## 4 Discussion
Nevertheless, a variety of control treatments had been used for comparison, indicating that there is a lack of an accepted gold standard of care [22]. Chemical plaque controls tested either through oral rinses or a denitrice had limited adjunctive effect. Patient-administered mechanical plaque control alone (with manual or powered toothbrush) can be considered the current standard of care [22]. In well-designed clinical randomized trials, therapeutic measures demonstrating efficacy should be evaluated in field studies. The comparison of clinical parameters should be based on changing the relationship between time and treatment rather than absolute values [22]. The study shows that the results obtained are similar for both test and control groups, in the sense that it was not possible to find significant differences between the two groups in terms of PI and mBI. Chlorhexidine is a powerful broad-spectrum antiseptic, effective both as Gram-positive and Gram-negative. Its bactericidal properties have long been recognized by numerous studies in the literature [13; 38]. The dicationic nature of CHX molecule permits the bacteriostatic and germicide effect of the product and a long lasting presence on the tooth surface; however, this chemical treatment has a side effect of tooth pigmentation [39]. This side effect, could potentially have a negative impact on patients' compliance [40]. So, the research of a new class of molecules potentially used as CHX, but with no side effects, could be a strategy for fighting against peri-implant mucositis. The test group gel is based on the principle that the combination of several bactericidal or bacteriostatic substances, such as Cetylpyridinium chloride, triclosan, and some essential oils, multiplies the disintegration effect of the biofilm. The efficacy and safety of Cetylpyridinium chloride was previously evaluated in in vitro and in vivo studies. Cetylpyridinium chloride has been shown to reduce bacterial load on titanium surfaces in vitro while reducing undesired side effects [19]. In an in vivo study, Cetylpyridinium chloride in combination with chlorhexidine was effective in reducing peri-implant mucositis [41]. Another 2019 study by [PERSON] et al. highlighted the potential of chlorhexidine as an antibacterial molecule for covering the internal chamber of the implant, developing a procedure and a strategy to reduce the risk of onset of mucositis and peri-implantitis. The results of this study show good soft tissue healing and an absence of tissue inflammation demonstrated by PCR analysis. Furthermore, the coating is also able to influence the quality of the microbiota [42]. The results of the present study show that the reduction of bleeding at probing is not different for the two groups; the test group has a percentage reduction of 71% and the control group has a reduction of 68%. These results can be attributed to the great bactericidal power of both substances. Another important feature of chlorhexidine is the high thickness and therefore the ability to adhere to dental surfaces, thus ensuring its action for a long time while also inhibiting the formation of bacterial plaque. The gel used in the test group containing the mixed salt of Na/Ca of the copolymer methyl-vinylether/polyvinyl-pyrylidone/Na carboxymethylcellulose has an increased ability to adhere over time to the tissues of the teeth and other mucous membranes of the oral cavity. However, in the light of these results, it could be hypothesized that the inhibiting power against bacterial plaque is slightly different from that of chlorhexidine, which is slightly higher (65% PI reduction for the control group and 60% for the test group). The use of the test group gel does not appear to cause pigmentation on crowns or bars, as it was found in the group that used chlorhexidine.