Y?lmaz BN. Three-dimensional imaging in orthodontics. Turkish J Orthodont. 2018;31(3):86. https://doi.org/10.5152/TurkJOrthod.2018.17041
Christopoulou I, Kaklamanos EG, Makrygiannakis MA, Bitsanis I, Perlea P, Tsolakis AI. Intraoral Scanners in Orthodontics: A Critical Review. Inter J Environment Res Public Health. 2022;19(3):1407. https://doi.org/10.3390/ijerph19031407
Mangano F, Gandolfi A, Luongo G, Logozzo S. Intraoral scanners in dentistry: a review of the current literature. BMC Oral Health. 2017;17(1):1-11. https://doi.org/10.1186/s12903-017-0442-x
Grünheid T, McCarthy SD, Larson BE. Clinical use of a direct chairside oral scanner: an assessment of accuracy, time, and patient acceptance. Am J Orthod Dentofacial Orthop. 2014;146(5):673-82. https://doi.org/10.1016/j.ajodo.2014.07.023
Impellizzeri A, Horodynski M, De Stefano A, Palaia G, Polimeni A, Romeo U, Guercio-Monaco E, Galluccio G. CBCT and Intra-Oral Scanner: The Advantages of 3D Technologies in Orthodontic Treatment. Int J Environ Res Public Health. 2020;17(24):9428. https://doi.org/10.3390/ijerph17249428. PMID: 33339197; PMCID: PMC7765620.
Wiranto MG, Engelbrecht WP, Nolthenius HET, van der Meer WJ, Ren Y. Validity, reliability, and reproducibility of linear measurements on digital models obtained from intraoral and cone-beam computed tomography scans of alginate impressions. Am J Orthod Dentofacial Orthop. 2013;143(1):140-7. https://doi.org/10.1016/j.ajodo.2012.06.018
Farzanegan F, Zarch SHH, Mobasheri MF, Rangrazi A. Evaluation of the relationship between morphology, volume, and density of the mandible and dentofacial vertical dimension using cone beam computed tomography. Pesqui Bras Odontopediatria Clin Integr. 2020;19. https://doi.org/10.4034/PBOCI.2019.191.128
Alassiry AM. CLINICAL ASPECTS OF DIGITAL THREE-DIMENSIONAL INTRAORAL SCANNING IN ORTHODONTICS-A SYSTEMATIC REVIEW. The Saudi Dent J. 2023.
Stevens DR, Flores-Mir C, Nebbe B, Raboud DW, Heo G, Major PW. Validity, reliability, and reproducibility of plaster vs digital study models: comparison of peer assessment rating and Bolton analysis and their constituent measurements. Am J Orthod Dentofacial Orthop. 2006;129(6):794-803. https://doi.org/10.1016/j.ajodo.2004.08.023
Torassian G, Kau CH, English JD, Powers J, Bussa HI, Marie Salas-Lopez A, et al. Digital models vs plaster models using alginate and alginate substitute materials. The Angle Orthodontist. 2010;80(4):662-9. https://doi.org/10.2319/072409-413.1
Cuperus AMR, Harms MC, Rangel FA, Bronkhorst EM, Schols JG, Breuning KH. Dental models made with an intraoral scanner: a validation study. Am J Orthod Dentofacial Orthop. 2012;142(3):308-13. https://doi.org/10.1016/j.ajodo.2012.03.031
Cerroni S, Pasquantonio G, Condò R, Cerroni L. Orthodontic fixed appliance and periodontal status: An updated systematic review. Open Dent J 2018;12:614. https://doi.org/10.2174/1745017901814010614
Proffit WR, Fields Jr HW, Sarver DM. Contemporary orthodontics: Elsevier Health Sciences; 2006.
Kumar AA, Phillip A, Kumar S, Rawat A, Priya S, Kumaran V. Digital model as an alternative to plaster model in assessment of space analysis. J Pharm Bioallied Sci. 2015;7(Suppl 2):S465. https://doi.org/10.4103/0975-7406.163506
Leifert MF, Leifert MM, Efstratiadis SS, Cangialosi TJ. Comparison of space analysis evaluations with digital models and plaster dental casts. Am J Orthod Dentofacial Orthop. 2009;136(1):16. e1-e4. https://doi.org/10.1016/j.ajodo.2008.11.019
Shellhart WC, Lange DW, Kluemper GT, Hicks EP, Kaplan AL. Reliability of the Bolton tooth-size analysis when applied to crowded dentitions. The Angle Orthodontist. 1995;65(5):327-34.
Fleming P, Marinho V, Johal A. Orthodontic measurements on digital study models compared with plaster models: a systematic review. Orthod Craniofacial Res. 2011;14(1):1-16. https://doi.org/10.1111/j.1601-6343.2010.01503.x
Becker K, Schmücker U, Schwarz F, Drescher D. Accuracy and eligibility of CBCT to digitize dental plaster casts. Clinical Oral Investigations. 2018;22(4):1817-23. https://doi.org/10.1007/s00784-017-2277-x
Robbena J, Muallahb J, Wesemannc C, Nowakd R, Mahe J, Pospiechf P, et al. Suitability and accuracy of CBCT model scan: an in vitro study Eignung und Genauigkeit von DVT-Aufnahmen für die Digitalisierung von Gipsmodellen: Eine In-vitro-Untersuchung. Int J Comput Dent. 2017;20(4):363-75.
Vögtlin C, Schulz G, Jäger K, Müller B. Comparing the accuracy of master models based on digital intra-oral scanners with conventional plaster casts. Physics in Medicine. 2016;1:20-6. https://doi.org/10.1016/j.phmed.2016.04.002
Al-Mashraqi AA, Alhammadi MS, Gadi AA, Altharawi RA, Zamim KAH, Halboub E. Accuracy and reproducibility of permanent dentitions and dental arch measurements: comparing three different digital models with a plaster study cast. Int J Comput Dent. 2021;24(4):353-62.
Goracci C, Franchi L, Vichi A, Ferrari M. Accuracy, reliability, and efficiency of intraoral scanners for full-arch impressions: a systematic review of the clinical evidence. European journal of orthodontics. 2016;38(4):422-8. https://doi.org/10.1093/ejo/cjv077
Khraishi H, Duane B. Evidence for use of intraoral scanners under clinical conditions for obtaining full-arch digital impressions is insufficient. Evidence-based dentistry. 2017;18(1):24-5. https://doi.org/10.1038/sj.ebd.6401224
Copyright (c) 2024 Swet Nisha, Debanjan Das, Sandip Kulavi, Pratibha Shashikumar

This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY 4.0). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. © 2024.