Bulletin of Stomatology and Maxillofacial Surgery
2025; 210–218
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EFFICIENCY OF HYALURONIC MOUTHWASH COMPARED TO CHLORHEXIDINE MOUTHWASH TO PREVENT PLAQUE INDUCED GINGIVITIS IN PATIENT WEARING FIXED ORTHODONTIC APPLIANCES

Yadgar Mahmood*, Aveen Jalal, Chinar Muhammed

Lecturer, Periodontics, College of Dentistry, HMU, Kurdistan Region, Iraq · Professor, Periodontics, College of Dentistry, HMU

Received: 2025-09-25 · Published: 2025-09-05

© 2025 The Author(s) and the original publisher.

CC BY-NC 4.0 This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
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Original title
EFFICIENCY OF HYALURONIC MOUTHWASH COMPARED TO CHLORHEXIDINE MOUTHWASH TO PREVENT PLAQUE INDUCED GINGIVITIS IN PATIENT WEARING FIXED ORTHODONTIC APPLIANCES
Authors
Yadgar Mahmood, Aveen Jalal, Chinar Muhammed
Source journal
Bulletin of Stomatology and Maxillofacial Surgery
Published
2025-09-05
Licence
Creative Commons Attribution-NonCommercial 4.0 International
Original
https://doi.org/10.58240/1829006X-2025.21.8-210

Abstract

Background: Plaque-induced gingivitis is a prevalent periodontal condition affecting over 90% of individuals, with orthodontic appliances thus hindering effective oral hygiene. Objectives: This study evaluated the efficacy of hyaluronic acid (HA) and chlorhexidine (CHX) mouthwashes in reducing gingival inflammation in patients with fixed orthodontic appliances. Materials and Methods: A total of 45 participants were randomized into three groups: Group I used HA mouthwash, Group II used CHX mouthwash, and Group III brushed their teeth without a mouthwash. All participants underwent professional scaling and polishing before the study and followed standardized oral hygiene protocols. Saliva samples were collected at baseline (day 0), one month, and three months for measuring levels of pro-inflammatory cytokines (IL-1β, TNF-α, and INF-γ). Gingival index (GI), plaque index (PI), and bleeding on probing (BOP) were assessed at each interval. Results: At one month, significant reductions in GI, PI, and BOP were observed across all groups. Both groups of HA and CHX mouthwashes demonstrated greater reductions in clinical parameters compared to brushing alone. At three months, all groups showed continued significant improvements from baseline in all parameters except PI, which remained unchanged in the HA and brushing-only groups. Salivary cytokine analysis revealed variations correlating with clinical improvements, highlighting the anti-inflammatory benefits of both HA and CHX. Conclusion: This study demonstrates that HA and CHX mouthwashes, alongside proper oral hygiene practices, effectively reduce gingival inflammation in orthodontic patients. These findings underscore the importance of integrating supportive periodontal therapies with rigorous oral hygiene regimens for maintaining oral health during orthodontic treatment.
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