title: Effect of ultrasonic debridement using a chlorhexidine irrigant on circulating levels of lipopolysaccharides and interleukin-6.
abstract: OBJECTIVE
  Transient bacteraemia and endotoxaemia, and elevated levels of systemic cytokines have been reported following subgingival debridement. This study aimed to investigate the effect of chlorhexidine (CHX) solution on circulating levels of lipopolysaccharide (LPS) and interleukin-6 (IL-6) when used as an irrigant during ultrasonic debridement in patients with periodontitis.
  
  
  METHODS
  Eighteen patients with moderate to advanced chronic periodontitis were treated in a split-mouth, crossover, single-masked study. Irrigation with 0.02% CHX solution or water was used during treatment of two ipsilateral quadrants on two separate occasions 7 days apart, randomized as to order. Peripheral blood samples were collected for circulating levels of LPS and IL-6 at baseline, 5 and 120 min. after instrumentation commenced.
  
  
  RESULTS
  Median concentrations of LPS were elevated from baseline to 5 min. into treatment with both CHX and control irrigant (p<0.05). Median levels of IL-6 increased with both treatments from baseline to 120 min. (p<0.001): CHX, 0.81-1.85 pg/ml; control, 0.78-1.78 EU/ml.
  
  
  CONCLUSIONS
  Ultrasonic instrumentation in patients with moderate to advanced periodontitis increases circulating levels of LPS after 5 min. and IL-6 120 min. after commencement of treatment, and is not affected by using 0.02% CHX as an irrigant instead of water.
authors.affiliation: King's College London, Dental Institute-Periodontology, London, UK.
authors.forename: Monica K
authors.initials: MK
authors.lastname: Lee
authors.forename: Mark
authors.initials: M
authors.lastname: Ide
authors.forename: Paula Y
authors.initials: PY
authors.lastname: Coward
authors.forename: Ron F
authors.initials: RF
authors.lastname: Wilson
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000627:therapeutic use*; D002908:Chronic Disease; D018592:Cross-Over Studies; D012534:Dental Scaling / Q000379:methods*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008070:Lipopolysaccharides / Q000097:blood; D008297:Male; D016555:Matched-Pair Analysis; D010518:Periodontitis / Q000097:blood* / Q000628:therapy*; D011446:Prospective Studies; D016037:Single-Blind Method; D007507:Therapeutic Irrigation; D014464:Ultrasonic Therapy
chemical_list: D000891:Anti-Infective Agents, Local; D015850:Interleukin-6; D008070:Lipopolysaccharides; D002710:Chlorhexidine