Use of a Biodegradable Chlorhexidine Chip in the Treatment of Adult Periodontitis: Clinical and Radiographic Findings

Jeffcoat, Marjorie K.; Palcanis, Kent G.; Weatherford, Thomas W.; Reese, M.; Geurs, Nicolaas C.; Flashner, Moshe

doi:10.1902/jop.2000.71.2.256

Cited by 44 publications

(46 citation statements)

References 12 publications

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“…Regarding adjunctive local (SRPloc) therapy, irrigation of the pockets with disinfectants, application of local drug delivering devices [17][18][19][20][21][22] or local laser treatment [23][24][25][26] were identified. Pocket irrigation and mouth rinses in most of the studies were performed with chlorhexidine [27][28][29]66].…”

Section: Resultsmentioning

confidence: 99%

“…Two studies assessing local antibiotic/antiseptic treatment ( Figure 1) [20,24] as well as three studies with a systemic antimicrobial approach Figure 2) [40, 41,43] showed relatively high values for standardized mean differences in pocket reduction. This can be explained as follows: some of these studies included high numbers (up to 190) of participants [68] and/or had a small spread i.e.…”

Section: Discussionmentioning

confidence: 99%

“…This can be explained as follows: some of these studies included high numbers (up to 190) of participants [68] and/or had a small spread i.e. standard deviation (SD) of their data [20], which gives them a higher weight in the meta-analysis. On the other hand, study design plays a crucial role.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, study design plays a crucial role. For example, one study included only four sites per patient with probing depths between 5 and 8 mm [20]. Other studies just referred to single-rooted teeth [40] or sites with PD deeper than 3 mm [41], which of course also results in a higher mean pocket reduction compared to publications who dealt with full-mouth measurements.…”

Section: Discussionmentioning

confidence: 99%

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Improving Scaling And Root Planing Over The Past 40 Years: A Meta-Analysis

M¹

2014

Dentistry

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Aim: To screen whether or not classical non-surgical periodontal therapy improved over the last four decades and how adjunctive local or systemic measures influenced its clinical outcome. Methodology:Starting from the year 1970, the entire annual sets of publications of every 5th year of the "Journal of Clinical Periodontology" and the "Journal of Periodontology" were hand searched for articles dealing with nonsurgical periodontal therapy, i.e. scaling and root planing either alone (SRP) or in combination with adjunctive local (SRPloc) or systemic (SRPsyst) treatment. Mean pocket reduction was computed for each of the three treatment modalities. Where applicable, a meta-analysis and a meta-regression as well as linear regression were performed.Results: A total of 52 articles were found. Twenty-six thereof were randomized clinical trials. The meta-analysis revealed a standardized mean difference of pocket reduction of 0.77 mm (95% CI=0.283; 1.255) and 0.90 mm (95% CI 0.210; 1.593 for SRPloc-SRP and SRPsyst-SRP, respectively (P<0.0001). Meta regression showed significantly more mean pocket reduction for SRPloc (p=0.011) and SRPsyst (p=0.001) than for SRP. In addition, a negative correlation between time to re-evaluation and mean pocket reduction could be found (p=0.015). None of the treatment modalities improved over the past 40 years. Conclusion:Adjunctive local or systemic measures seem to improve the classic non-surgical periodontitis therapy, i.e. scaling and root planing. None of the three analyzed treatment modalities improved over the past 40 years.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Improving Scaling And Root Planing Over The Past 40 Years: A Meta-Analysis

M¹

2014

Dentistry

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“…In its present formulation, the chip resorbs and releases chlorhexidine in the pocket for approximately 7 to 10 days following placement. The average CHX concentration remain above 150 ppm at least 7 days (18). Polytetrafluoroethylene (PTFE) nonporous membrane (Tecnoflon-Brasflon, Ind.…”

Section: -Microscopic Analysismentioning

confidence: 99%

Biocompatibility of a chlorhexidine local delivery system in a subcutaneous mouse model

Monteiro¹,

Macedo²,

Macedo³

et al. 2011

Med Oral

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Objective: This study aimed evaluating histologically and histomorphometrically the response of the conjunctive tissue face to the implant of chlorhexidine chips in the subcutaneous tissues of rats. Study Design: In this research 35 male rats Wistar were used to analyze the biocompatibility and the degradation process of chlorhexidine chip. In each animal, it was made 2 incisions for subcutaneous implantation of chlorhexidine chip (test group) and a polytetrafluorethylene membrane (control group). The morphological changes in subcutaneous implantations were assessed after 1, 3, 5, 7, 10, 14, 21 days. The data were submitted to Friedman nonparametric test to analyze the comparisons among observation periods and to allow the comparison among groups. Results: Differences were found in the analysis of the inflammatory response when comparing the tested materials (p values ≤ 0.05). In test group was observed hemorrhage, edema and intense inflammatory infiltrate predominantly neutrophilic around material. From 3-day and subsequent periods was verified granulation tissue externally at this infiltrate. From 10-day on was observed crescent area of degradation of chlorhexidine chip, associated with neutrophilic and macrophagic infiltrate, that maintained until 21-day. In the control group, moderate inflammatory infiltrate was observed initially, predominantly polymorphonuclear, edema and granulation tissue 3-day period. The inflammatory infiltrate was gradually replaced for granulation tissue, culminating in a fibrous capsule. Giant multinucleate cells situated at contact interface with the coating was examined since 3-day and persisted until 21-day. Conclusion: The chlorhexidine chip induces an intense acute inflammatory response at subcutaneous tissue of rats. Therefore, at conditions of this study was not biocompatible.

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Application of chitosan gel in the treatment of chronic periodontitis

2006

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Local administration of antibiotics in periodontal therapy can be provided with an appropriate delivery system. The purpose of this study was to evaluate the clinical effectiveness of chitosan, both as a carrier in gel form and as an active agent in the treatment of chronic periodontitis (CP). The chitosan gel (1% w/w) incorporated with or without 15% metronidazole was prepared and applied adjunctive to scaling and root planing (SRP) in comparison to SRP alone (control group-C), in CP patients. The clinical parameters such as probing depth (PD), clinical attachment level, the amount of gingival recession, plaque index, gingival index, and gingival bleeding time index were recorded at baseline and at weeks 6, 12, and 24. In all groups, significant improvements were observed in clinical parameters between baseline and week 24 (p < 0.05). The reductions in PD values were 1.21 mm for Ch, 1.48 mm for Ch + M, and 0.94 mm for C groups. No complications related to the chitosan were observed in patients throughout the study period. It is suggested that chitosan itself is effective as well as its combination with metronidazole in CP treatment due to its antimicrobial properties.

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Use of a Biodegradable Chlorhexidine Chip in the Treatment of Adult Periodontitis: Clinical and Radiographic Findings

Abstract: These data indicate that the CHX chip, when used as an adjunct to scaling and root planing, significantly reduces loss of alveolar bone.

Cited by 44 publications

References 12 publications

Improving Scaling And Root Planing Over The Past 40 Years: A Meta-Analysis

Improving Scaling And Root Planing Over The Past 40 Years: A Meta-Analysis

Biocompatibility of a chlorhexidine local delivery system in a subcutaneous mouse model

Application of chitosan gel in the treatment of chronic periodontitis

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