Comparison of the efficacy of chlorhexidine varnish and chip in the treatment of chronic periodontitis

Abstract

Background:The purpose of this study was to clinically evaluate the benefits of sub gingival chlorhexidine (CHX) varnish and biodegradable CHX chip application used as an adjunct to scaling and root planning (SRP) as combined therapy and also to compare the effect of combined therapy with SRP alone.Materials and Methods:Fifteen patients with at least three sites with a probing pocket depth (PPD) of 5-8 mm were considered. Following baseline evaluation, all three sites were subjected for SRP. After completing SRP, each site was randomly subjected for CHX varnish, CHX chip application and the 3rd site was left without any medication as a control. Clinical parameters such as sulcus bleeding index, plaque index, bleeding on probing (BOP), PPD, and clinical attachment level (CAL) were recorded at baseline, 1 month and 3 months post-operatively.Results:All three groups presented with an improvement in clinical parameters compared to baseline. The mean reduction in PPD was 2.4 mm in SRP sites, 2.5 mm in SRP + CHX varnish sites and 2.8 mm in SRP + CHX chip sites. The mean gain in CAL was 2.4 mm in SRP sites, 2.3 mm in SRP + CHX varnish sites and 2.8 mm SRP + CHX chip sites.Interpretation and Conclusion:The present study indicated that application of CHX varnish and placement of CHX chip as an adjunct to SRP produced a clinically significant reduction in the PPD, BOP and a gain in CAL at 30th day and 90th day from baseline when compared to SRP alone. The results though were not statistically significant.

The effect of carbonate apatite membrane gelatin application on IL-1β level gingival crevicular fluid in chronic periodontitis patients

“…Periodontal treatment is successful if the improvement of the inflammatory response occurs, characterised by decreasing of IL-1β. 11 IL-1β triggers an inflammatory response which activates osteoclasts thus plays an essential role in bone remodelling. 12 The apatite carbonate membrane gelatin is a synthetic product of a thin gelatin layer containing apatite carbonate.…”

“…8 The period of 30 days in this current study was selected because, in a study comparing the effectiveness of chlorhexidine varnish and chips in chronic periodontitis patients, significant differences were seen only in the 30 th day after treatment, while the results at three months and six months after treatment did not show any differences. 11 The apatite carbonate membrane gelatin can be well biodegraded and have excellent biocompatibility, resembling a bone connective tissue collagen matrix, which may initiate increased attachment and cell spread, and may also increase proliferation of fibroblasts. 11,13 The gelatin concentration in the apatite carbonate membrane used in this study was in the ratio of 7:3.…”

“…11 The apatite carbonate membrane gelatin can be well biodegraded and have excellent biocompatibility, resembling a bone connective tissue collagen matrix, which may initiate increased attachment and cell spread, and may also increase proliferation of fibroblasts. 11,13 The gelatin concentration in the apatite carbonate membrane used in this study was in the ratio of 7:3. This composition was appropriate and resulting in a large porosity that increases cell proliferation and facilitates the transport of oxygen and also nutrient supply.…”

Efficacy of grape seed extract gel in the treatment of chronic periodontitis: A randomized clinical study

“…It is worth noting that as the depth of the pockets increases, difficulty in reaching the bottom of the pockets to perform effective scaling and root planing increases . Accordingly, the deep pocket sites that were selected as test sites might not have had the efficient mechanical debridement that is considered an essential modality in the treatment of chronic periodontitis .…”

“…In addition to mechanical debridement via scaling and root planning, the current treatment of chronic periodontitis is also based on the use of topical antimicrobials, such as metronidazole, tetracycline, and chlorohexidine, which are delivered locally into the mucosa in the form of gel, ointment, or fibers to inhibit or eliminate pathogenic microorganisms and reduce tissue inflammation . However, these medicaments can be associated with a number of drawbacks.…”