Effectiveness of chlorhexidine, hyaluronic acid, and anti-discoloration mouthrinses on periodontal wound healing: A systematic review and meta-analysis.
DOI:
https://doi.org/10.64716/82t49t21Keywords:
Chlorhexidine, Hyaluronic Acid, Mouthwashes, Periodontal Diseases, Wound HealingAbstract
Periodontal wound healing following surgical or non-surgical therapy remains a clinical challenge, and adjunctive mouthrinses are commonly prescribed to enhance tissue repair and control biofilm accumulation. Chlorhexidine is considered the gold standard for chemical plaque control; however, adverse effects such as tooth staining have prompted the development of modified formulations, including hyaluronic acid and anti-discoloration systems (ADS). This systematic review and meta-analysis aimed to compare the effectiveness of chlorhexidine-based mouthwashes, hyaluronic acid formulations, and anti-discoloration systems versus other rinses on periodontal healing outcomes. A comprehensive electronic search was conducted in accordance with PRISMA 2020 guidelines, and randomized controlled trials were included. The protocol was prospectively registered in PROSPERO (CRD42024616667). Risk of bias was assessed using the Cochrane RoB 2 tool, and certainty of evidence was evaluated with the GRADE approach. Of 339 records screened, five trials involving 242 participants met the eligibility criteria. Outcomes included gingival healing indices, plaque index, bleeding scores, and dental pigmentation. While individual studies reported clinical improvements within intervention groups, pooled analyses showed small and non-statistically significant effects across healing, plaque, and bleeding outcomes. Overall certainty of evidence ranged from low to moderate due to heterogeneity and limited sample sizes. Current evidence suggests comparable short-term effectiveness among these formulations, without clear superiority of any specific regimen for periodontal healing.
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The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.
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Copyright (c) 2026 Jorge Oscar Espejo-Zuñiga, María Victoria Espinoza-Salcedo, Augusto Alberto Aguirre-Aguilar (Autor/a)
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