Assessment of Periodontal Status and Biocompatibility in Orthodontic Patients with and without Adjunct Chlorine Dioxide Mouthwash – A Comparative Study

Introduction: Malocclusion and fixed orthodontic appliances can increase plaque accumulation and the risk of periodontal disease. Effective plaque control is crucial during orthodontic treatment. While chlorhexidine is a gold standard mouthwash, it has side effects like staining and enhance metal ion release from orthodontic appliances. Chlorine dioxide (ClO 2 ) mouthwash is a promising alternative with potentially fewer adverse effects. Aim: The aim of the study is to assess the periodontal status and biocompatibility in the buccal cells of orthodontic subjects on mechanotherapy with and without adjunct ClO 2 using Micronucleus test. Materials and Methods: This randomized, controlled, single-blinded trial enrolled 40 patients aged 18–30 undergoing fixed orthodontic treatment. Participants were assigned to two groups: Group I (mechanical plaque control only) and Group II (mechanical plaque control with adjunct ClO 2 mouthwash). Plaque index (PI), gingival bleeding index (GBI), probing pocket depth (PPD), clinical attachment level (CAL), and micronuclei (MN) in buccal epithelial cells assessed at baseline, 1 st and 3 rd months. Results: Group II showed significantly lower PI and GBI scores at 1 and 3 months compared to Group I. While both groups showed increased PPD and CAL over time, the differences between groups were not significant. Critically, Group I exhibited a significant increase in micronucleated cells over time, while Group II showed a decrease from 1 st to 3 rd months. Conclusion: ClO 2 mouthwash significantly reduced plaque and gingival bleeding in orthodontic patients, mitigating MN increase from fixed appliances, suggesting DNA damage protection.