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The effect of cetylpyridinium chloride mouthrinse as adjunct to toothbrushing compared to placebo on interproximal plaque and gingival inflammation—a systematic review with meta-analyses

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Abstract

Objectives

The present study aimed to systematically review the literature about the interproximal anti-plaque and anti-gingivitis efficacy of cetylpyrydinium chloride (CPC) mouthrinse compared to placebo solution.

Materials and methods

Three databases (PUBMED, SCOPUS, and EMBASE) were searched for randomized clinical trials that compared the interproximal anti-plaque and anti-gingivitis effect of CPC and placebo mouthrinses as an adjunct to toothbrushing, after a minimum of 6 weeks. Individuals with any periodontal diagnosis were considered. Two meta-analyses were performed for the Turesky modification of the Quigley-Hein plaque index and the Löe and Silness gingival index. For both analyses, the mean differences (MD) between baseline and 6-weeks were calculated using a random-effect model.

Results

Eight studies were included. All included studies showed significant improvement in at least one of the parameters, favoring the CPC mouthrinse when compared to placebo. The meta-analysis demonstrated that groups that used CPC displayed a significantly greater reduction in the plaque index score (MD; 95% confidence interval [95%CI]: − 0.70; − 0.83 to − 0.57) and in the gingival index (MD; 95%CI: − 0.38; − 0.47 to − 0.28) when compared to placebo. However, high heterogeneity was observed in both analyses (I2 = 89% and I2 = 98%, respectively).

Conclusions

When considering interproximal surfaces, CPC is efficacious both in plaque and gingival inflammatory parameters, demonstrating the potential to compensate for the limitations of interproximal plaque control.

Clinical relevance

CPC may be a good alternative to compensate interproximal plaque removal, improving interproximal gingivitis

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Funding

This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) – Finance Code 001. Gerson Pedro J. Langa received a scholarship from Latin America Oral Health Association (LAOHA).

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Authors and Affiliations

  1. Graduate Program in Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Gerson Pedro José Langa

  2. Department of Periodontology, Graduate Program in Dentistry, School of Dentistry, Federal University of Pelotas, Rua Gonçalves Chaves, 457, Pelotas, Rio Grande do Sul, Brazil

    Francisco Wilker Mustafa Gomes Muniz

  3. School of Dentistry, Feevale University, Novo Hamburgo, Rio Grande do Sul, Brazil

    Ricardo dos Santos Araújo Costa

  4. Graduate Program in Dentistry, Federal University of Pelotas, Pelotas, Rio Grande do Sul, Brazil

    Taciane Menezes da Silveira

  5. Department of Periodontology, Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

    Cassiano Kuchenbecker Rösing

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  1. Gerson Pedro José Langa
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  2. Francisco Wilker Mustafa Gomes Muniz
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  3. Ricardo dos Santos Araújo Costa
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  5. Cassiano Kuchenbecker Rösing
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Correspondence to Francisco Wilker Mustafa Gomes Muniz.

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Langa, G.P.J., Muniz, F.W.M.G., Costa, R.d.S.A. et al. The effect of cetylpyridinium chloride mouthrinse as adjunct to toothbrushing compared to placebo on interproximal plaque and gingival inflammation—a systematic review with meta-analyses. Clin Oral Invest 25, 745–757 (2021). https://doi.org/10.1007/s00784-020-03661-2

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