An economic evaluation of a chlorhexidine chip for treating chronic periodontitis - The CHIP (CHlorhexidine In Periodontitis) study

Background. The authors previously suggested that an adjunctive, controlled -release chlorhexidine, or CHX, chip may reduce periodontal surgical needs at little additional cost. This Article presents an economic analysis of th e CHX chip in general dental practice. Methods. In a one-year prospective clinical. trial, 484 chronic periodontit is patients in 52 general practices across the United States were treated w ith either scaling and root planing, or SRP, plus any therapy prescribed by treating, unblinded dentists; or SRP plus other therapy as above but inclu ding the CHX chip. Economic data were collected from bills, case report for ms and 12-month treatment recommendations from blinded periodontist evaluat ors. Results. Total dental charges were higher for SRP + CHX chip patients vs. S RP patients when CHX chip costs were included (P = .027) but lower when CHX chip costs were excluded (P = .012). About one-half of the CHX, chip acqui sition cost was offset by savings in other charges. SRP + CHX chip patients were about 50 percent less likely to undergo surgical procedures than were SRP patients (P = .021). At the end of the trial, periodontist evaluators recommended similar additional procedures for both groups: SRP, about 46 pe rcent; maintenance, about 37 percent; surgery, 56 percent, for SRP alone an d 63 percent for SRP + CHX chip. Conclusions. Adjunctive CHX chip use for general-practice patients with per iodontist increased costs but reduced surgeries over one year. At study's e nd, periodontists recommended similar additional surgical treatment for bot h groups. Clinical Implications. In general practice, routine use of the CHX chip sug gests that costs will be partially offset by reduced surgery over at least one year.