Evaluating Soft Tissue Healing after Implant Placement Using Two Different Mouthwashes (Myrrh and Chlorhexidine Gluconate): A Randomized Control Trial.

The use of mouthwash is often recommended by dental experts for dental healing. A double-blind, randomized clinical study was conducted to evaluate the efficacy of two mouthwashes (myrrh and chlorhexidine gluconate) on postoperative pain and their effects on tissues after dental implant placement in 35 patients (18 in the myrrh group and 17 in the chlorhexidine gluconate group). Soft tissue healing was evaluated in terms of wound closure, soft tissue swelling, and the color of the gingiva at 1 week postoperative. To decrease the chances for error, only the participants who did not show preoperative symptoms of infection and those who committed to practicing better oral hygiene were included in the study. The samples were evaluated for the infiltration of inflammatory cells (using inflammatory extent and inflammatory cellularity grades), maturation of collagen (osteoblast activity), and arrangement of cells (for detecting the remodeling phase). A questionnaire pertaining to mouthwash satisfaction, the duration of postoperative pain after the procedure, the time of stoppage of bleeding at the surgical site, and any sensitivity at the surgical site was given to the patients. The Chi-square test and Mann-Whitney U-test were used to analyze the data. The difference in postoperative surgical swelling, pain, bleeding, and redness in the patients was not statistically significant between the myrrh and chlorhexidine gluconate mouthwash groups. However, in the acute phase, the myrrh mouthwash showed a positive impact on the process of wound healing after implant placement. The small sample size and inability to compare wound healing in different anatomical areas of the oral cavity were the study limitations.

Salivary parameters among Arabian snuff (Shammah) users.

OBJECTIVES: To evaluate the salivary flow rate (SFR),  pH, and buffer capacity (BC) among healthy shammah users (SU) in comparison with healthy non-shammah users (NSU). Methods: This case-control study was conducted at the College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia between March 2016 and May 2017. A sample of 27 SU and 30 NSU were recruited. Unstimulated saliva was collected and SFR, pH, and BC were determined. Dental health was assessed using the decay-missing-filled teeth (DMFT) index.  Results: Shammah users were slightly older than NSU (28.9±6.9 versus 24.9±4.3 years). Salivary flow rate  was not significantly different, but pH (6.68±0.46) and BC (5.7±2.07) were significantly lower in SU users than in NSU (7±0.37; p=0.002 versus 8.1±1.47; p less than 0.001). Conversely, the DMFT in SU users was significantly higher (7.96±5.17) compared to that of NSU (4.53±3.46; p=0.007). Salivary pH and BC were significantly and directly correlated (rs= 0.576). The former was significantly and directly correlated with SFR (rs= 0.404), but the latter was not. In contrast, BC inversely correlated with decay (rs= -0.385) and DMFT (rs= -0.399). Conclusions: Shammah use is associated with alterations in saliva quality (pH and BC). It is also associated with poor dental health either through a direct effect or mediation by altered salivary parameters.