PERIO - Periodontal Practice Today 5 (2008), No. 4 4. June 2009
PERIO - Periodontal Practice Today 2 (2005), No. 2 (11.07.2005)
Sustained Local Delivery of Chlorhexidine During Initial Therapy of Chronic Periodontitis
Meyle, Jörg / Ammoura, Ayham / Hossain, Hamid / Bödecker, Rolf-Hasso / Chakraborty, Trinad / Domann, Eugen
Controlled local delivery of disinfecting agents has been demonstrated to be efficient in improving the outcome of periodontal therapy. The use of PerioChip® as an adjunctive to scaling and root planing (SRP) has been reported to improve the result of local therapy. In this study, the effect of the chip on clinical and microbiological parameters prior to SRP was analyzed. The following clinical parameters - probing pocket depth (PPD), attachment level (AL) and bleeding on probing (BOP) - were recorded at six sites/tooth in 14 patients with chronic periodontitis. Subgingival samples were collected from the deepest periodontal pocket (total: 56 sites) and analyzed by means of polymerase chain reaction (PCR). Chlorhexidine chips were then inserted into these pockets and the clinical and microbiological recordings were repeated on the 10th and 28th day post-placement. At baseline, Porphyromonas gingivalis (P.g.), Tannerella forsythia (T.f.), and Treponema denticola (T.d.) were the most frequently detected pathogens (95%, 98% and 81% of sites respectively). The use of PerioChip® resulted in significant (p<0.05) clinical improvements (mean PPD reduction: 0.96 mm; reduction in the percentage of bleeding sites: 53%) and in a significant reduction in the frequency of P.g., T.f. and T.d. (95 to 15%, 98 to 35% and 81 to 11%) respectively. It is concluded that the local disinfection of periodontal pockets with PerioChip® prior to mechanical therapy is effective in reducing putative pathogens in the pockets and also in improving clinical signs of periodontitis. However, sole use of PerioChip® without subsequent SRP cannot be recommended.
Keywords: periodontitis, chlorhexidine, local disinfection, pocket disinfection, periodontal pathogens, plaque