THE USE OF 0.2-PERCENT CHLORHEXIDINE IN THE ABSENCE OF A STRUCTURED MECHANICAL REGIMEN OF ORAL HYGIENE FOLLOWING THE NONSURGICAL TREATMENT OF PERIODONTITIS

The aim of the present study was to evaluate a 0.2 % chlorhexidine mou thrinse following the non-surgical treatment of advanced human periodo ntitis in the absence of a structured mechanical oral hygiene regimen. 10 patients and a total of 1483 sites were used. Recordings for plaqu e, bleeding, pocket depth and attachment levels were made at baseline and at 3, 6, 9, and 12 months. Debridement was performed under local a naesthesia. No instruction or reinforcement in mechanical oral hygiene procedures was given at any time. However, at each visit the patients were instructed in the 2x daily use of 0.2 % chlorhexidine mouthwash. The plaque indices, scored as % of sites with removable deposits, sho wed negligible improvement from baseline scores of 80 % - 100 % for al l categories of initial probing depth. Mean bleeding score was reduced to 10 - 20 % irrespective of initial probing pocket depth, site locat ion or tooth surface location. Sites greater than or equal to 7 mm at baseline demonstrated a reduction in mean probing pocket depth of 3.9 mm and a gain in mean probing attachment level of 2.5 mm. Moderately d eep sites (4 - 6.5 mm) demonstrated a reduction in mean probing pocket depth of 2 mm and a gain in mean probing attachment level of 0.8 mm. Shallow sites (less than or equal to 3.5 mm) demonstrated a reduction in mean probing pocket depth of 0.5 mm and a loss in mean probing atta chment level of 0.2 mm. Site-specific attachment level analysis demons trated that over 80% of losing sites were shallow with low bleeding fr equency, indicating that the loss of attachment may have occurred for reasons other than inflammatory periodontal disease. The results indic ate that chlorhexidine can be used as an adjunct to inadequate mechani cal oral hygiene over an observation period of 1 year.