Adjunctive effect of chlorhexidine antiseptics in mechanical periodontal treatment: first results of a preliminary case series

Int J Dent Hyg. 2013 Aug;11(3):180-5. doi: 10.1111/idh.12009. Epub 2012 Dec 6.

Abstract

Objectives: The aim of the present case series was to evaluate the clinical and microbiological effects of a single session of mechanical and manual scaling and root planing (SRP) combined with the use of two different chlorhexidine formulations in the treatment for generalized chronic periodontitis.

Methods: Ten patients affected by chronic periodontal disease with periodontal probing depth (PPD) ≥ 5 mm were treated with SRP plus local chlorhexidine. In each patient, similar teeth, treated with SRP with the adjunctive use of chlorhexidine digluconate and dihydrochloride or chlorhexidine gluconate, respectively, were selected and assigned to a test and a control group. In both groups, PPD, bleeding on probing (BOP) parameters, total bacterial counts (TBC) and quality of periodontal bacteria at time 0 and 6 weeks after treatment were measured.

Results: PPD significantly decreased over time both in the test and in the control group; however, no significant differences between the two groups were observed. BOP and TBC were significantly lower in the test than in the control group 6 weeks after treatment. In the post-treatment revaluation, a significant decrease both in the treatment and in the control group, for each of the single periodontal pathogens, was observed.

Conclusion: In this study--a preliminary case series with small sample size and short follow-up--the adjunctive use of chlorhexidine (CHX) to SRP resulted in clinical and microbiological benefits in the treatment for generalized chronic periodontitis. A CHX gel formulation consisting of CHX digluconate and CHX dihydrochloride seems to lead some additional benefits over SRP plus CHX gluconate in the short term. Additional investigations are needed to evaluate the effectiveness of this antiseptic therapy.

Keywords: chlorhexidine; instrumentation; micro-organism; periodontitis.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aggregatibacter actinomycetemcomitans / drug effects
  • Anti-Infective Agents, Local / chemistry
  • Anti-Infective Agents, Local / pharmacology
  • Anti-Infective Agents, Local / therapeutic use*
  • Bacteroides / drug effects
  • Chemotherapy, Adjuvant
  • Chlorhexidine / analogs & derivatives
  • Chlorhexidine / chemistry
  • Chlorhexidine / pharmacology
  • Chlorhexidine / therapeutic use*
  • Chronic Periodontitis / drug therapy
  • Chronic Periodontitis / microbiology
  • Chronic Periodontitis / therapy*
  • Dental Plaque / microbiology
  • Dental Scaling*
  • Double-Blind Method
  • Humans
  • Middle Aged
  • Periodontal Index
  • Porphyromonas gingivalis / drug effects
  • Statistics, Nonparametric
  • Treponema denticola / drug effects

Substances

  • Anti-Infective Agents, Local
  • chlorhexidine gluconate
  • Chlorhexidine