Effect of chlorhexidine chip as an adjunct in non-surgical management of periodontal pockets: a meta-analysis

Lili Ma,Xiuchun Diao

doi:10.1186/s12903-020-01247-8

Abstract

BackgroundThe aim of this meta-analysis was to evaluate the difference in treatment outcomes between sub-gingival placement of chlorhexidine chip (CHX chip) in adjunct to scaling and root planing (SRP) and SRP alone for the management of periodontal pockets in patients suffering from chronic periodontitis.MethodsWe searched the MEDLINE (PubMed), SCOPUS and CENTRAL databases and identified 15 randomized clinical trials published within the last decade (2007–2019): 9 with split-mouth design and 6 with parallel study design. We extracted data and performed both qualitative and quantitative syntheses. The primary outcomes assessed were gain in clinical attachment level (CAL), reduction in probing pocket depth (PPD), improvement in gingival inflammation, and results of microbiological assays.ResultsWe used meta-analysis plots to assess all the clinical outcomes. The mean differences in PPD reductions at 1 month (MD 0.63), 3 months (MD 0.69), and 6 months (MD 0.75); and the CAL gains at 1 month (MD 0.54), 3 months (MD 0.64), and 6 months (MD 0.68) showed more favorable responses in sites treated with the CHX chip as an adjuvant to SRP, than in sites treated with SRP alone.ConclusionSRP with adjunctive CHX chips showed better clinical outcomes than SRP alone for the management of periodontal pockets in patients with chronic periodontitis.

Highlights

The aim of this meta-analysis was to evaluate the difference in treatment outcomes between subgingival placement of chlorhexidine chip (CHX chip) in adjunct to scaling and root planing (SRP) and SRP alone for the management of periodontal pockets in patients suffering from chronic periodontitis
The CHX chips used in the studies had 2.5 mg of CHX (20% CHX embedded in a collagen matrix) under the brand name of PERIOCOL – CG (Eucare Pharmaceuticals, India) or PERIOCHIP (Perioproducts, Jerusalem, Israel)
We found similar results in other 4 studies evaluating mean periodontal pathogens reductions through quantitative-PCR that showed better outcomes in sites treated with SRP and CHX chip than in those treated with SRP alone [23, 26, 29, 32]

Summary

Introduction

The aim of this meta-analysis was to evaluate the difference in treatment outcomes between subgingival placement of chlorhexidine chip (CHX chip) in adjunct to scaling and root planing (SRP) and SRP alone for the management of periodontal pockets in patients suffering from chronic periodontitis. Periodontal disease is characterized by inflammation of tooth supporting structures, and is primarily caused by the presence of dental plaque and calculus [1]. The goal of periodontal treatment is to render the tooth surface free from dental plaque and calculus, thereby reducing or Scaling and root planing (SRP) is an effective nonsurgical periodontal therapy for chronic periodontitis at its early stages [8]. The operator’s accessibility to clean deep periodontal pockets remains limited in cases of furcation, multi-rooted teeth, developmental grooves, root concavities, mal-occlusion, and inter-proximal areas. This limitation to proper instrumentation in inaccessible areas compromises the effectiveness of SRP [9]. This has led to the use of antimicrobials as an adjunct to SRP, assuming that such agents would aid to treat the dysbiosis in these

Methods

Results

Discussion

Conclusion