Clinical Efficacy of Freshchlor Mouth rinse in Post-periodontal flap Surgery Healing- A randomized controlled clinical trial

Maintenance of high level of oral hygiene plays a crucial role in success of any oral surgical procedure (1). Reduction of biofilm formation, prevention of infective complications on wound site and wound stability are very important for early wound healing (2). Reduction or elimination of oral biofilms is necessary to restore gingival tissues to a healthy state especially after a surgical procedure (3). However, mechanical means are often inadequate in ensuring plaque control and preventing infection at surgical sites (2,3). So, chemical agents can be used along with mechanical plaque control methods to ensure early wound healing (2).

Chlorhexidine is a widely used chemical antiplaque agent routinely prescribed to patients after common oral surgical procedures (1)(3)(4). It is a cationic bisbiguanide and has broad spectrum antimicrobial activity against gram positive bacteria, gram negative bacteria, yeast, viruses leading to chlorhexidine being a gold standard for oral biofilm prevention (3)(4).

A new mouthwash containing Hydrogen peroxide .1%, lactoferrin .05% and Zinc Lactate .14% is being tried for its beneficial effects on periodontal wound healing due to the individual constituents. Lactoferrin is a known antimicrobial agent and effects biofilm formation (5,6,7)

Orsi 2024 stated that Lactoferrin (Lf) is a multifunctional iron glycoprotein which is known to exert a broad-spectrum primary defense activity against bacteria, fungi, protozoa and viruses. Its iron sequestering property is at the basis of the bacteriostatic effect, (8)

Hydrogen peroxide is seen to be an antibacterial agent and a wound healing promotor (9,10,11) and Zinc has an important role in wound healing. (12)

H2O2 has been reported to be a reactive biochemical molecule synthesized by various cells that influences biological behavior through multiple mechanisms: alterations of membrane potential, generation of new molecules, and changing intracellular redox balance, which results in activation or inactivation of different signalling transduction pathways. Contrary to the traditional viewpoint that H2O2 probably impairs tissue through its high oxidative property, a proper level of H2O2 is considered an important requirement for normal wound healing.(11)  As it is widely known that for the completion of wound healing; hemostasis by platelet activating factors, growth factors and cytokines followed by inflammatory response by the body leading to removal of bacteria, foreign bodies and damaged tissues accompanied with angiogenesis, fibroblast proliferation, collagen synthesis and maturation is absolutely necessary. (5)

Therefore, this study aims to evaluate the efficacy Freshchlor + mouthwash containing Hydrogen peroxide .1%, lactoferrin .05% and Zinc Lactate .14%   in post periodontal flap surgery healing in comparison with Chlorhexidine 0.2% mouthwash .