A Randomized Clinical Trial on the Clinical and Immunological Efficacy of a Mouth Rinse Containing Hydrogen Peroxide and Hyaluronic Acid in Patients with Gingivitis.

Autores/as

  • Ahmed Hashim Khudhair Department of Periodontics, College of Dentistry, University of Baghdad
  • Maha Abdul Aziz Ahmed Department of Periodontics, College of Dentistry, University of Baghdad

DOI:

https://doi.org/10.5195/d3000.2023.556

Palabras clave:

Hyaluronic acid, Interleukin-1β, Hydrogen peroxide, Gingivitis, Saliva

Resumen

OBJECTIVE: The present study aimed to investigate the impact of HA/H2O2 (Hyaluronic Acid/Hydrogen Peroxide) mouthwash on pro-inflammatory cytokines, specifically IL-1β and IL-6, in individuals diagnosed with gingivitis. Furthermore, a comparison was made between the effects of HA/H2O2 and those of CHX (Chlorhexidine) and placebo.
MATERIALS AND METHODS: This clinical trial was randomized, double-blinded, and parallel. Fifty-four students with biofilm-induced gingivitis (18 to 23 years old) were randomly assigned to three mouthwash groups: HA/H2O2, CHX, and placebo. Unidentified bottles were delivered to participants. For 14 days, 10 millilitres of HA/H2O2 mouthwash formulation, CHX (0.12%), and placebo were used twice a day. All subjects were assessed twice, once at baseline and once after 14 days. Before and after each participant's mouthwash usage, bleeding on probing was measured as a clinical parameter for inflammation, Salivary IL-1β and IL-6 were also assessed by ELISA. Changes in salivary interleukins and bleeding between baseline and after treatment were determined and compared by the t test with an alpha of 0.05.
RESULTS: There was a statistically significant decrease in salivary interleukin-1β and IL-6 in all three groups. However, intergroup comparisons at second visits showed no significant difference between HA/H2O2 and CHX groups (P>0.05) for the interleukins tested. Furthermore, all treatments considerably reduced bleeding on probing, although mouthwash with hyaluronic acid (HA) and hydrogen peroxide (H2O2) had a greater impact than the other two treatments.
CONCLUSION: Mouthwash containing HA/H2O2 demonstrated an anti-inflammatory effect, suggesting they are immunomodulatory agents. These findings may be beneficial and encouraging for the use of HA/H2O2 in the treatment of gingivitis; thus, HA/H2O2 rinse has the potential to serve as an appropriate replacement for chlorhexidine (CHX).

Citas

Dental plaque–induced gingival conditions. Journal of clinical periodontology. Murakami S, Mealey BL, Mariotti A, Chapple IL. 2018 Jun;45: S17-27.

Evaluation of Entamoeba gingivalis and Trichomonas tenax in patients with periodontitis and gingivitis and its correlation with some risk factors. Ibrahim S, Abbas R. J Bagh Coll Dentistry. 2012;24(3):158–62.

Prevalence and severity of gingivitis in American adults. Li Y, Lee S, Hujoel P, Su M, Zhang W, Kim J, Zhang YP, De Vizio W. American journal of dentistry. 2010 Feb 1;23(1): 9.

Serum levels of interlukine-1beta and interlukine-2 in chronic periodontitis. Al-Ghurabei BH, Shaker ZF, Fadhel R, Al-Khayli NG, Mustafa LK. Al-Mustansiriya J. Sci. 2012;23(3):55-62.

Biologic Basis for Interleukin-l in Disease.Dinarello CA. The Journal of The American Society of Hematology. 1996. Vol. 87.

Interleukin-1 function and role in rheumatic disease. Schett G, Dayer JM, Manger B. Nature Reviews Rheumatology. 2016 Jan;12(1):14-24.

Biological effects of interleukin‐6 on gingival fibroblasts: cytokine regulation in periodontitis .Naruishi K, Nagata T. Journal of cellular physiology. 2018 Sep;233(9):6393-400.

Effect of a chlorhexidine mouthrinse on plaque, gingival inflammation and staining in gingivitis patients: A systematic review. An Strydonck DAC, Slot DE, Van Der Velden U, Van Der Weijden F. J Clin Periodontol. 2012 Nov;39(11):1042–55.

Antibacterial efficiency of chlorhexidine digluconate 0.2% against oral β-hemolytic streptococci and oral Staphylococcus aureus in immunocompromisedpatients .Qanbar FH. J Bagh College Dentistry. 2012;24(2):166-9.

Evaluation of Salvadora persica L. and green tea anti-plaque effect: a randomized controlled crossover clinical trial. Abdulbaqi HR, Himratul-Aznita WH, Baharuddin NA. BMC complementary and alternative medicine. 2016 Dec;16(1):1-7.

A Systematic Review of the Effect of Oral Rinsing with H 2 O 2 on Clinical and Microbiological Parameters Related to Plaque, Gingivitis, and Microbes.Muniz FW, Cavagni J, Langa GP, Stewart B, Malheiros Z, Rösing CK. International journal of dentistry. 2020 Oct 31;2020.

Randomised controlled trial comparing the clinical effectiveness of mouthwashes based on essential oils, chlorhexidine, hydrogen peroxide and prebiotic in gingivitis treatment.Yaneva BK, Dermendzhieva YB, Mutafchieva MZ, Stamenov NV, Kavlakova LB, Tanev MZ, Karaslavova E, Tomov GT. Folia Medica. 2022 Aug 31;64(4):588-95.

Hyaluronan-containing mouthwash as an adjunctive plaque-control agent. Rodrigues SV, Acharya AB, Bhadbhade S, Thakur SL. Oral health & preventive dentistry. 2010 Jan 1;8(4):389-94.

Hyaluronan: its nature, distribution, functions and turnover.Fraser JR, Laurent TC, Laurent UB. Journal of internal medicine. 1997 Jul;242(1):27-33.

Hyaluronic acid: a boon in periodontal therapy. Dahiya P, Kamal R.North American journal of medical sciences. 2013 May;5(5):309.

Plaque‐induced gingivitis: Case definition and diagnostic considerations. Trombelli L, Farina R, Silva CO, Tatakis DN. Journal of clinical periodontology. 2018 Jun;45:S44-67.

Anti-inflammatory effects of manuka honey on salivary cytokines (clinical study). Al-Kubaisi MW, Al-Ghurabi BH, Alkubaisy W, ABDULLAH NN. Journal of Baghdad College of Dentistry. 2023 Mar 15;35(1):10-9.

Targeted salivary biomarkers for discrimination of periodontal health and disease (s). Ebersole JL, Nagarajan R, Akers D, Miller CS. Frontiers in cellular and infection microbiology. 2015 Aug 19;5:62.

Problems and proposals for recording gingivitis and plaque. Ainamo J, Bay I. International dental journal. 1975 Dec 1;25(4):229-35.

Changes of Four Pro-inflammatory Proteins in Whole Saliva during Experimental Gingivitis. Zhou M, Meng HX, Zhao YB, Chen ZB. Chinese Journal of Dental Research. 2012 Jan 1;15(2):121.

The effects of hydrogen peroxide mouthwashes on the prevention of plaque and gingival inflammation: a systematic review. Hossainian N, Slot DE, Afennich F, Van der Weijden GA. International journal of dental hygiene. 2011 Aug;9(3):171-81.

The Effect of Hyaluronic Acid Gel on Periodontal Parameters, Pro-Inflammatory Cytokines and Biochemical Markers in Periodontitis Patients. Mohammad CA, Mirza BA, Mahmood ZS, Zardawi FM. Gels. 2023 Apr 12;9(4):325.

Inflammatory markers in the saliva of cerebral palsy individuals with gingivitis after periodontal treatment. Yoshida RA, Gorjão R, Mayer MP, Corazza PF, Guare RO, Ferreira AC, Santos MTBrazilian oral research. 2019 Jul 1;33.

Association between interleukin-8 levels and chronic periodontal disease: A PRISMA-compliant systematic review and meta-analysis. Finoti LS, Nepomuceno R, Pigossi SC, Corbi SC, Secolin R, Scarel-Caminaga RMMedicine. 2017 Jun;96(22).

Treatment of gingivitis is associated with reduction of systemic inflammation and improvement of oral health‐related quality of life: A randomized clinical trial. Perić M, Marhl U, Gennai S, Marruganti C, Graziani F. Journal of Clinical Periodontology. 2022 Sep;49(9):899-910.

A randomized double‐blind clinical trial to evaluate the efficacy of chlorhexidine, antioxidant, and hyaluronic acid mouthwashes in the management of biofilm‐induced gingivitis. Abdulkareem AA, Al Marah ZA, Abdulbaqi HR, Alshaeli AJ, Milward MR International journal of dental hygiene. 2020 Aug;18(3):268-77.

The" Hawthorne effect"—what did the original Hawthorne studies actually show? Wickström G, Bendix T. Scandinavian journal of work, environment & health. 2000 Aug 1:363-7.

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Publicado

2023-11-21

Número

Vol. 11 Núm. 1 (2023)

Sección

Adults & the Elderly

Licencia

Derechos de autor 2023 Ahmed Hashim Khudhair, Maha Abdul Aziz Ahmed

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