Controlled-delivery chlorhexidine chip versus amoxicillin/metronidazole as adjunctive antimicrobial therapy for generalized aggressive periodontitis: a randomized controlled clinical trial.
BACKGROUND
Subgingival application of chlorhexidine via a controlled-delivery device (CHX chip) improves the clinical outcome of scaling/root planing (SRP) in therapy for chronic periodontitis. Generalized aggressive periodontitis (GAP) is commonly treated with SRP and adjunctive antimicrobial medication. To date, the efficacy of CHX chips in GAP therapy has not been evaluated.


OBJECTIVE
To compare SRP plus adjunctive CHX chip placement with SRP plus adjunctive systemic amoxicillin/metronidazole with regard to clinical efficacy in first-line therapy for GAP.


METHODS
Thirty-six GAP patients were treated with SRP and randomly with either placement of CHX chips or systemic amoxicillin/metronidazole. Clinical attachment level (CAL), probing depth (PD), bleeding on probing (BoP) and suppuration (Pus) were measured at baseline, 3 and 6 months after therapy.


RESULTS
CAL, PD, BoP and Pus were significantly reduced in both groups after 3 months. In the CHX chip group, PD significantly increased again between 3 and 6 months. Finally, amoxicillin/metronidazole patients presented significantly more CAL "gain", PD reduction and less remaining deep sites after 6 months. Pus remained detectable in CHX chip patients only.


CONCLUSIONS
In first-line non-surgical therapy for GAP, SRP plus adjunctive systemic amoxicillin/metronidazole was more efficacious in clinically relevant measures of outcome than SRP plus adjunctive placement of CHX chips.
Kaner
Doğan
D
Institute for Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany. dogan.kaner@charite.de
Bernimoulin
Jean-Pierre
JP
Hopfenmüller
Werner
W
Kleber
Bernd-Michael
BM
Friedmann
Anton
A
D000328:Adult; D000658:Amoxicillin / Q000008:administration & dosage* / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage* / Q000009:adverse effects; D002710:Chlorhexidine / Q000008:administration & dosage* / Q000009:adverse effects; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D012534:Dental Scaling; D005260:Female; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000008:administration & dosage* / Q000009:adverse effects; D017622:Periodontal Attachment Loss / Q000188:drug therapy; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy; D010518:Periodontitis / Q000188:drug therapy* / Q000382:microbiology; D016745:Root Planing; D016037:Single-Blind Method; D012907:Smoking / Q000009:adverse effects; D018709:Statistics, Nonparametric
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D003692:Delayed-Action Preparations; D008795:Metronidazole; D000658:Amoxicillin; D002710:Chlorhexidine