Multiple applications of flurbiprofen and chlorhexidine chips in patients with chronic periodontitis: a randomized, double blind, parallel, 2‐arms clinical trial

Abstract

AimThe aim of the present randomized, double blind, parallel, 2-arm clinical study was to examine the safety and efficacy of frequent applications of chlorhexidine chip (CHX) and flurbiprofen chip (FBP) in patients with chronic periodontitis.MethodsSixty patients were randomized into CHX and FBP groups. Following OHI and scaling and root planing (SRP), baseline pocket depth (PD) measurements, gingival recession and bleeding on probing (BOP) were performed and repeated at week 4 and 8. The assigned chip was placed at weeks 0, 1, 2, 3, 5, 7.ResultsMean PD reduction in the CHX group was 2.08 mm (7.17 to 5.09, p < 0.0001). Mean PD reduction in the FBP group was 2.27 mm (6.72 to 4.45, p < 0.0001). Ninety-seven percentage and 95% of these sites exhibited PD reduction ≥1 mm, while 38% and 34% of the sites exhibited PD ≥3 mm (FBP and CHX, respectively). Clinical attachment level gain (1.66 and 1.95 mm, respectively) was statistically significant (p < 0.0001). Baseline BOP dropped from 98% and 100% to 24% and 30% for the CHX and FBP groups, respectively (p < 0.0001).ConclusionFrequent applications of CHX and FBP chips resulted in a significant improvement in the periodontal condition in these sites. Furthermore studies will be required to compare this new treatment regimen to SRP or SRP with single chip application.

Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study

“…Mean PPD reduction from baseline to week 11 visit for the SRP plus CHX group was 1.9 ± 0.32 mm similar to the results obtained by Kondreddy K et al, [30] where he noted a mean reduction in probing pocket depth between 0 and 90 th day of 1.6±0.5 mm and 1.26+1.19 mm as seen by Grover V et al, [17]. Mean PPD reduction of 2.08 mm was noted in a similar study after 8 weeks and could be attributed to the repeated placement of CHX chips as opposed to the single time placement in the present study [31]. An additional PPD reduction of 0.8 mm was obtained in the SRP plus CHX group as compared to the SRP group at 11 weeks.…”

Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study

“…Mean PPD reduction from baseline to week 11 visit for the SRP plus CHX group was 1.9 ± 0.32 mm similar to the results obtained by Kondreddy K et al, [30] where he noted a mean reduction in probing pocket depth between 0 and 90 th day of 1.6±0.5 mm and 1.26+1.19 mm as seen by Grover V et al, [17]. Mean PPD reduction of 2.08 mm was noted in a similar study after 8 weeks and could be attributed to the repeated placement of CHX chips as opposed to the single time placement in the present study [31]. An additional PPD reduction of 0.8 mm was obtained in the SRP plus CHX group as compared to the SRP group at 11 weeks.…”

Treatment of peri‐implantitis using multiple applications of chlorhexidine chips: a double‐blind, randomized multi‐centre clinical trial

“…More recently, we have reported (Machtei et al. ) on the clinical response to a similar intensive protocol of chlorhexidine chips placement around teeth: Mean PD reduction was incredibly similar (2.09 mm) compared with that around implants in this study (2.13 mm); In contrary, CAL gain in this study (2.18 mm) was much greater than what we have achieved around teeth (1.66 mm). This phenomenon would require further research as it may lend some clues to the less favourable response to therapy often reported with dental implants (Lang & Berglundh ).…”

Controlled release devices as adjuvants in nonsurgical periodontal therapy: A systematic review

“…[ 13 , 18 ] Furthermore, its action together with flurbiprofen is also beneficial, due to the additional anti-inflammatory effect of flurbiprofen. [ 31 ] Furthermore, after analyzing the risk of bias, this study was classified as low risk, showing its reliability.…”

“…In this same perspective, Machtei et al ,[ 31 ] in 2011, observed an improvement in all clinical periodontal parameters in patients treated with SRP associated with CHX Chips and SRP combined with flurbiprofen, and this is due to the anti-infective effect of the application of these chips it caused the microbial flora with chlorhexidine and the inflammatory response with flurbiprofen. However, the results had no statistically relevant differences between them, which suggests that mechanical therapy alone is not as effective, but also highlights that the use of the drug without the SRP will be ineffective, regardless of the drug used.…”

Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study

“…Mean PPD reduction from baseline to week 11 visit for the SRP plus CHX group was 1.9 ± 0.32 mm similar to the results obtained by Kondreddy K et al, [30] where he noted a mean reduction in probing pocket depth between 0 and 90 th day of 1.6±0.5 mm and 1.26+1.19 mm as seen by Grover V et al, [17]. Mean PPD reduction of 2.08 mm was noted in a similar study after 8 weeks and could be attributed to the repeated placement of CHX chips as opposed to the single time placement in the present study [31]. An additional PPD reduction of 0.8 mm was obtained in the SRP plus CHX group as compared to the SRP group at 11 weeks.…”

Treatment of peri‐implantitis using multiple applications of chlorhexidine chips: a double‐blind, randomized multi‐centre clinical trial

“…More recently, we have reported (Machtei et al. ) on the clinical response to a similar intensive protocol of chlorhexidine chips placement around teeth: Mean PD reduction was incredibly similar (2.09 mm) compared with that around implants in this study (2.13 mm); In contrary, CAL gain in this study (2.18 mm) was much greater than what we have achieved around teeth (1.66 mm). This phenomenon would require further research as it may lend some clues to the less favourable response to therapy often reported with dental implants (Lang & Berglundh ).…”

Controlled release devices as adjuvants in nonsurgical periodontal therapy: A systematic review

“…[ 13 , 18 ] Furthermore, its action together with flurbiprofen is also beneficial, due to the additional anti-inflammatory effect of flurbiprofen. [ 31 ] Furthermore, after analyzing the risk of bias, this study was classified as low risk, showing its reliability.…”

“…In this same perspective, Machtei et al ,[ 31 ] in 2011, observed an improvement in all clinical periodontal parameters in patients treated with SRP associated with CHX Chips and SRP combined with flurbiprofen, and this is due to the anti-infective effect of the application of these chips it caused the microbial flora with chlorhexidine and the inflammatory response with flurbiprofen. However, the results had no statistically relevant differences between them, which suggests that mechanical therapy alone is not as effective, but also highlights that the use of the drug without the SRP will be ineffective, regardless of the drug used.…”

Adjunctive Effects of A Piscean Collagen-Based Controlled-Release Chlorhexidine Chip in the Treatment of Chronic Periodontitis: A Clinical and Microbiological Study

“…Mean PPD reduction from baseline to week 11 visit for the SRP plus CHX group was 1.9 ± 0.32 mm similar to the results obtained by Kondreddy K et al, [30] where he noted a mean reduction in probing pocket depth between 0 and 90 th day of 1.6±0.5 mm and 1.26+1.19 mm as seen by Grover V et al, [17]. Mean PPD reduction of 2.08 mm was noted in a similar study after 8 weeks and could be attributed to the repeated placement of CHX chips as opposed to the single time placement in the present study [31]. An additional PPD reduction of 0.8 mm was obtained in the SRP plus CHX group as compared to the SRP group at 11 weeks.…”

Treatment of peri‐implantitis using multiple applications of chlorhexidine chips: a double‐blind, randomized multi‐centre clinical trial

“…More recently, we have reported (Machtei et al. ) on the clinical response to a similar intensive protocol of chlorhexidine chips placement around teeth: Mean PD reduction was incredibly similar (2.09 mm) compared with that around implants in this study (2.13 mm); In contrary, CAL gain in this study (2.18 mm) was much greater than what we have achieved around teeth (1.66 mm). This phenomenon would require further research as it may lend some clues to the less favourable response to therapy often reported with dental implants (Lang & Berglundh ).…”

Controlled release devices as adjuvants in nonsurgical periodontal therapy: A systematic review

“…[ 13 , 18 ] Furthermore, its action together with flurbiprofen is also beneficial, due to the additional anti-inflammatory effect of flurbiprofen. [ 31 ] Furthermore, after analyzing the risk of bias, this study was classified as low risk, showing its reliability.…”

“…In this same perspective, Machtei et al ,[ 31 ] in 2011, observed an improvement in all clinical periodontal parameters in patients treated with SRP associated with CHX Chips and SRP combined with flurbiprofen, and this is due to the anti-infective effect of the application of these chips it caused the microbial flora with chlorhexidine and the inflammatory response with flurbiprofen. However, the results had no statistically relevant differences between them, which suggests that mechanical therapy alone is not as effective, but also highlights that the use of the drug without the SRP will be ineffective, regardless of the drug used.…”