Hypochlorous Acid as a Potential Postsurgical Antimicrobial Agent in Periodontitis: A Randomized, Controlled, Non-Inferiority Trial

Autores organización

• David Augusto Diaz Baez

  Autor

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  Nathaly Andrea Delgadillo Salgado

  Autor

• 

  Diana Marcela Castillo Perdomo

  Autor

• Yormaris Castillo Romero

  Autor

• Yineth Neuta Poveda

  Autor

• 

  Gloria Ines Lafaurie Villamil

  Autor

Autores

• Plata JC
• Hurtado CP
• Calderón JL

Grupos de investigación

• Unidad de Investigación Básica Oral UIBO

  

  Investigador

  Gloria Ines Lafaurie Villamil

Resumen

Background: Hypochlorous acid (HOCl) is an antimicrobial agent with high affinity to Gram-negative bacteria of the subgingival biofilm. It could have an equivalent or no inferiority effect to chlorhexidine (CHX) to avoid recolonization of these microorganisms after the post-surgical period. Objective: The objective is to compare the reduction of plaque index (PI), gingival index (GI), pocket depth (PD), gain of clinical attachment level (CAL), and bacterial recolonization of periodontopathic microorganisms in subgingival biofilm at 7, 21, and 90 days after Open Flap Debridement (OFD) under two antimicrobial protocols: (A) HOCl 0.05% followed by HOCl 0.025% and (B) CHX 0.2%/CHX 0.12% used per 21 days without regular oral hygiene during the post-surgical period. Material and methods: A no-inferiority randomized controlled trial was carried out. Thirty-two patients were randomly divided to receive each antiplaque protocol after OFD in patients with periodontitis. Clinical indexes and bacterial recolonization were assessed using qPCR for up to 90 days. Data were analyzed using repeated measures ANOVA, mixed effects models adjusted for treatment, time, and the Chi-squared/Fisher test. A no-inferiority analysis was also performed using the Hodges–Lehmann hypothesis test for non-inferiority. Results: HOCl was not inferior to CHX in reducing PI. Both groups showed a comparable reduction of recolonization for Porphyromonas gingivalis, Tannerella forsythia, and Eubacterium nodatum. However, the HOCl protocol was non-inferior to the CHX protocol for Treponema denticola and Aggregatibacter actinomicetemcomitans. Conclusions: HOCl improved periodontal healing. HOCl showed an impact in reducing the recolonization of periodontopathic bacteria in the postoperative period. © 2023 by the authors.

Keywords

• antiinfective agent; hypochlorous acid; adult; Aggregatibacter; analysis of variance; Article; bacterial colonization; bacterial recolonization; biofilm; bleeding on probing; burning sensation; clinical article; clinical attachment level; clinical feature; controlled study; debridement; Eubacterium; female; follow up; gingival index; human; male; non-inferiority trial; nonhuman; pain; paresthesia; periodontal pocket depth; periodontitis; plaque index; polymerase chain reaction; Porphyromonas gingivalis; postoperative period; randomized controlled trial; Tannerella forsythia; Treponema denticola