Assessment of chlorhexidine combined with a Periplaneta americana extract mouthwash for preventing peri-implant diseases: a retrospective comparative study

Peri-implant diseases are common oral complications associated with implant-supported rehabilitation and are characterized by inflammatory conditions of peri-implant tissues induced by bacterial biofilms, including peri-implant mucositis and peri-implantitis. Although numerous studies have focused on therapeutic approaches, comparatively fewer investigations have addressed preventive strategies. This study aimed to evaluate the preventive effect of chlorhexidine combined with a Periplaneta americana extract mouthwash on peri-implant diseases. This retrospective study included patients who underwent dental implant surgery at the Department of Stomatology, Henan Provincial People’s Hospital, between January 2022 and December 2024. According to postoperative supportive peri-implant care (SPIC) regimens, patients were divided into three groups: (1) clean water rinsing, (2) chlorhexidine mouthwash (during the first 4 weeks post-implantation), and (3) chlorhexidine (during the first 4 weeks post-implantation) combined with Periplaneta americana extract mouthwash (during the first 2 weeks post-implantation). The primary effectiveness endpoint was the incidence of peri-implant diseases at 6 months postoperatively. A total of 1,268 patients (1,819 implants) were screened, of whom 682 patients (956 implants) were included in the final analysis: 106 patients in the clean water rinsing control group (149 implants), 450 patients in the chlorhexidine group (623 implants), and 126 patients in the chlorhexidine plus Periplaneta americana group (184 implants). The proportions of male patients were 66.0% (70/106), 71.3% (321/450), and 63.5% (80/126), respectively, with mean ages of 60.6 ± 7.2, 60.1 ± 8.1, and 60.4 ± 7.4 years. At 6 months postoperatively, the incidence of peri-implant mucositis was 18.9% (20/106), 10.2% (46/450), and 2.4% (3/126), respectively, with statistically significant differences among the groups (all p < 0.05). In contrast, the incidence of peri-implantitis was 1.9% (2/106), 1.1% (5/450), and 0% (0/126), respectively, with no statistically significant differences among the groups (all p > 0.05). This retrospective study provides evidence that the adjunctive use of chlorhexidine and Periplaneta americana extract mouthwash may reduce the incidence of peri-implant mucositis at 6 months postoperatively. Further prospective studies and mechanistic investigations are warranted to confirm these findings.