Background:The combination of orthodontic forces with periodontal tissue inflammation leads to External apical root
resorption (EARR) which occurs as a common side effect of orthodontic treatment. Research studies need to
investigate how Chlorhexidine (CHX) which functions as an antimicrobial and anti-inflammatory agent affects EARR
reduction in addition to its established benefits for plaque control and gingival inflammation management.
Objective:The research evaluates the clinical and radiographic and biochemical and mechanical effects of CHX
mouthwash on EARR and periodontal health in orthodontic patients who have fixed appliances.
Materials and Methods:The research included forty participants between ages 12 and 25 who used 0.12% CHX
mouthwash twice daily or did not receive CHX treatment. The researchers evaluated Periodontal indices (Plaque
Index, Gingival Index, and Bleeding on Probing) at four time points: baseline and months 1, 3 and 6. The researchers
used Cone-beam computed tomography (CBCT) to evaluate changes in root length. The researchers studied gingival
crevicular fluid and saliva to measure IL-1β and TNF-α cytokines and MDA and TAC oxidative stress markers and
TRAP and ALP enzymes. The study examined mechanical and surface characteristics of orthodontic wires and
brackets which underwent CHX exposure in laboratory tests.
Results:The CHX treatment resulted in a major reduction of plaque formation and gingival inflammation and bleeding (p < 0.05). The CBCT results showed that patients who received CHX treatment experienced less root shortening especially in their maxillary incisors. The biochemical analysis showed that CHX treatment decreased IL-1β and TNFα and MDA levels while it elevated TAC and ALP activity. The tensile strength and elastic modulus and surface integrity of orthodontic materials remained unchanged.
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