Effect of chlorhexidine chip as an adjunct in non-surgical management of periodontal pockets: a meta-analysis

Abstract

Background The aim of this meta-analysis was to evaluate the difference in treatment outcomes between sub-gingival placement of chlorhexidine chip (CHX chip) in adjunct to scaling and root planing (SRP) and SRP alone for the management of periodontal pockets in patients suffering from chronic periodontitis. Methods We searched the MEDLINE (PubMed), SCOPUS and CENTRAL databases and identified 15 randomized clinical trials published within the last decade (2007–2019): 9 with split-mouth design and 6 with parallel study design. We extracted data and performed both qualitative and quantitative syntheses. The primary outcomes assessed were gain in clinical attachment level (CAL), reduction in probing pocket depth (PPD), improvement in gingival inflammation, and results of microbiological assays. Results We used meta-analysis plots to assess all the clinical outcomes. The mean differences in PPD reductions at 1 month (MD 0.63), 3 months (MD 0.69), and 6 months (MD 0.75); and the CAL gains at 1 month (MD 0.54), 3 months (MD 0.64), and 6 months (MD 0.68) showed more favorable responses in sites treated with the CHX chip as an adjuvant to SRP, than in sites treated with SRP alone. Conclusion SRP with adjunctive CHX chips showed better clinical outcomes than SRP alone for the management of periodontal pockets in patients with chronic periodontitis.

Treatment of residual pockets using an oscillating chitosan device versus regular curettes alone—A randomized, feasibility parallel‐arm clinical trial

“…However, other studies have shown beneficial effects of using antimicrobials 41 depending on the type of antimicrobial 42 . The use of adjunctive antiseptics, like chlorhexidine, has revealed additional beneficial effects in non‐surgical treatment, 43,44 but such results have been debated by other authors 45,46 …”

“…38 Similarly, adjunctive use of local antibiotics showed limited results, 39 in line with a study conducted by Tomasi et al 40 However, other studies have shown beneficial effects of using antimicrobials 41 depending on the type of antimicrobial. 42 The use of adjunctive antiseptics, like chlorhexidine, has revealed additional beneficial effects in non-surgical treatment, 43,44 but such results have been debated by other authors. 45,46 In this study, the broadly accepted metric of recording changes in PPD and BoP was used as a surrogate marker for active periodontal disease.…”

Treatment planning considerations in the older adult with periodontal disease

“…In a random sampling of 465 patients over 65 years old and wearing a complete or partial denture, over 77% of patients presenting for evaluation had a fungal infection 52 . Adjunctive use of subgingival chlorhexidine chips is often helpful in elderly patients that are not candidates for surgery 53 . Chlorhexidine has disadvantages, in causing staining, so other products, such as chlorine dioxide–based oral rinse, are often considered for a similar therapeutic effect.…”

“…52 Adjunctive use of subgingival chlorhexidine chips is often helpful in elderly patients that are not candidates for surgery. 53 Chlorhexidine has disadvantages, in causing staining, so other products, such as chlorine dioxide-based oral rinse, are often considered for a similar therapeutic effect. This type of oral rinse contains Cloralstan (a stabilized version of chloride dioxide) and has been shown to inhibit the growth of pathogens associated with periodontal disease.…”

Different applications forms of green tea (Camelliasinensis (L.) Kuntze) for the treatment of periodontitis: a systematic review and meta‐analysis

“…This has been the underlying principle for the development of new therapies to treat periodontitis that are based on the control of these factors, especially Gram‐negative anaerobic bacteria present in the subgingival environment of periodontal pockets 15,17 . The adjuvant use of antimicrobial agents has been advocated along with mechanical instrumentation 18‐20 . Chlorhexidine is considered the gold standard of chemical agents for the control of gingival inflammation, due to the antibiofilm effect 21,22 .…”