Use of chlorhexidine chip after scaling and root planning on periodontal disease: A systematic review and meta-analysis

Abstract

Objective This systematic review aims to assess the efficacy chlorhexidine chip as an adjunctive therapy of scaling and root planning on periodontal disease treatment. Material and methods This study follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA) and was registered in the PROSPERO database (CRD42019148221). The search was performed in PubMed/MEDLINE, Scopus, and Cochrane databases until April 2020. The PICO question was: “Is the chlorhexidine chip (CHX) effective as an adjunctive therapy of scaling and root planning on periodontal disease treatment?”. Inclusion criteria involved: randomized controlled clinical trials, with a minimum of 15 patients included on the sample and each patient has two sites of probing depth of ≥5 mm; The minimum follow up was at least 1 months of follow-up and the outcomes present in the studies probing depth (PD), plaque index (PI) and clinical attachment level (CAL) after scaling and root planning (SRP). Results After searching the databases, 13 articles were selected for qualitative and 8 for quantitative analysis. Were included 427 patients, with a mean age of 45.6 years. The results shown that the association of chlorhexidine chips to scaling and root planning reduce periodontal pocket depths ( P < 0.00001; MD −0.77 [CI −1.0 to −0.55]; I 2 = 23%, P = 0.24), gain on the clinical attachment level ( P < 0.0001; MD −0.57 [CI −0.86 to −0.27]; I 2 = 33%, P = 0.18P < 0.0001) and reduction on plaque index (P = 0.04; MD −0.23 [CI −0.45 to −0.01]; I 2 = 91%, P < 0.00001). Conclusions Thus, we can conclude that chlorhexidine chip when used associated to scaling and root planning promoted a significant improvement the reduction of periodontal diseases.

A Review of the Effects of Collagen Treatment in Clinical Studies

“…The use of different biomaterials in periodontal regeneration has been studied for years. Several treatment options for periodontal disease include open flap debridement (OFD), biologically active regenerative materials, bone-replacement graft materials, scaling and root planning, and guided tissue regeneration with barrier membranes [87][88][89][90][91][92]. The combined use of barrier membranes and biomaterials was shown to be more effective than using OFD alone.…”

Local Oral Delivery Agents with Anti-Biofilm Properties for the Treatment of Periodontitis and Peri-Implantitis. A Narrative Review

“…It has been shown that the number of pockets ≥7 mm-deep that reduced ≥2 mm was almost doubled in patients treated with SRP plus CHX Gluconate Chip compared to SRP alone [ 52 ]. Improvement of pocket depth (PD), Clinical Attachment Level (CAL) with the CHX Gluconate Chip as an adjunct to SRP has also been shown for pockets ≥ 5 mm [ 17 ]. Moreover, studies have shown mean improvement in PD between 2.3 and 3.4 mm and CAL gain 1.0–2.3 mm [ 53 ].…”

“…Specifically for periodontitis and peri-implantitis, commonly used anti-biofilm agents include a variety of antibiotics and the antiseptic chlorhexidine (CHX), which can be delivered systemically or locally [ 13 , 14 , 15 , 16 , 17 ]. Different systematic reviews have compared traditional non-surgical mechanical treatment for periodontitis and peri-implantitis with debridement combined with anti-biofilm agents or anti-biofilm agents alone [ 13 , 15 , 16 , 17 , 18 ]. For local delivery antibiotics, the results are still controversial [ 13 , 15 , 19 ].…”

“…For local delivery antibiotics, the results are still controversial [ 13 , 15 , 19 ]. Apart from antibiotics, local delivery of CHX combined with scaling and root planing (SRP) has been shown to improve the outcome of periodontal treatment [ 17 ]. Recently, antimicrobial agents isolated from animals, microbes, or plants have been introduced.…”

The Emerging Role of Plant-Derived Exosomes-Like Nanoparticles in Immune Regulation and Periodontitis Treatment

“…Therefore, the effective treatment of periodontitis is vital for a healthy life. Conventional treatment approaches to periodontitis including non-surgical, surgical, and adjunctive pharmacological therapy have limitations, such as residual bacterial and calculus in the deep periodontal pocket, limited effect on inflammation regulation, limited periodontal tissue regeneration, and lack of consideration of the effect of systemic diseases (6)(7)(8).…”