MedPath

Mouthwashes During Orthodontic Treatment

Phase 4
Conditions
Gingivitis
Interventions
Drug: Essential oils
Drug: Placebos
Registration Number
NCT03179735
Lead Sponsor
University of Taubate
Brief Summary

The number of orthodontic treatment provided to Brazilian population has been increased. Unfortunately, some negative effects such as gum bleeding and bad breath are commonly observed. It partially happens because tooth brushing and flossing become more difficult in the presence of braces. Therefore, there is a need for clinical protocols able to maintain the mouth healthy during orthodontic treatment.

Considering that proper use of mouthwashes by in individuals without braces is accompanied by decrease in plaque and gum inflammation levels, it was hypothesized that, during orthodontic treatment their anti-gingivitis and anti-plaque properties would positively affect oral health. Objectives: The present study will compare the effects of two commercially available mouthwashes with a placebo mouthwash in orthodontic patients wearing fixed appliances.

Whole-mouth clinical examinations will be performed in periodontally healthy patients 15 days before, at the day of bonding and also 3 and 6 months after braces bonding. Hard and soft tissues status, presence of gingivitis and amount of dental plaque will be monitored to determine mouthwashes efficacy. At these same time-points plaque samples will be collected from dental sites and braces surfaces aiming at determining total levels of bacteria and levels of specific bacteria related to gum disease. After a full-mouth ultrasonic debridement to remove dental plaque, stains and tartar, patients will be randomly assigned to an Essential oils, Cetylpyridinium chloride or a placebo mouthwash for 6 months (40 ml/day). Further, samples of orthodontic wires will be analyzed under microscopy to check whether regular use of mouthwashes increases the risk of corrosion or not.

Detailed Description

Not available

Recruitment & Eligibility

Status
UNKNOWN
Sex
All
Target Recruitment
60
Inclusion Criteria
  • good general health;
  • class I or class II malocclusions with a nonsurgical orthodontic treatment plan for alignment and leveling including no-extraction, extraction of two upper premolars or extraction of four premolars; no previous orthodontic treatment; overbite and overjet that allowed brackets to be placed on the lower teeth without occlusal interferences;
  • periodontal health (with no clinical signals of inflammation, GI <1 e no clinical attachment loss);
  • at least 26 natural teeth;
Exclusion Criteria
  • severe skeletal malocclusion in anteroposterior, vertical or transverse dimensions; surgical orthodontic plan;
  • mouth breathing;
  • gingivitis; periodontitis; gingival overgrowth;
  • prosthetic fixed devices, removable partial dentures or overhanging restorations;
  • systemic diseases or conditions that could influence the periodontal status;
  • smokers and former-smokers;
  • pregnancy or breast-feeding;
  • history of sensitivity or suspected allergies following the use of oral hygiene products; any antibiotic prophylaxis;
  • antibiotics and/or anti-inflammatory drug use in the six months prior to the beginning of the study;
  • regular use of chemotherapeutic antiplaque/antigingivitis products;
  • periodontal treatment performed within six months prior to study initiation;
  • unwillingness to return for follow-up.

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Essential oils mouthwashEssential oilsEssential-oils group will rinse with an alcohol-free mouthwash (twice daily use; 20 ml/30 s) containing a fixed combination of four essential oils (eucalyptol 0.092%, menthol 0.042%, methyl salicylate 0.060%, thymol 0.064%)
Cetylpyridinium mouthwashCetylpyridinium Chloride 0.7 mg/mlCetylpyridinium chloride group will rinse with an alcohol-free mouthwash (twice daily use; 20 ml/30 s) containing cetylpyridinium chloride 0.7 mg/ml
Placebos mouthwashPlacebosPlacebo group will rinse with an alcohol-free placebo solution (twice daily use; 20 ml/30 s)
Primary Outcome Measures
NameTimeMethod
Changes in gingival indexup to 6 months

Gingival index changes (mean scores) from baseline to 6 months.

Secondary Outcome Measures
NameTimeMethod
Changes in plaque indexup to 6 months

Plaque index changes (mean scores) from baseline to 6 months.

Changes in subgingival bacterial levelsup to 6 months

Changes in bacterial levels (total number of bacterial cells and specific numbers of Actinomyces naeslundii, Streptococcus oralis, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola) from sub gingival samples.

Changes in bracket bacterial levelsup to 6 months

Changes in bacterial levels (total number of bacterial cells and specific numbers of Actinomyces naeslundii, Streptococcus oralis, Fusobacterium nucleatum, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola) from bracket samples.

Changes in gingival overgrowth measurementsup to 6 months

Gingival overgrowth changes (mean scores) from baseline to 6 months.

Corrosion of orthodontic devicesup to 6 months

Percentage of areas of orthodontic devices showing corrosive superficial changes at 3 and 6 months.

Trial Locations

Locations (1)

Nucleus of periodontal research of University of Taubate

🇧🇷

Taubate, SP, Brazil

© Copyright 2025. All Rights Reserved by MedPath