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Killoy WJ.
Department of Periodontics, University of Missouri-Kansas City, School
of Dentistry 64108, USA.
BACKGROUND: Several multicenter random clinical trials have studied a
second-generation easy-to-use chlorhexidine local delivery system to
assess its effectiveness as an adjunct to scaling and root planing, or
SRP. METHODS: The author reviews the pharmacokinetics of the local
delivery system and two of the multicenter randomized clinical trials.
One study evaluated 118 patients using split-arch design and the other
study 447 patients using parallel design. All patients underwent SRP.
Test sites, which had pocket depths of 5 millimeters or larger,
received a chlorhexidine chip (in both studies) or a placebo chip (the
parallel study only). Test sites that remained 5 mm or larger were
re-treated with a chip at three months and at six months (parallel
study only). RESULTS: Both studies found greater mean reductions in
probing depth when the chlorhexidine chip was used in conjunction with
SRP than when SRP was used alone (1.16 mm vs. 0.7 mm, P < or =
.0001, in the split-arch-design study and 0.95 mm vs. 0.65 mm, P =
.00001, in the parallel-design study). The combined therapy resulted
in significantly more sites with probing depth reductions of 2 mm or
more compared with SRP alone (49.5 percent vs. 32.1 percent; P <
.0001, in the split-arch-design study and 19.1 percent vs. 8 percent,
P < .0001, in the parallel-design study). CONCLUSIONS: Use of the
chlorhexidine chip has significantly improved the clinical parameters
of periodontitis when used as an adjunct to SRP. CLINICAL
IMPLICATIONS: When used with SRP, the chlorhexidine chip offers the
clinician a new method of achieving and maintaining periodontal
stability.
PMID: 10203909 [PubMed - indexed for MEDLINE]
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