The aim of this systematic review and meta-analysis was to determine the efficacy of chlorhexidine (CHX) as an adjunctive therapy to mechanical debridement in the treatment of peri-implant diseases. Five databases (PubMed, EMBASE, Cochrane Central Register of Controlled Trails, Web of Science, and ClinicalTrials.gov) were searched. Randomized controlled trials (RCTs) comparing mechanical debridement combined with CHX to mechanical debridement alone for patients with peri-implant disease were identified. The trial investigators evaluated factors indicating inflammatory levels, including bleeding on probing (BOP), probing depth (PD), and clinical attachment level (CAL). Six RCTs with 207 patients were ultimately included in this review. Low- to moderate-quality evidence demonstrated that the adjunctive CHX therapy had no significant effect on BOP reduction within 1 month (mean difference [MD], 0.10; 95% confidence interval [CI], −0.06 to 0.25), 3–4 months (MD, 0.06; 95% CI, −0.03 to 0.15), and 6–8 months (MD, 0.06; 95% CI, −0.03 to 0.14) of follow-up. Significant differences in PD reduction and CAL gain were also not found. Although 1 subgroup analysis revealed a significant result (MD, 009; 95% CI, 0.01–0.18) for the use of CHX solution, this could be interpreted as clinically slight. Based on available evidence, adding CHX to mechanical debridement, compared with mechanical debridement alone, did not significantly enhance the clinical results. Therefore, clinicians should consider the negligible effect of adjunctive CHX.
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February 2021
review article|
July 14 2020
Clinical Efficacy of Chlorhexidine as an Adjunct to Mechanical Therapy of Peri-Implant Disease: A Systematic Review and Meta-Analysis
Pengfei Zhao, DDS;
Pengfei Zhao, DDS
1State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
2Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Qian Wang, DDS;
Qian Wang, DDS
1State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
2Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Peng Zhang, DDS;
Peng Zhang, DDS
1State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
2Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Xinyi Zhou, DDS;
Xinyi Zhou, DDS
1State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
2Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Lulingxiao Nie, DDS;
Lulingxiao Nie, DDS
1State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
2Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Xing Liang, DDS, PhD;
Xing Liang, DDS, PhD
1State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
2Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Yi Ding, DDS, PhD;
Yi Ding, DDS, PhD
1State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
3Department of Periodontology, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
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Qi Wang, DDS, PhD
Qi Wang, DDS, PhD
*
1State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
2Department of Prosthodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
* Corresponding author, e-mail: wqinno8751@gmail.com
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J Oral Implantol (2021) 47 (1): 78–87.
Citation
Pengfei Zhao, Qian Wang, Peng Zhang, Xinyi Zhou, Lulingxiao Nie, Xing Liang, Yi Ding, Qi Wang; Clinical Efficacy of Chlorhexidine as an Adjunct to Mechanical Therapy of Peri-Implant Disease: A Systematic Review and Meta-Analysis. J Oral Implantol 1 February 2021; 47 (1): 78–87. doi: https://doi.org/10.1563/aaid-joi-D-19-00213
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