Evaluating Soft Tissue Healing after Implant Placement Using Two Different Mouthwashes (Myrrh and Chlorhexidine Gluconate): A Randomized Control Trial.

2022-09-26
Medicina (Kaunas, Lithuania) 58(10)
- Wael I Ibraheem
- Afaf A Hakami
- Ahlam A Shafei
- Salehah A Jerah
- Ammar Almarghlani
- Ali M Makrami
- Ashok K Bhati

PubMed: 36295512
DOI: 10.3390/medicina58101351

Study Design

Type: Randomized Controlled Trial (RCT)
Sample size: n = 35
Population: 35 patients after dental implant placement (18 in the myrrh group and 17 in the chlorhexidine gluconate group)
Methods: Double-blind, randomized clinical study comparing myrrh and chlorhexidine gluconate mouthwashes after dental implant placement, evaluated at 1 week postoperative
Blinding: Double-blind
Duration: 1 week

The use of mouthwash is often recommended by dental experts for dental healing. A double-blind, randomized clinical study was conducted to evaluate the efficacy of two mouthwashes (myrrh and chlorhexidine gluconate) on postoperative pain and their effects on tissues after dental implant placement in 35 patients (18 in the myrrh group and 17 in the chlorhexidine gluconate group). Soft tissue healing was evaluated in terms of wound closure, soft tissue swelling, and the color of the gingiva at 1 week postoperative. To decrease the chances for error, only the participants who did not show preoperative symptoms of infection and those who committed to practicing better oral hygiene were included in the study. The samples were evaluated for the infiltration of inflammatory cells (using inflammatory extent and inflammatory cellularity grades), maturation of collagen (osteoblast activity), and arrangement of cells (for detecting the remodeling phase). A questionnaire pertaining to mouthwash satisfaction, the duration of postoperative pain after the procedure, the time of stoppage of bleeding at the surgical site, and any sensitivity at the surgical site was given to the patients. The Chi-square test and Mann-Whitney U-test were used to analyze the data. The difference in postoperative surgical swelling, pain, bleeding, and redness in the patients was not statistically significant between the myrrh and chlorhexidine gluconate mouthwash groups. However, in the acute phase, the myrrh mouthwash showed a positive impact on the process of wound healing after implant placement. The small sample size and inability to compare wound healing in different anatomical areas of the oral cavity were the study limitations.

Research Insights

Myrrh→Reduced Postoperative Pain
The difference in postoperative surgical swelling, pain, bleeding, and redness in the patients was not statistically significant between the myrrh and chlorhexidine gluconate mouthwash groups.
Effect
Neutral
Effect size
Small
Myrrh→Reduced Redness at Surgical Site
The difference in postoperative surgical swelling, pain, bleeding, and redness in the patients was not statistically significant between the myrrh and chlorhexidine gluconate mouthwash groups.
Effect
Neutral
Effect size
Small
Myrrh→Reduced Surgical Site Bleeding
The difference in postoperative surgical swelling, pain, bleeding, and redness in the patients was not statistically significant between the myrrh and chlorhexidine gluconate mouthwash groups.
Effect
Neutral
Effect size
Small
Myrrh→Reduced Surgical Swelling
The difference in postoperative surgical swelling, pain, bleeding, and redness in the patients was not statistically significant between the myrrh and chlorhexidine gluconate mouthwash groups.
Effect
Neutral
Effect size
Small