Sustained Local Delivery of Chlorhexidine in the Treatment of Periodontitis: A Multi‐Center Study

Abstract

The safety and efficacy of a degradable, subgingivally placed drug delivery system containing 2.5 mg chlorhexidine (CHX) were evaluated in a randomized, blinded, multi-center study of 118 patients with moderate periodontitis. A split-mouth design was used to compare the treatment outcomes of scaling and root planing (SRP) alone with the combined use of SRP and the CHX in pockets with probing depths of 5 to 8 mm. The two maxillary quadrants were used for the two treatment arms of the study. Scaling and root planing was performed at baseline only, while the CHX was inserted both at baseline and at 3 months. Clinical and safety measurements including probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP) as well as gingivitis, plaque, and staining indices were recorded at baseline, and at 1, 3, and 6 months. The average PD reduction in the CHX-treated sites was significantly greater than in the sites receiving SRP alone at both 3 and 6 months with a mean difference of 0.42 mm (P < or = 0.01) at 6 months. The reduction in CAL at the treated sites was greater than at the SRP sites, although the difference was statistically significant at the 6-month visit only. An analysis of patients with initial probing depths of 7 to 8 mm (n = 56) revealed a significantly greater reduction in PD and CAL in those pockets treated with CHX compared to SRP at both 3 and 6 months. The mean differences between test and control sites at 6 months were 0.71 mm and 0.56 mm PD and CAL respectively.

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

“…This has also been seen by PerioChip as noted by Stabholz et al, [9] and Soskolne et al, [32]. At baseline, sites receiving SRP plus CHX and sites receiving solely SRP exhibited similar levels of periodontal pathogens.…”

“…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. Similarly an additional 0.4mm and 0.3 mm PPD reduction were noted by Soskolne et al, [32] and Jeffcoat et al, [33] in clinical trials with PerioChip. Complex root morphology and difficulty in access can limit the efficacy of SRP [34].…”

Auxiliary chemical therapies in the treatment of aggressive periodontitis: current aspects

“…However, in recent years, was published a systematic review that assessed the effects of debridement in single-stage (with or without antiseptic) and conventional therapy in patients with chronic periodontitis. This study did not find a relevant clinical advantage among the protocolos 26 .…”

Adsorption and release studies of sodium ampicillin from hydroxyapatite and glass-reinforced hydroxyapatite composites

“…The treatment of chronic periodontitis is focussed on stopping the destruction of the periodontal support of the teeth, by eliminating the pathogenic bacteria present in the in#amed pocket [3] followed by tissue reconstruction via guided tissue regeneration.…”

“…Recently, a new approach using local antibiotic delivery systems has been introduced, which allows the therapeutic agents to be targeted to the disease site with minimal systemic e!ects [3,4].…”