Results of a prospective study on the effectiveness of two different chlorhexidine preparations in cleft lip and palate patients with multibracket appliances

摘要

The aim of this clinical study was to reduce the caries risk in cleft lip and palate (CLP) patients with multibracket appliances by a compliance-independent method.Sixty-eight CLP patients with multibracket appliances were submitted to professional tooth cleaning in four-week intervals. After randomization, patients of group A wore a splint filled with chlorhexidine (CHX) gel (Chlorhexamed) for 15 minutes (3 x 5 min) every 12 weeks. Patients of group B were treated with CHX varnish (EC40) every 12 weeks. Fluoride varnish (Fluoridin) was applied to all teeth 4 and 8 weeks after the respective CHX treatments.Regular salivary bacteria counts (CRT) were carried out to determine the therapeutic effectiveness. The initial DMFS values were compared to the final ones.The initial findings of the salivary test and the DMFS index confirmed the high caries risk. Despite this systematic prophylaxis program, the DMFS value increased dramatically in both groups. The bactericidal effect of both CHX preparations turned out to be markedly weaker than that described in the literature.Though the CHX and fluoride application had a limited effect, at least in this test population, it should be kept in mind that precisely this population requires very intensive prophylaxis and that no antibacterial adjuvant is more effective than CHX. However, the application interval should be individually adapted to the bacteria count.