Clinical effects of different antiplaque agents on patients undergoing fixed orthodontic treatment- A comparative study

Abstract

Objectives: The purpose of this study was to compare the short-term clinical effects of a Chlorhexidine mouth wash (CHX-MW), Chlorhexidine gel (CHX), Metronidazole gel (MTZ) and combination of Chlorhexidine and Metronidazole (CHX-MTZ) in orthodontic patients with fixed appliances aged from 14 to 25 years. Materials and Methods: One hundred fifty subjects undergoing fixed orthodontic treatment selected and divided into five groups: Group 1 – Controls, Group 2 – Chlorhexidine mouth wash (CHX-MW) gel, Group 3- Chlorhexidine (CHX) gel, Group 4 – Metronidazole (MTZ) gel and Group 5 – chlorhexidine-metronidazole (CHX-MTZ) gel. Clinical evaluation was undertaken using the probing depth (PD), Gingival Index (GI) and the Papillary Bleeding Index (PBI) at baseline, 2 weeks, 4 weeks, 8 weeks and 12 weeks. A subjective evaluation was also undertaken by questionnaire. Results: Groups treated with all three gels (CHX, MTZ and CHX-MTZ) showed significant clinical improvement as compared to the controls and CHX-MW group. The reduction in PD, GI and PBI in the group treated with the CHX-MTZ combination gel was significant when compared to those treated with CHX and MTZ gels. Conclusion: Topical application of CHX or MTZ alone or in combination may have a role in the management of gingivitis in orthodontic patients. Keywords: Chlorhexidine; Metronidazole; Fixed orthodontic treatment; Probing depth; Gingival Index; Papillary Bleeding Index