Comparison of Electric Toothbrush, Persica and Chlorhexidine Mouthwashes on Reduction of Gingival Enlargement in Orthodontic Patients: A Randomised Clinical Trial

Purpose: To compare the efficacy of chlorhexidine, Persica mouthwash and electric toothbrushes in improving gingival enlargement in patients with fixed orthodontic appliances. Materials and Methods: Seventy-two orthodontic patients with at least two sites of gingival enlargement were randomly allocated into four equal groups: 1) manual toothbrush; 2) electric toothbrush; 3) manual toothbrush + Persica mouthwash; 4) manual toothbrush + chlorhexidine mouthwash. All participants were instructed to brush their teeth at least twice a day. The subjects in groups 3 and 4 were instructed to use Persica or chlorhexidine according to the respective manufacturer's instructions. Bleeding on probing (BOP) index, gingival index (GI), O'Leary's plaque index (PI) and constructed hyperplastic index (HI) of all the subjects were measured in a blind manner at the start of the study and 2 weeks later. Changes of indices in the entire oral cavity and individual affected teeth were analysed with SPSS 16 using chi-square, ANOVA, ANCOVA, LSD and the paired t-test. Results: In the entire oral cavity, there was a statistically significant improvement in indices in all the groups except for HI, which significantly improved only in group 4 (p = 0.001). Data of individual teeth with hyperplastic gingiva showed significant reduction of all the variables except for HI in group 1 (p = 0.08). No significant differences were found between groups 1 and 2 or between groups 3 and 4. Conclusion: The efficacy of Persica was similar to that of chlorhexidine in improving gingival conditions. None of the treatment modalities could reduce gingival enlargement to the clinically acceptable level of health. Keywords: gingival hyperplasia, herbal mouthwash, orthodontics, plaque index