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A Novel Approach to the Use of Subgingival Controlled‐Release Chlorhexidine Delivery in Chronic Periodontitis: A Randomized Clinical Trial
Author(s) -
Gonzales Jose R.,
Harnack Lutz,
SchmittCorsitto Gabriella,
Boedeker Rolf H.,
Chakraborty Trinad,
Domann Eugen,
Meyle Joerg
Publication year - 2011
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.2011.100287
Subject(s) - chlorhexidine , medicine , dentistry , randomized controlled trial , periodontitis , chronic periodontitis , gingival and periodontal pocket , surgery
Background: We aimed to analyze clinical, microbiologic, and serologic effects of chlorhexidine (CHX) chips used as a subgingival controlled‐release delivery device before and immediately after scaling and root planing (SRP). Methods: Twenty‐four patients presenting with ≥12 teeth with probing depth (PD) ≥5 mm and bleeding on probing were assigned in test or control groups. After prophylaxis, CHX chips (test) or placebo chips (control) were placed in pockets with PD ≥5 mm. Ten days later, SRP was performed in all teeth with PD ≥4 mm in a single appointment. Immediately after SRP, new chips were inserted in all pockets with PD ≥5 mm. Parameters were assessed at baseline; beginning of SRP; and 1, 3, and 6 months after treatment. Subgingival samples were obtained at baseline; beginning of SRP; and at 1 month after treatment. Periodontal pathogens Aggregatibacter actinomycetemcomitans , Porphyromonas gingivalis , Prevotella intermedia , Tannerella forsythia , and Treponema denticola were analyzed. Serum levels of high sensitive C‐reactive and lipopolysaccharide‐binding proteins were measured. The changes of the parameters between and within the groups were tested by Mann‐Whitney U test ( P <0.05). Results: All clinical and serologic parameters improved in both groups over time. There was a significant difference in clinical attachment level (CAL) gain from baseline to 6 months between groups (1.17 mm in the test group versus 0.79 mm in the placebo group) ( P <0.05). The treatment with CHX chips showed a greater reduction of the microorganisms of the “red complex” after 1 month ( P = 0.02). Conclusion: The use of CHX chips before and immediately after SRP improved CAL and reduced the subgingival microorganisms of the red complex in the treatment of chronic periodontitis.