Evolution of CPITN Index in Relation to Chlorhexidine Mouthwash Use in Patients with Deflective Occlusal Contacts

Abstract

Background/Objectives: Occlusal trauma does not initiate periodontitis but may accelerate its progression when inflammation is present. Chlorhexidine (CHX) mouthwash is widely used as an adjunct to periodontal therapy, although its effectiveness in patients with occlusal trauma is insufficiently documented. This study aimed to evaluate the effect of CHX mouthwash on periodontal status in patients with deflective occlusal contacts, in the absence of occlusal adjustments. Materials and Methods: This observational prospective study analyzed data from 52 patients (20 males, 32 females; mean age 41.35 years). Periodontal status was assessed using the Community Periodontal Index of Treatment Needs (CPITN) at baseline, 3 months, and 6 months. Patients were divided into groups based on CHX use and concentration. Statistical analysis evaluated intra- and intergroup variations. Results: Patients using CHX demonstrated statistically significant improvements in CPITN scores at 3 months for all sextants except sextant 5 (p < 0.05). Between 3 and 6 months, further significant improvement was observed only for sextant 6 and for the overall score. In contrast, patients without CHX showed a slight trend toward worsening CPITN values, with no statistically significant differences over the same period. Conclusions: CHX mouthwash significantly improved periodontal parameters in patients with occlusal trauma during the first three months of use. However, improvements plateaued after this period, highlighting the short-term benefits and limitations of CHX. These findings support the adjunctive role of CHX in managing periodontal disease associated with occlusal trauma but reinforce the necessity of mechanical occlusal correction for long-term stability. The CPITN index provides moderate clinical utility compared with full-mouth clinical periodontal measurements.