## 4 Discussion  
Plaque-related gingivitis is the most common infective oral disease together with caries [15], its proper treatment and management is crucial in the prevention of chronic periodontitis, which is the main cause of tooth loss, with negative consequences on life quality and global health [16]. This study highlighted the value of a CHX gel as an adjuvant treatment for patients following non-surgical periodontal treatment. Patients who applied the gel daily ended up with larger improvements of both FMPS and GI, compared with the control group. The FMPS underwent a greater and quicker improvement from the first week of use, while the GI decrease required more time. This is probably due to the character of the indexes: in fact, the GI is a tissue inflammation parameter, valuing the degree of gingival injury, and therefore the gingival epithelium restoration can only happen after the removal of the irritative bacterial trigger. In addition, GI is more easily affected by individual factors, like gingival biotype, age, smoking and teething [3]. The plaque accumulation's removal and control are essential for a successful periodontal disease therapy, and professional oral hygiene instructions are proven to boost the gingival inflammation indexes [17]. The utility of additional chemical anti-plaque agents for gingivitis treatment is acknowledged [18], and the active substance delivery format is relevant to the patient needs and compliance. The use of CHX mouthwashes appears to be more effective than toothpastes, while, when compared to gel and varnish, mouthwashes were less powerful in plaque control [19]. The gel ensures a longer-term release and antibacterial activity of CHX, while fluid formulation only demonstrated a short-term effect [19]. This is probably due to the higher control that the patient has over the gel application, which allows them to perfectly dose the amount of gel needed in every site and guarantees that the CHX contained in the product reaches all the desired areas, while liquid textures are less controllable. Moreover, the gel can stay longer on the gums, since the patients were asked to avoid drinks, food and rinses for at least 30 minutes after application, while mouthwashes are generally kept in the mouth only for a few minutes and often rinsed with water. \begin{table}
\begin{tabular}{c c c c c} \hline \hline  & **Group** & **n. Patients** & **Decrease 0–03 (\%)** & **\(p\) Value** \\ \hline \multirow{2}{*}{FMPS} & Study & 12 & 87\% & 0.03 * \\  & Control & 12 & 75\% & 0.03 * \\ \hline \multirow{2}{*}{GI} & Study & 12 & 84\% & 0.03 * \\  & Control & 12 & 80\% & 0.03 * \\ \hline \multicolumn{4}{c}{* Statistically significant (\(p<0.05\)).} \\ \end{tabular}
\end{table} 
Table 1: Full mouth plaque score (FMPS) and Gingival index (GI) reduction from \(\Omega\) to \(\Omega\) in study and control groups. \begin{table}
\begin{tabular}{c c c c c c c c c c c c c} \hline \hline  & \multicolumn{4}{c}{**Patients**} & \multicolumn{4}{c}{**Plaque Score (Means)**} & \multicolumn{4}{c}{**Cingival Index (Means)**} \\ \hline  & **n** & **Mean Age** & **Sex** & **t0** & **t1** & **t2** & **t3** & **(A(\Omega\)-\(\Omega\))** & **t0** & **t1** & **t2** & **t3** & **(A(\Omega\)-\(\Omega\))** \\ \hline \multirow{2}{*}{Study group} & \multirow{2}{*}{12} & \multirow{2}{*}{50} & F \(\sim\)7 & 2.11 & 1.09 & 0.63 & 0.31 & 1.83 & 1.6 & 0.9 & 0.54 & 0.26 & 1.34 \\  & & M \(\sim\)5 & SD \(\sim\)0.6 & SD \(\sim\)0.3 & SD \(\sim\)0.2 & SD \(\sim\)0.1 & SD \(\sim\)0.5 & SD \(\sim\)0.3 & SD \(\sim\)0.2 & SD \(\sim\)0.1 & SD \(\sim\)0.4 \\The brush-on application of CHX brings the benefit of a lower risk of teeth discoloration, which is the main side effect of this antiseptic compared to mouthwashes [20], other than the easier compliance for the patients, requiring a gesture similar to teeth brushing.