***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: The aim of the present trial was to determine the effect of different mouthwash preparations used as supplements to regular oral hygiene measures on dental plaque and gingivitis in humans . 96 volunteers were recruited for the study . Following a baseline examination , each subject was given a careful prophylaxis , following which the mouthrinse regimens were initiated . During the 6 weeks of trial , the subjects continued to exercise their regular non-supervised , self-performed plaque control measures . The 96 volunteers were assigned either to 1 or 3 different treatment groups or to a control group according to a r and omized code . The members of the control group and the listerine group rinsed with 20 ml of the mouthrinse for 30 s , twice daily , while the members of the chlorhexidine groups ( using either a 0.2 % or a 0.1 % solution ) rinsed with 10 ml of the antiseptic solution for 60 s twice daily . Examinations regarding extrinsic stain and plaque were performed at baseline and after 3 and 6 weeks , while the conditions of the gingiva were examined at baseline and after 6 weeks . Extrinsic stain was evaluated using the Lobene index , plaque was assessed by the Turesky modification of Quigley-Hein index and the gingival condition was examined using the gingival index system of Loe & Silness . The results of the trial demonstrated that the 3 active mouthwash preparations used as supplements to regular tooth cleaning measures markedly improved both the oral hygiene status and the gingival conditions of the participating human volunteers , compared to the control rinse . ( ABSTRACT TRUNCATED AT 250 WORDS Aim : To compare the effect of herbal extract mouthwash and chlorhexidine mouthwash on the  dental plaque level .  Material s and Methods : The subjects ( 60 healthy medical students aged ranges between 20 and 25 years ) were r and omly divided into two groups , that is , the herbal group and the chlorhexidine gluconate mouthwash group . The data were collected at the baseline and 3 days . The plaque was disclosed using erythrosine disclosing agent and their scores were recorded using the Quigley and Hein plaque index modified by Turesky-Gilmore-Glickman . Statistical analysis was carried out later to compare the effect of all the two groups . Results : Our result showed that the chlorhexidine group shows a greater decrease in plaque score followed by herbal extract , but the result was statistically insignificant . Conclusion : The results indicate that herbal mouthwash may prove to be an effective agent owing to its ability to reduce plaque level , especially in low socioeconomic strata The purpose of this investigation was to evaluate the effect of 0.2 % chlorhexidine gluconate mouthrinse following  gingivectomy on plague under the dressing and on healing .  Twenty-eight patients with indications for gingivectomy were selected .  Coe-Pak was used as surgical dressing . In addition to unsual home care , the patients rinsed twice daily with chlorhexidine or placebo for 21 d after surgery . The study followed a cross-over double-blind design . Gingival exu date was assessed and Pl I and G I were registered at 7 , 14 , and 21 d postsurgically . The study indicated that chlorhexidine did not influence the amount of plaque under the dressing , and it was uncertain whether chlorhexidine had any effect on the healing process when the surgical area was covered by Coe-Pak . However , ( 1 ) after the surgical dressing was removed , the chlorhexidine maintained plaque scores at the same low level as under the dressing , ( 2 ) healing was was promoted when chlorhexidine was used , and ( 3 ) the presence of a dressing in one side of the mouth did not prevent the patient from maintaining good oral hygiene Previous studies have demonstrated the potential beneficial effects of post-surgical rinsing with 0.2 % chlorhexidine . In the present investigation a new chlorhexidine formulation ( Peridex ) ( CHx ) and concentration ( 0.12 % ) was evaluated clinical ly to determine if similar effects could be detected from the use of the new product and treatment regimen . A double blind , r and omized , placebo-controlled study was carried out in 40 patients during a 6 week period . Patients who had moderate periodontitis ( AAP Class III ) received osseous periodontal surgery in one quadrant . Each surgical site received periodontal dressing and patients were given a placebo or CHx mouthrinse to be used twice each day . Compared to placebo , CHx significantly reduced plaque at all examinations ( 54.4 % reduction over placebo at 6 weeks , P less than 0.05 ) . Visible plaque ( PlI greater than 2 ) in the CHx group was reduced by 99 % over the placebo group at 6 weeks and at 4 weeks post-surgical , gingival inflammation scores were significantly lower in the CHx group ( 17 % reduction over the placebo at 4 weeks , P less than 0.05 ) . Gingival bleeding scores ( GI greater than 2 ) were significantly lower in the CHx group at 4 and 6 weeks ( 41 % and 40 % reduction over the placebo group , P less than 0.05 ) . Probing pocket depth and attachment level changes were not significantly different between both groups . Epithelialization rates and pain assessment demonstrated consistently better results in the CHx group , although differences were not statistically significant . Use of 0.12 % chlorhexidine immediately following periodontal surgery , for 6 weeks , has been shown to be a clinical ly effective adjunct providing enhancement of the post-surgical management of periodontal surgical patients Objectives : The study was performed to evaluate the incidence of post‐surgical adverse events at submerged implant sites as well as the antiplaque , antigingivitis and antistaining effects in the entire dentition of patients treated with two mouthwashes . Methods : The present r and omized controlled clinical study considered 40 patients subjected to dental implant treatment .  Two 0.12 % chlorhexidine mouthwashes were compared for 15 days : one with 0.1 % hyaluronic acid ( CHX⊗HYL group ) and one without it ( CHX group ) . Surgical outcome variables , and plaque , gingival , and staining indexes were recorded . Results : Significant differences were found between the two rinses regarding the presence of oedema within 2 days after surgery ( 20 % for the CHX⊗HYL group and 78 % for the CHX group ) . No other significant differences were recorded between the two mouthwashes . No intergroup differences in plaque , staining and gingivitis indexes were registered . The intragroup analysis revealed that for the plaque and gingival indexes , the differences between the baseline values ( before surgery ) and those at 15 days were all found to be significant just for CHX⊗HYL rinse , with final values ranging from 0.18 to 0.23 for the plaque index and from 0.06 to 0.07 for the gingival index . The staining index increased for both mouthwash types with significant results ( with final value of 0.19 and 0.31 for CHX⊗HYL and CHX groups , respectively ) . Conclusions : In the sites of patients subjected to dental implant placement , an additional anti‐oedematigenous effect in early healing seemed to be disclosed for 0.12 % CHX⊗HYL mouthwash . Regarding antiplaque and antigingivitis activities , HYL seemed to be ineffective Objectives The use of chlorhexidine ( CHX ) with or without alcohol has been recommended for a number of clinical applications . On the other h and , there is a plethora of widely subscribed antiseptics , such as agent C31 G ( alkyl dimethyl glycine/alkyl dimethyl amine oxide ) , which has not yet been evaluated postsurgically . The effectiveness of three different mouthrinses ( CHX with and without alcohol , C31 G ) in plaque control and early wound healing was compared postoperatively . Material s and methods In this , r and omized , double-blind , controlled clinical trial 42 patients were allocated to three groups assigned to  2 weeks rinsing after non-regenerative periodontal flap surgery with or without osseous surgery with C31 G ( group A ) , alcohol-free CHX 0.12 % ( group B ) or alcohol-based CHX 0.12 % ( group C ) . At days 7 and 14 , plaque and early wound healing indices were recorded . At day 14 , total bacterial counts were estimated utilizing real-time quantitative polymerase chain reaction ( qPCR ) . Statistics included linear and generalized linear mixed models . Results At day 7 , healing response was not significantly different among groups . At day 14 , group A revealed the highest while group C demonstrated the lowest plaque index values ( B vs A , odds ratio — OR = 0.18 , p = 0.012 ; C vs A , OR = 0.01 , p < 0.001 ; C vs B , OR = 0.06 , p < 0.001 ) . Group C demonstrated the lowest bacterial counts levels at day 14 ( 38.470 × 106 , 48.190 × 106 , and 3.020 × 106 for groups A , B , and C , respectively ) . At day 14 , healing was significantly better in group C compared to B ( p = 0.007 ) . Group A showed no significant differences compared to other groups . Conclusions ( 1 ) The presence of alcohol may increase the effectiveness of CHX in early wound healing , ( 2 ) C31 G might be an alternative solution prescribed during early postoperative period after non-regenerative periodontal flap surgery . Clinical relevance The present study found that active agent C31 G displayed no significant differences to CHX formulations regarding periodontal wound healing improvement and might be used alternatively after non-regenerative periodontal flap surgery . In addition , an alcohol based 0.12 % CHX mouthwash was more effective than an alcohol-free 0.12 % CHX and C31 G mouthrinse on plaque control in the absence of mechanical oral hygiene BACKGROUND Previous studies have shown that using an oxidising agent in addition to chlorhexidine reduces staining . AIM The purpose of the present study was to investigate whether , compared to chlorhexidine alone , the use of an oxidising mouthrinse as an adjunct to chlorhexidine is efficacious in reducing stain , plaque and gingivitis . METHOD This study had a single-blind , 2-group parallel design , including a 14-day experimental non-brushing period during which 1 group ( n= 14 ) used chlorhexidine alone ( CHX ) ( chlorhexidine mouthrinse , 0.12 % Oral-B laboratories , Irel and ) , and the other ( n= 14 ) used chlorhexidine in combination with an oxidising agent ( sodiumperborate-monohydrate-Bocasan , Oral-B laboratories , Irel and ) . Patients were r and omly assigned to either group . All participants received a scaling and polishing before the start of the trial . No oral hygiene instructions were given . Since , at the start of the experiment , all stain and plaque were removed , only the gingival condition was evaluated at baseline by means of bleeding on marginal probing . The examination after 14 days of rinsing included the evaluation of plaque , bleeding on marginal probing and stain ( GMSI : gingival modification of the stain index ) . RESULTS The results showed at day 14 , a significant difference between the 2 groups for plaque ( CHX : 0.18 , CHX+PER : 0.08 , p=0.03 ) and gingival bleeding ( CHX : 0.38 , CHX+PER : 0.21 , p<0.001 ) . The proportion of stained surfaces was less in the CHX+PER group ( 28 % ) , than in the chlorhexidine group ( 48 % ) ( p=0.04 ) . CONCLUSIONS In conclusion , the adjunctive use of an oxidising agent peroxyborate to chlorhexidine , proved to be superior to chlorhexidine alone with regard to the inhibition of plaque and development of gingivitis . In addition , the proportion of stained surfaces was significantly less when adding the oxidising mouthrinse to chlorhexidine The purpose of this study was to assess the efficacy of supragingival irrigation with 0.06 % chlorhexidine gluconate ( CHX ) on naturally occurring gingivitis . The relative benefit of CHX irrigation in comparison with CHX rinsing , water irrigation , and normal oral hygiene was evaluated . In a blind , placebo-controlled 6-month study 222 patients were assigned to one of four groups : Group 1 : Once daily irrigation with 300 ml water followed by irrigation with 200 ml 0.06 % chlorhexidine gluconate ( experimental ) ; Group 2 : Twice daily rinsing with 15 ml 0.12 % chlorhexidine ( positive control ) ; Group 3 : Once daily irrigation with 500 ml water ( irrigation control ) and Group 4 : Sodium fluoride dentifrice for normal oral hygiene only ( negative control ) . All groups used the same sodium fluoride dentifrice for tooth brushing . At baseline , 3 months , and 6 months patients were examined for Gingival Index ( GI ) , Bleeding on Probing ( BOP ) , Plaque Index ( PLI ) , Pocket probing depth ( PD ) , Calculus Index ( CI ) , and stain . After the baseline visit all patients received a supra- and subgingival oral prophylaxis . At 6 months GI and BOP were significantly ( P less than or equal to 0.05 ) reduced by adjunctive CHX irrigation ( 
    Output:
    
Mainly early publications assessed the benefits of CHX over placebo rinsing , whereas more recent publications focused more on the evaluation of new formulations with regard to effectiveness and side effects .
The use of CHX after surgery showed in general significant reduction in plaque ( means of 29–86 % after 1 week ) and bleeding ( up to 73 % ) as compared to placebo .
No consensus , however , was found regarding the most beneficial CHX formulation avoiding side effects .
Conclusion Chlorhexidine rinsing helps to reduce biofilm formation and gingival inflammation after surgery .
However , no additional reduction of periodontal probing depth over any given placebo or control solution could be found irrespective of whether CHX was used or not .
The use of additives such as antidiscoloration systems ( ADS ) or herbal extracts may reduce side effects while retaining efficacy .
Clinical relevance Within the limitations of this review , it can be concluded that CHX may represent a valuable chemo-preventive tool immediately after surgery , during the time period in which oral hygiene capacity is compromised .
To reduce the side effects of CHX and maintain comparable clinical effects , rinsing with less concentrated formulations ( e.g. , 0.12 % ) showed the most promising results so far