Comparison of the antimicrobial effect of the application of chlorhexidine gel, amine fluoride gel and stannous fluoride gel in debrided periodontal pockets

Abstract

The clinical and microbiological effect of locally-applied chlorhexidine gel 2%, amine fluoride gel 1.25%, stannous fluoride gel 4% or placebo gel in 40 periodontal pockets of 10 patients were studied. The gels were applied 3 x within 10 min. after mechanical debridement of the pockets. The treatment effect on the subgingival microflora was evaluated by microscopic and culture studies of the subgingival plaque samples. In addition, supragingival plaque, bleeding after probing and probing pocket depth were scored. Examination were carried out before and during a period of 36 weeks after treatment. At the start, the cultured microflora consisted mainly of anaerobic Gram-positive bacteria. Following treatment, the clinical parameters were significantly reduced. Concomitantly, the %s of spirochetes, motile rods and non-motile rods decreased significantly. A significant decrease was also found in the total anaerobic count, whereas the facultative counts remained at the same level found before treatment. This suggested that the treatment resulted in a mainly facultative subgingival microflora. The % Gram-negative rods showed a significant reduction after treatment, but returned to base line at week 12. Statistical analysis of the bacteriological and clinical examinations failed to demonstrate any significant differences between the 4 treatment groups. Thus, in comparison to the placebo gel, subgingival application of chlorhexidine gel 2%, amine fluoride gel 1.25% or stannous fluoride gel 4% did not augment the effect of mechanical debridement on bacteriological and clinical parameters during the experimental period of 36 weeks. However the indicated treatments resulted in a facultative subgingival microflora which is compatible with the host.

Clearance of topically-applied PVP-iodine as a solution or gel in periodontal pockets in men

“…However, a few reports on the clearance of agent vehicles have been published [19,32]. Therefore, the aim of the present study was to investigate the clearance of PVP-iodine in either solution or gel form applied in the periodontal pockets with and without instrumentation.…”

“…In addition, various attempts to eliminate pathogenic bacteria by additively administered chemical means have been undertaken: Systemically administered antibiotics proved significant effectiveness in combination with scaling and root planning [9][10][11][12] but bear the risk of undesirable side-effects and the development of bacterial resistance [13]. Topical application of antiseptics in periodontal pockets as an adjunctive to the mechanical debridement has been suggested [14][15][16][17][18] and tested in various clinical trials [19,20].…”

The comparative evaluation of xanthan gel with chlorhexidine (Chlosite) in smokers and non-smokers: A clinical and microbiological assessment

“…Attempts to prolong the subgingival application of CHX by incorporation of an antiseptic in a gel have not resulted in improved treatment outcomes,[9] However, with the use of chlosite, effective subgingival concentration of CHX can be maintained for several days. The physical properties of xanthan render it an optimum substrate for the formation of a stable gel that is easily extruded from a syringe needle; therefore, xanthan appears to be the best biocompatible vehicle for clinical application.…”

The Role of Subgingival Irrigations in the Treatment of Periodontitis

“…52 Rosling and coworkers64 used a different approach to deliver an antimicrobial agent and prolong its contact with the bacteria for an extended period of time. They connected the cooling system of a powerful (46,000 cps) ultrasonic sealer11 to a pressure tank containing a 0.05% povidone iodine solution for simultaneous scaling and irrigation, through the entire period of scaling and root planing.…”