SHORT-TERM MICROBIOLOGICAL AND CLINICAL EFFECTS OF SUBGINGIVAL IRRIGATION WITH AN ANTIMICROBIAL MOUTHRINSE

FIFTY CHRONIC ADULT PERIODONTITIS PATIENTS completed a 6-week controll ed, double-blind, split mouth clinical study to determine the effects of subgingival irrigation with an antimicrobial mouthrinse on periodon tal microflora, supragingival plaque, and gingivitis when used as an a djunct to normal oral hygiene. Qualifying subjects had at least four s ites, two on each side of the mouth, with probing depths between 4 and 6 mm, which bled on gentle probing. Following baseline examinations, subjects received a half mouth scaling and prophylaxis and full mouth subgingival irrigation with either the antimicrobial mouthrinse or ste rile colored water control professionally delivered. Subjects continue d irrigation at home once daily for 42 days with their assigned rinse delivered via a subgingival delivery system. All sites in the mouth we re scored at baseline and at day 42 for supragingival plaque, bleeding on probing, and redness. For the four selected periodontitis sites, p robing depth and attachment level were measured at baseline and on day 42; additionally, supragingival plaque and gingival redness were scor ed on days 7 and 21. Subgingival plaque samples for microbiological an alysis were harvested from the selected periodontal sites at baseline and on days 7, 21, and 42. Microbiologically, irrigation with the anti microbial mouthrinse resulted in statistically significant reductions compared to control in putative periodontopathogens, including black p igmenting species, which persisted at 42 days. Clinically, subgingival irrigation with the antimicrobial mouthrinse produced a significant r eduction in supragingival plaque (P<0.001), bleeding on probing (P=0.0 19), and redness (P=0.017) compared to the control, whether or not the area irrigated received a prophylaxis. While there were no significan t differences between active and control groups in either probing dept h or attachment level (P>0.05); this finding was not surprising in vie w of the small number of periodontitis sites and relatively short stud y duration. The findings indicate that subgingival delivery of the ant imicrobial mouthrinse by means of an oral irrigation device can play a potential role in the management of chronic periodontitis by virtue o f its significant effects on the subgingival periodontopathic microflo ra and supragingival plaque and gingivitis.