A Systematic Review on the Effects of the Chlorhexidine Chip When Used as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis

Abstract

The clinical and microbiological data currently available on the chlorhexidine chip are limited and conflicting. More research is needed to elucidate the additional value of the chlorhexidine chip when used as an adjunct to scaling and root planing.

Adsorption of chlorhexidine on synthetic hydroxyapatite and in vitro biological activity

“…In periodontal therapy, the use of CHX chip (Periochip ® , Dexcel Pharma Technologies, Jerusalem, Israel), which contains 2.5 mg of CHX digluconate formulated in a biodegradable cross-linked gelatin matrix has emerged as a promising drug delivery device [19]. However, some studies were controversial about the advantages of this device compared to conventional therapy [20,21]. In this way, novel substrates to adequately adsorb and deliver CHX should be investigated, due to the excellent biocompatibility and antimicrobial characteristics of CHX.…”

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

“…CHX chip treatment of adult periodontitis lesions provides little or no additional antimicrobial benefits in comparison to thorough SRP alone (10). In a review study, Cosny et al (4) concluded that the clinical and microbiological data currently available on the CHX chip are limited and conflicting and more research are needed to elucidate the additional value of the CHX chip when uses as an adjunct to scaling and rooting planning. CHX chip consists in a degradable matrix of crosslinked hydrolyzed gelatin (18).…”

“…However, mechanical debridement may fail to remove pathogenic organisms because of their location in subepithelial gingival tissue, crevicular epithelial cells, collagenous substrata, altered cementum and radicular dentinal tubuli, subgingival hard deposits, furcations or other anatomic features complicating adequate instrumentation. Moreover, pathogens frequently colonize oral mucosa, tongue dorsum, tonsils and other buccal domains and may translocate from non-periodontal sites to periodontal crevices (3)(4). As an antiseptic, chlorhexidine (CHX) has been used effectively for over than 30 years in the treatment of gingival inflammation.…”

“…Improved patient compliance, drug access to the site of disease, and lower total drug dosage are the main benefits of a controlled delivery device (5). A degradable, subgingivally placed drug delivery system containing 2.5 mg chlorhexidine gluconate ‡ was developed(6), but experimental and clinical studies demonstrated controversial results about the use of CHX chip as an adjunct of SRP in the treatment of periodontal disease (3)(4)(5)(6)(7)(8)(9)(10). A strong anti-inflammatory effect was associated to CHX, by reducing the activity of matrix metalloproteinases (MMPs) (7), the basal concentration of leucocytes and the levels of the proinflammatory cytokines (11).…”

Chapter 13. Antimicrobial Photodynamic Therapy (aPDT) for Oral Infections

“…As a result, multiple adjunctive approaches have been evaluated including systemic antibiotics, 79 locally applied antibiotics 80 and topical disinfectants such as chlorhexidine gluconate. 81 In practice, however, growing concerns over antibiotic resistance have made the widespread use of systemic antibiotics impractical. Furthermore, the difficulty in applying topical agents sub-gingivally combined with the propensity for rapid flushing due to excessive secretion of gingival crevicular fluid has limited the effectiveness of most topical adjuncts to SRP.…”