ADJUNCTIVE USE OF A SUBGINGIVAL CONTROLLED-RELEASE CHLORHEXIDINE CHIPREDUCES PROBING DEPTH AND IMPROVES ATTACHMENT LEVEL COMPARED WITH SCALING AND ROOT PLANING ALONE

THE PRESENT STUDIES EVALUATED the efficacy of a controlled-release bio degradable chlorhexidine (CHX) (2.5 mg) chip when used as an adjunct t o scaling and root planing on reducing probing depth (PD) and improvin g clinical;attachment level (CAL) in adult periodontitis. Two double-b lind, randomized, placebo-controlled multicenter clinical trials (5 ce nters each) were conducted; pooled data are reported from all 10 cente rs (447 patients). At baseline, following 1 hour of scaling and root p laning (SRP) in patients free of supragingival calculus, the chip was placed in target sites with PD 5 to 8 mm which bled on probing. Chip p lacement was repeated at 3 and/or 6 months if PD remained greater than or equal to 5 mm. Study sites in active chip subjects received either CHX chip plus SRP or SRP alone (to maintain study blind). Sites in pl acebo chip subjects received either placebo chip plus SRP or SRP alone , Examinations were performed at baseline; 7 days; 6 weeks; and 3, 6, and 9 months. At 9 months significant reductions from baseline favorin g the chlorhexidine chip compared with both control treatments were ob served with respect to PD (chlorhexidine chip plus SRP, 0.95 +/- 0.05 mm; SRP alone, 0.65 +/- 0.05 mm, P < 0.001; placebo chip plus SRP, 0.6 9 +/- 0.05 mm, P < 0.001) and CAL (chlorhexidine chip plus SRP, 0.75 /- 0.06 mm; SRP alone, 0.58 +/- 0.06 mm, P < 0.05; placebo chip plus S RP, 0.55 +/- 0.06 mm, P < 0.05). The proportion of patients who eviden ced a PD reduction from baseline of 2 mm or more at 9 months was signi ficantly greater in the chlorhexidine chip group (19%) compared with S RP controls (8%) (P < 0.05), Adverse effects were minor and transient toothache, including pain, tenderness, aching, throbbing, soreness, di scomfort, or sensitivity was the only adverse effect that was higher i n the chlorhexidine group as compared to placebo (P = 0.042). These da ta demonstrate that the adjunctive use of the chlorhexidine chip resul ts in a significant reduction of PD when compared with both SRP alone or the adjunctive use of a placebo chip. These multi-center randomized control trials suggest that the chlorhexidine chip is a safe and effe ctive adjunctive chemotherapy for the treatment of adult periodontitis .