The efficacy of 0.12% chlorhexidine mouthrinse compared with 0.2% on plaque accumulation and periodontal parameters: a systematic review

Objectives: The aim of this systematic review was to evaluate the effects of 0.12% chlorhexidine (CHX) mouthrinse compared with 0.2% on plaque and periodontal parameters.
Materials and methods: MEDLINE-PubMed and the Cochrane Central Register of Controlled Trials were searched for (randomized) clinical trials and cohort studies. Plaque scores, parameters of periodontal inflammation and periodontal attachment loss were selected as primary outcome parameters.
Results: Screening of 409 titles and abstracts identified eight eligible publications. A meta-analysis of seven studies using the same plaque index showed a significant difference between 0.2% and 0.12% CHX (p=0.008). The Weighted Mean Difference for plaque based on the Quigley & Hein Plaque Index (1968) was 0.10 (95%CI [0.03-0.17]) (heterogeneity I2=0%, p=0.87). Three studies that compared 0.12% and 0.2% CHX mouthrinse products provided data on gingival inflammation. No difference in the effect of gingivitis between the two concentrations was found in these studies. No studies could be found that compared the two CHX concentrations and evaluated the probing pocket depth and/or the periodontal attachment level.
Conclusions: In comparing 0.12% and 0.2% CHX, information concerning the effect on gingival inflammation was sparse and no studies could be found that compared the two CHX concentrations and evaluated the probing pocket depth and/or the periodontal attachment level. With respect to plaque inhibition, the results showed a small but significant difference in favour of the 0.2% CHX concentration. However, the clinical relevance of this difference is probably negligible.