Is chlorhexidine mouth rinse, used as a mono-therapy or adjunct with oral hygiene, effective at reducing plaque growth and gingival inflammation?

This study describes a systematic review of the best available evidence on the effectiveness of a chlorhexidine mouth rinse as a mono-therapy or as an adjunct to mechanical oral hygiene against plaque growth and gingival inflammation. Medline, EMBASE and the Cochrane Central register of Controlled Trials were searched up to April 2011. Randomised controlled clinical trials that compared chlorhexidine to placebo or controlled mouth rinses or regular oral hygiene for a minimum duration of at least four weeks amongst gingivitis patients (≥ 18 years of age) were included. A total of 30 publications fulfilled the selection criteria. Clinical parameters measured at baseline and end of trial were plaque, gingival inflammation, bleeding and staining. Chlorhexidine reduced plaque by 33% and gingivitis by 26% compared to a placebo or a control mouth rinse. The investigators concluded that when used together with oral hygiene, chlorhexidine mouth rinses provide significant reductions in plaque and gingivitis scores in gingivitis patients, but a significant increase in staining compared to placebo or control mouth rinses.

Does adjunctive use of metronidazole plus amoxicillin benefit patients receiving non-surgical scaling and root planing for the treatment of generalised aggressive periodontitis?

This article describes a double-blinded, placebo-controlled randomised clinical trial thatinvolved 30 eligible subjects experiencing generalised aggressive periodontitis. Subjectswere randomly assigned to either the test group (scaling and root planing + metronidazole[400 mg]) and amoxicillin [500 mg]) or the control group (scaling and root planing withoutthe adjunctive antibiotics combination). Both antibiotics and placebos were administeredthree times per day for 14 days. Participants were examined at baseline, and again six monthsand one year after therapy. Both therapies led to a statistically significant improvementin all clinical parameters as measured after one year. However, subjects who received themetronidazole–amoxicillin combination showed the greatest reduction in mean probingdepth, an improved clinical attachment level and a lower mean number of residual sitesafter one year. The investigators concluded that the non-surgical treatment of generalisedaggressive periodontitis was markedly improved by the adjunctive use of metronidazole andamoxicillin up to one year after treatment.

The impact of four harvesting techniques on the cell viability and osteogenic behaviour of cells in autogenous bone grafts: A critical appraisal of an experimental study

The investigators tested the null hypothesis that there would be no differences between the different bone harvesting techniques with regard to cell viability, cell activity and osteogenic potential of grafted cells. Bone grafts were harvested from the mandibles of 12 miniature pigs using four different harvesting techniques: bone milling, bone scraping, bone drilling (bone slurry) and piezosurgery. Cell viability was determined according to an immunoassay of released signalling molecules and gene expression that affect bone formation and resorption. The osteogenic activity of conditioned graft-sampled media was assessed in a bioassay using isolated bone cells. Cells in autogenous bone grafts obtained by using a bone mill and a bone scraper showed a higher viability and a stronger osteogenic potential than those from piezosurgery and bone drilling (slurry). This study contributed towards the understanding of the impact of harvesting techniques on the viability and osteogenic behaviour of grafted cells.