Corsodyl

The test groups were as follows:1-

A high-molecular-weight hyaluronic-acid-containing toothpaste (non-commercial) diluted in PBS at a 20% (v/v) concentration;

2-

A fluoride-containing toothpaste (Aquafresh, GSK, Weybridge, UK) diluted in PBS at a 20% (v/v) concentration;

3-

A 67% sodium-bicarbonate-containing toothpaste (Corsodyl, GSK, Weybridge, UK) diluted in PBS at a 20% (v/v) concentration;

4-

The antibiotics penicillin and streptomycin (100 IU:100 mg/mL) (Sigma, Dorset, UK);

5-

A 0.2% w/v chlorhexidine digluconate mouthwash (Corsodyl, GSK, Weybridge, UK);

6-

Mechanical rinsing with phosphate-buffered saline (PBS) using a pipette;

7-

No bacterial removal;

8-

Oral mucosal models without bacteria.

Professional oral hygiene was applied 7–10 days prior to surgery. One hour before the operation, all patients received antibiotic prophylaxis with 2-g amoxicillin + clavulanic acid (Augmentin, GlaxoSmithKline, Italy) to prevent postsurgical infection.
Fifteen minutes before surgery, one tablet containing either 500-mg paracetamol + 30-mg codeine (Coefferalgan, Farma 1000, Italy) or starch (placebo) was administered orally; the two types of tablets had an identical appearance. Immediately before applying local anaesthesia, all participants were instructed to execute three mouth rinses with an antiseptic at 0.20 mg/ml (0.2% chlorhexidine, Corsodyl, GlaxoSmithKline, Italy).
Postsurgical instructions were given to each patient concerning food consumption as well as hygiene at the surgical site (0.2% chlorexidine spray, Corsodyl, GlaxoSmithKline, Italy). During this period, both groups of patients (analgesic and placebo) were allowed to take the same paracetamol-codeine tablets given preoperatively at 6-hour intervals depending on their pain symptoms (up to a maximum of 4-g paracetamol and 240-mg codeine per 24 hours). Any adverse events (nausea, vomiting, headaches, or dizziness) occurring between the start of the trial and 1 week later at the time of suture removal were recorded.

No postoperative antibiotics were prescribed, but we instructed participants to take 3 g of paracetamol daily for 10 days and to rinse their mouths with a solution of chlorhexidine digluconate (0.2%; Corsodyl, GlaxoSmithKline Consumer Healthcare, Buhl, Germany) for 1 min, twice daily for 10 days. We removed the sutures 10 days after surgery. Patients were asked to avoid mechanical brushing on the treated region for one week. A control healing visit occurred one week postsurgery, during which sutures were removed and participants were recommended to conduct a soft mechanical cleaning, beginning with the second week after the intervention, using a very soft surgical dental brush with 0.15 mm bristles (Meridol^®, GABA International AG, Therwil, Switzerland). Participants could progressively resume their usual oral hygiene measures from the third week after surgery. Three months and six months after surgery they returned for professional supragingival cleaning around the implant and teeth (performed by ST) and a reminder of oral hygiene technique.