Comparative evaluation of subgingivally delivered xanthan-based chlorhexidine gel and herbal extract gel in the treatment of chronic periodontitis

Abstract

Background:Local drug delivery agents can effectively deliver the antimicrobial drugs in bactericidal concentration, and have shown improved clinical outcomes when used as an adjunct to mechanical therapy. The aim of this study was to evaluate the efficacy of a xanthan-based chlorhexidine gel versus herbal extracts’ gel as an adjunct to periodontal therapy in the treatment of chronic periodontitis.Materials and Methods:A total of 150 sites, age group of 30-50 years, periodontal pockets measuring 5-8 mm and diagnosed with chronic periodontitis were selected for the study. The selected sites were randomized in five groups: Scaling and root planing (SRP) alone (Group A), SRP + Chlosite gel (Group B), SRP + Herbal gel (Group C), Chlosite gel alone (Group D) and Herbal gel alone (Group E). Clinical parameters such as Plaque Index, Gingival Index, probing pocket depth and clinical attachment level were recorded at baseline and 1- and 3-month intervals.Results:After 3 months, there were statistically significant reductions in all the clinical parameters for Groups B and C compared with Group A. There was no significant reduction in all clinical parameters between Group D and E where no mechanical therapy was performed.Conclusion:The results indicate that the local application of herbal gel can be comparably used as chlorhexidine gel in the treatment of chronic periodontitis as an adjunct to mechanical periodontal therapy.

Efficacy of local phytotherapy in the nonsurgical treatment of periodontal disease: A systematic review

“…One study showed that the test group presented a significant greater BOP change than control group; however, there were no differences between groups as regards PI and GI . Another study found a greater reduction in PI and GI on the test group . One study did not find differences in the GI between test and control groups and another did not find differences in BOP change and PI between groups…”

“…Initially, 164 patients with chronic periodontitis were enrolled, and 154 (93.9%) completed the follow‐up. Just 1 study included smokers and 6 others excluded them …”

“…Three studies were considered to have an unclear risk of bias, and 4 studies were judged to have high risk of bias (Table ).…”

“…The individual outcomes of studies are present in Table . Besides 1 paper did not use clinical attachment level gain as clinical outcome, all included studies showed that periodontal treatment in association with local phytotherapic delivery promoted a significant PPD reduction and 6 of them showed clinical attachment level gain . One study showed that the test group presented a significant greater BOP change than control group; however, there were no differences between groups as regards PI and GI .…”

“…Some papers have studied the effects of plants as adjuncts to periodontal treatment . Still, it is necessary to review systematically the evidence regarding their efficacy, in periodontal treatment.…”