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Long‐Term Clinical Effects of a Chlorhexidine Varnish Implemented Treatment Strategy for Chronic Periodontitis
Author(s) -
Cosyn Jan,
Wyn Iris,
De Rouck Tim,
Sabzevar Mehran Moradi
Publication year - 2006
Publication title -
journal of periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.036
H-Index - 156
eISSN - 1943-3670
pISSN - 0022-3492
DOI - 10.1902/jop.2006.050144
Subject(s) - scaling and root planing , medicine , dentistry , chlorhexidine , periodontitis , chronic periodontitis , oral hygiene , randomized controlled trial , clinical trial , gingival and periodontal pocket , surgery
Background: Scaling and root planing in combination with oral hygiene monitoring are still considered the therapeutic standards for periodontitis. Although this treatment concept customarily results in satisfactory clinical improvements, treatment outcome may become less favorable predominantly when full access to periodontal defects is compromised, thereby leaving accretions behind. The purpose of this study was to investigate, over a 9‐month period, the clinical benefits of a treatment strategy for chronic periodontitis based on a combination of sequential scaling and root planing and subgingival chlorhexidine varnish administration. Methods: This randomized controlled, single blind, parallel trial included 26 volunteers with chronic periodontitis. The control group received oral hygiene instructions and was scaled and root planed in two sessions. The test group received the same instructions and treatment; however, all pockets were additionally disinfected using a highly concentrated chlorhexidine varnish. Clinical response parameters were recorded at baseline and at 1, 3, 6, and 9 months. The impact of the initial strategy on the decision‐making process for supplementary therapy at 9 months was investigated based on treatment decisions made by five independent clinicians. Results: Both treatment strategies showed significant reductions in probing depth and gains in clinical attachment at study termination in comparison with baseline ( P <0.001). However, combination therapy resulted in a significant additional pocket reduction of 0.62 mm ( P <0.001). Initially deep pockets (≥7 mm) around multirooted teeth seemed to benefit most from the combination strategy, resulting in an additive pocket reduction of 1.06 mm ( P = 0.009) and a clinical attachment gain of 0.54 mm ( P = 0.048) in comparison to scaling and root planing alone. A trend toward a reduction of surgical treatment needs following the varnish‐implemented strategy was found ( P = 0.076). Conclusion: These findings suggest that the outcome of initial periodontal therapy may benefit from the adjunctive subgingival administration of a highly concentrated chlorhexidine varnish.