Chlorhexidine gluconate rinses are prescription treatments commonly marketed in formulations containing 0.12% chlorhexidine gluconate with 11.6% alcohol (Peridex®, 3M ESPE Dental Products). An alcohol-free formula has been introduced in the United States that is reportedly as effective as formulas with alcohol (Sunstar GUM®, Paroex™).8 Chlorhexidine is strongly adsorbed to oral surfaces. Approximately 30% is reported to be retained in the oral cavity post-rinsing, creating a reservoir for sustained antibacterial activity against a broad range of bacteria.9 Chlorhexidine rinses are indicated for use between dental visits as part of a professional program for the treatment of gingivitis and was considered the gold standard for therapeutic rinses. Their effect on periodontitis or acute necrotizing ulcerative gingivitis has not been determined.9
Numerous long-term clinical studies have evaluated the effects of chlorhexidine rinses with concentrations ranging from 0.12% to 0.2%.6,10-14 Excellent efficacy has been reported for gingivitis, gingival bleeding and plaque. Formulations with 0.12% chlorhexidine demonstrated gingivitis reductions from 17% to 40% and plaque reductions from 35% to 61%.6 Despite its clinical potency, extended use of chlorhexidine is generally avoided due to the potential development of extrinsic stain, taste alteration, and calculus formation.15 New research now linked to adverse effects of use of Chlorhexidine can alter the physicochemistry and cytocompatibilty of titanium surfaces. Chlorhexidine can remove the oxide layer on the dental implant, compromise the biocompatibility of the titanium surface and is now not recommended to detoxify implants.39
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