THE LOCAL EFFECT OF CHLORHEXIDINE AGENTS IN THE TREATMENT OF CHRONIC PERIODONTITIS PATIENTS

  • RAFAH HUSSEIN MOHAMMAD Dept. of Periodontic & Oral Surgery,College of dentistry, University of Duhok, Kurdistan Region-Iraq
  • SAEED ALI MOHAMMAD Dept. of Periodontic & Oral Surgery,College of dentistry, University of Duhok, Kurdistan Region-Iraq
Keywords: KEY WORDS: Chronic periodontitis, Chlorhexidine gluconate. Abbreviation: Chlorhexidine (CHX), Scaling root planning (SRP). Gingival index (GI), Plague index (PI), Clinical Attachment loss (CAL), Probing pocket depth (PPD).

Abstract

ABSTRACT

Background: Periodontitis is an immuno-inflammatory disease of the tissues surrounding the teeth. Various treatment modalities like mechanical debridement and use of antimicrobials have been followed in the treatment of such conditions. Introduction of local drug delivery system in the periodontal pocket is a promising therapeutic modality for achieving better clinical outcomes when used as an adjunct to conventional non-surgical periodontal therapy.

 objectives: To evaluate clinical effect of different local delivery chlorhexidine Periochips and solution agents as adjuncts to SRP as combined therapy in patients with chronic periodontitis.

Materials and methods: A Clinical comparative study was conducted on 45 patients of both gender (male and female) with an age of 30-50 years and with chronic moderate to severe periodontist, all patients are being undergone full-mouth mechanical debridement by using ultrasonic scaler and universal and Gracey curettes. Periodondontal pockets are to be irrigated by distillate water. Then the subjects were divided into two main group; first group consist of 15 patients with chronic periodontitis treated by chlorhexidine periochips, second group consist of 15 patients with chronic periodontitis treated by chlorhexidine Solution In addition to control group consist of 15 patients which were treated by SPR only. The criteria for chronic periodontitis was defined by the presences of PPD≥5mm and CAL≥3, in two or more different sites for each patient of at least two teeth in each quadrant, and then the results were analyzed statistically.

Results: The most significant improvements were found concerning CAL, PI and GI in the group treated with CHX solution over CHX periochips (P < 0. 05), over three months. Regarding PPD, there were no significant differences in PPD reduction gain in between the two agents (P > 0. 05).

Conclusion:  Results of this study favor combination therapy using CHX solution as an adjunct to SRP due to greater improvement in periodontal condition of patients with chronic periodontitis, compared to those obtained by SRP alone or with SRP and CHX periochips.

 

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References

REFERENCES
Abdaly MMAJ,Refai ANMEI,Gouda UM, Atty HA (2008). Evaluation of Topical Application of CHLO-SITE (Chlorhexidine gel) in Management of Chronic Periodontitis. Suez Canal Univ Med J; 11:35 -40.
Ann LG, Clifford JB, James HC , Noah DF, Purnima SK, Zamin KY, Mircea Pand Eugene JL (2012). Distinct and complex bacterial profiles in human periodontitis and health revealed by 16S pyrosequencing. J The ISME; 6:1176–1185
Bonesvoll P, Lokken P, Rolla G (1974). Influence of concentration, time, temperature and pH on the retention of chlorhexidine in the human oral cavity after mouth rinses. Arch Oral Biol; 19: 1025-1029.
Braatz L, Garrett S, Claffey N (1985). Antimicrobial irrigation of deep pockets to supplement non-surgical periodontal therapy. II. Daily irrigation. J Clin Periodontol; 12:630–638.
Carranza NTK (2012). carranza clinical periodonyology 11th Edition;31
Carvalho J, Novak MJ, Mota LF (2007). Evaluation of the effect of subgingival placement of chlorhexidine chips as an adjunct to scaling and root planing. J Periodontol; 78:997-01.
Carvalho J, Novak MJ, Mota LF (2007). Evaluation of the effect of subgingival placement of chlorhexidine chips as an adjunct to scaling and root planing. J Periodontol; 78:997–1001.
Davies G, Francis J, Martin A, Rose F, Swain G (1954) 1:6 Di4’ chlorophenldiguanidohexane. Laboratory investigation into a new antibacterial agent of high potency. Br J Pharmacol; 9: 192-196.
Dewhirst FE, Chen T, Izard J, Paster BJ, Tanner AC and Yu WH (2010). The human oral microbiome. J Bacteriol; 192: 5002–5017.
Emisilon C (1977). Susceptibility of various microorganisms to chlorhexidine. Scand J Dent Res 1977; 85: 255-265.
Estrela C, Ribeiro RG, Estrela CR, Pecora JD and Sousa-Neto MD (2003). An¬timicrobial effect of 2% sodium hypochlorite and 2% chlorhexi-dine tested by different methods. Braz Dent J;14(1):58-62.
Gottumukkala SNVS, Koneru S, Mannem S (2013). Effectiveness of sub gingival irrigation of an indigenous 1% curcumin solution on clinical and microbiological parameters in chronic periodontitis patients: a pilot randomized clinical trial. Contemp Clin Dent; 4:186–191.
Grenier, D (1996). Effect of chlorhexidine on the adherence properties of Porphyromonas gingivalis. J Clin Periodontol ; 23: 140-142.
Grisi DC, Salvador SL, Figueiredo LC (2002) Effect of a controlledrelease chlorhexidine chip on clinical and microbiological parametersof periodontal syndrome. J Clin Periodontol; 29:875–881.
Hanes PJ, Purvis JP (2003). Local anti-infective therapy: Pharmacological agents. A systematic review. Ann Periodontol; 8:79–98.
Heasman PA, Heasman L, Stacey F, McCracken GJ (2001). Local delivery of chlorhexidine gluconate (Periochip) in the periodontal maintenance patients. J Clin Peridontol; 28:90-5.
Hjeljord LG, Rolla G, Bonesvoll P (1973). Chlorhexidineprotein interactions. J Periodontal Res Suppl; 12:11–16.
Jeffcoat MK, Bray KS, Ciancio SG, Dentino AR, Fine DH, Gordon JM (1998). Adjunctive use of a subgingival controlled-release chlorhexidine chip reduces probing depth and improves attachment level compared with scaling and root planing alone. J Periodontol; 69:989–97.
Kaplish V, Walia M.K and Hari Kumar S.L (2013). Local Drug delivery system in the treatment of periodontitis: A Review. Pharmacophore; Vol. 4 (2), 39-49
Krishna MK, Ravindran SK, Vivekanandan G (2011). Effects of a single episode of subgingival irrigation with tetracycline HCl or chlorhexidine: a clinical and microbiological study. J Indian Soc Periodontol; 15:245–249
Lecic J, Cakic S, Janjic Pavlovic O, Cicmil A, Vukotic O, Petrovic V, Cicmil S (2016). Different methods for subgingival application of chlorhexidine in the treatment of patients with chronic periodontitis.Acta Odontol Scand;74(6):502-7
Loe H (1967). The gingival index, the plaque index, and the retention index systems. J Periodontol; 38:610.++
Lorenz K, Bruhn G, Heumann C, Netuschil L, Brecx M and Hoffmann T (2006). Effect of two new chlorhexidine mouthrinses on the develop¬ment of dental plaque, gingivitis, and discolouration. A random¬ized, investigator-blind, placebo-controlled, 3-week experimen-tal gingivitis study. J Clin Periodontol;33(8):561-7.
MacAlpine R, Magnusson I, Kiger R (1985). Antimicrobial irrigation of deep pockets to supplement oral hygiene instruction and root debridement. I. Bi-weekly irrigation. J Clin Periodontol; 12:568–577.
McCoy LC, Wehler CJ, Rich SE, Garcia RI, Miller DR and Jones JA (2008). Ad¬verse events associated with chlorhexidine use: results from the Department of Veterans Affairs Dental Diabetes Study. J Am Dent Assoc;139(2):178-83.
Newmann MG, Takei HH, Klokkevold PR, Carranza FA. 10th ed. Missouri: Saunders Elsevier; 2006. Text Book of Clin Periodontol; pp. 134–1692.
Oosterwaal PJ, Mikx FH, Van ’t Hof MA, Renggli HH (1991). Short-term bactericidal activity of chlorhexidine gel, stannous fluoride gel and aminefluoride gel tested in periodontal pockets. J Clin Periodontol; 18:97–100.
Paolantonio M, D’Angelo M, Grassi RF (2008). Clinical and microbiologic effects of subgingival controlled-release delivery of chlorhexidine chip in the treatment of periodontitis: a multicenter study. J Periodontol. 2008; 79:271–282.
Petersen PE, Ogawa H (2005). Strengthening the prevention of periodontal disease: the WHO approach. J Periodontol; 76: 2187-2193.
Reolla G, L€oe H, Schiott CR (1970). The affinity of chlorhexidine for hydroxyapatite and salivary mucins. J Periodont Res; 5:90–95.
Ramfjord SP (1959). Indices for prevalence and incidence of periodontal disease. J Periodontol; 30:51.
Ren C, McGrath; C, Jin L, Zhang C and Yang Y (2017). The effectiveness of low‐level laser therapy as an adjunct to non‐surgical periodontal treatment: a meta‐analysis. J Periodontal Res;52(1): 8–20.
Rodrigues IF, Machion L, Casati MZ (2007). Clinical evaluation of the use of locally delivered chlorhexidine in periodontal maintenance therapy. J Periodontol; 78:624–628.
Rodrigues IF, Machion L, Casati MZ (2007). Clinical evaluation of the use of locally delivered chlorhexidine in periodontal maintenance therapy. J Periodontol; 78:624–628
Ryan.ME (2005). Nonsurgical approaches for the treatment of periodontal diseases. Dent Clin N Am; 49:611–636.
Sandhu M, Grewal N (2011). Clinical Effectiveness of Chlorhexidine and Sodium Fluoride Mouth Rinses on Plaque and Gingivitis in Men¬tally Disabled Children and Normal Children. JIDA;5(1):081.
Scannapieco FA, Dasanayake AP and Chhun N. (2010). Does periodontal therapy reduce the risk for systemic diseases? Dent Clin North Am; 54: 163–181.
Siqueira JF, Jr., Rocas IN, Paiva SS, Guimaraes-Pinto T, Magalhaes KM and Lima KC (2007). Bacteriologic investigation of the effects of sodium hypochlorite and chlorhexidine during the endodontic treat¬ment of teeth with apical periodontitis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod;104(1):122-30.
Socransky.ss ,A.D. Haffajee .A.D,Cugini M.A, Smith.C, KentJr.R.L (1998). Microbial complexes in subgingival plaque. J Clin Periodontol; 25: 134-144.
Soskolne WA, Heasman PA, Stabholz A (1997). Sustained local delivery of chlorhexidine in the treatment of periodontitis: a multi-center study. J Periodontol; 68:32–38
Turkoglu O, Becerik S, Emingil G, Kutukculer N, Baylas H and Atilla G (2009). The effect of adjunctive chlorhexidine mouthrinse on clinical parameters and gingival crevicular fluid cytokine levels in un¬treated plaque-associated gingivitis. Inflamm Res;58(5):277- 83.
Vandana R.K.L, and Prakash Sh (2011). Effect of local drug delivery in chronic periodontitis patients: A meta-analysis. J Indian Soc Periodontol; 15(4): 304–309.
Walker CB, Karpinia K, Baehni P (2004). Chemotherapeutics: antibiotics and other antimicrobials. Periodontol 2000; 36:146–165
Walsh TF, Glenwrith HD, Hull PS (1992). Clinical effects of pulsed oral irrigation with 0.2% chlorhexidine digluconate in patients with adult periodontitis. J Clin Periodontol.;19:245–248.
Young MP, Korachi M, Carter DH, Worthington HV, McCord JF and Drucker DB (2002). The effects of an immediately pre-surgical chlorhex¬idine oral rinse on the bacterial contaminants of bone debris collected during dental implant surgery. Clin Oral Implants Res;13(1):20-9.
Published
2020-06-07
How to Cite
MOHAMMAD, R. H., & MOHAMMAD, S. A. (2020). THE LOCAL EFFECT OF CHLORHEXIDINE AGENTS IN THE TREATMENT OF CHRONIC PERIODONTITIS PATIENTS. Journal of Duhok University, 23(1), 32-40. https://doi.org/10.26682/sjuod.2020.23.1.4
Section
Pure and Engineering Sciences