Comparison of Chlorhexidine, Chlorhexidine with anti-discoloration system, and Polyvinylpyrrolidone-iodine on early wound healing after dental implant placement: A randomized clinical trial.

OBJECTIVES: This randomized clinical trial evaluated the effects of three different antiseptic mouth rinses, chlorhexidine (CHX), CHX with anti-discoloration system (CHX ADS), and povidone-iodine (PVP-Iodine), on early wound healing, plaque formation, microbial load, inflammation biomarkers, and patient satisfaction after dental implant placement. MATERIALS AND METHODS: Sixty patients received one dental implant and were assigned by a computer-generated simple random allocation (random.org) to rinse with either CHX 0.2%, CHX ADS 0.2%, or PVP-Iodine 10% preoperatively and for 10 days postoperatively. No blinding was implemented. Primary outcome of the study was the assessment of the Early Wound Healing Index (EHI). Secondary outcomes included bacterial load of five periopathogens, levels of activated matrix metalloproteinase-8 (aMMP-8), plaque index (PI), and patient satisfaction. Statistical analysis employed Kruskal-Wallis and chi-square tests with significance set at p < 0.05. RESULTS: No statistically significant differences were observed among the three groups in EHI scores, microbiological profiles, aMMP-8 levels, or PI at any time point. However, CHX ADS was rated significantly more favorably by patients regarding taste, dysgeusia, mucosal burning, and tooth discoloration (all p < 0.05). Interrater agreement on EHI was substantial (κ = 0.72). CONCLUSIONS: All tested mouth rinses demonstrated comparable efficacy in promoting early wound healing and infection control after implant surgery. CHX ADS showed superior patient acceptance, suggesting its potential as a preferred option based on subjective tolerability. Standardization of healing assessment indices is recommended for future studies to enhance comparability. CLINICAL RELEVANCE: While CHX, CHX ADS, and PVP-Iodine were equally effective for early peri-implant wound healing, CHX ADS showed better patient acceptance with fewer side effects (taste alteration, tooth discoloration), which is likely to improve compliance, reflecting enhanced tolerability rather than superior healing efficacy. This finding may guide clinicians in selecting antiseptic protocols that optimize both clinical outcomes and patient comfort and patient compliance.