Advanced approaches to managing peri-implant mucositis: the role of chlorhexidine gel combined with ADS, PVP-VA, and sodium DNA

Abstract

Peri-implant mucositis is an inflammatory and bacterial condition affecting dental implants' soft tissues. Including chlorhexidine (CHX) with polyvinylpyrrolidone-vinyl acetate (PVP-VA) in gel formulations enhances antibacterial properties by forming a protective film against microbial contamination and over-infection without directly impacting tissues or wounds. Sodium DNA promotes gingival tissue health. This study aimed to evaluate the effectiveness of a gel containing CHX (0.5%) with an anti-discoloration system (ADS), PVP-VA, and sodium DNA, compared to a placebo gel, for treating peri-implant mucositis. A single-center randomized controlled pilot trial included 24 patients with peri-implant mucositis. Participants were assigned to two groups: Group A (n = 12) received the test gel, while Group B (n = 12) used a placebo. The primary outcome was the Plaque Index (PI), with secondary outcomes including Bleeding on Probing (BOP) and Gingival Index (GI). Measurements were taken at baseline and two weeks post-treatment. At baseline, the mean PI scores were 2.4 ± 0.4 for Group A and 2.2 ± 0.5 for Group B (p > 0.05). After two weeks, Group A significantly reduced to 0.5 ± 0.4, compared to 1.7 ± 1.9 in Group B (p < 0.05). Similarly, mean BOP decreased from 57.1 ± 15.2% to 14.3 ± 6.6% in Group A, whereas Group B showed a smaller reduction from 55.3 ± 11.7% to 45.4 ± 9.8% (p < 0.05). After two weeks, the gel containing CHX, ADS, PVP-VA, and sodium DNA demonstrated significant improvements in gingival inflammation and biofilm reduction, outperforming the placebo. This treatment could provide an effective option for managing peri-implant mucositis.