title: Controlled-delivery chlorhexidine chip versus amoxicillin/metronidazole as adjunctive antimicrobial therapy for generalized aggressive periodontitis: a randomized controlled clinical trial.
abstract: 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.
authors.affiliation: Institute for Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany. dogan.kaner@charite.de
authors.forename: Doğan
authors.initials: D
authors.lastname: Kaner
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Bernimoulin
authors.forename: Werner
authors.initials: W
authors.lastname: Hopfenmüller
authors.forename: Bernd-Michael
authors.initials: BM
authors.lastname: Kleber
authors.forename: Anton
authors.initials: A
authors.lastname: Friedmann
mesh_terms: 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
chemical_list: D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D003692:Delayed-Action Preparations; D008795:Metronidazole; D000658:Amoxicillin; D002710:Chlorhexidine