title: A randomized clinical trial on the clinical and microbiological efficacy of a xanthan gel with chlorhexidine for subgingival use.
abstract: BACKGROUND
  The main indication of the adjunctive use of local antimicrobials lies around situations in which the outcome of non-surgical mechanical treatment results in a limited number of residual pockets. The purpose of this investigation was to evaluate the clinical and microbiological effects of the subgingival application of a xanthan-based 1.5% chlorhexidine (CHX) gel (Xan-CHX), adjunctive to scaling and root planing (SRP) in localized periodontitis.
  
  
  METHODS
  Periodontitis patients with four to ten residual (after conventional SRP) or relapsing (during supportive periodontal treatment) pockets were recruited and randomized to receive SRP plus the subgingival application of (Xan-CHX) or SRP plus a placebo gel. Supragingival plaque, bleeding on probing (BOP), probing pocket depth (PPD), and clinical attachment level were evaluated with a computerized probe at baseline, and after 1, 3, and 6 months. Subgingival samples were also collected for the microbiological analysis. Statistical analysis used ANOVA and chi-square tests.
  
  
  RESULTS
  Overall, the clinical results were better in the test group, with significant changes in BOP (between baseline and 3 months) and with a significant increase in the proportion of shallow pockets (1-3 mm) at 6 months. These results did not result in significant intergroup differences. The microbiological impact was limited in both treatment groups.
  
  
  CONCLUSIONS
  The adjunctive use of Xan-CHX may improve, although to a limited extent, the clinical outcomes (BOP and PPD), in chronic periodontitis patients with "residual" or "relapsing" pockets, but no significant differences were detected between groups. No side effects, neither clinical nor microbiological, were detected after the use of the test product.
  
  
  CONCLUSIONS
  Adjunctive use of slow-released chlorhexidine might be considered in the management of periodontal disease and gingival inflammation to reduce the need for periodontal surgery.
authors.affiliation: Section of Graduate Periodontology, Faculty of Dentistry, Complutense University, Plaza Ramón y Cajal S/N, 28040, Madrid, Spain.
authors.forename: Paula
authors.initials: P
authors.lastname: Matesanz
authors.forename: David
authors.initials: D
authors.lastname: Herrera
authors.forename: Ana
authors.initials: A
authors.lastname: Echeverría
authors.forename: Ana
authors.initials: A
authors.lastname: O'Connor
authors.forename: Itziar
authors.initials: I
authors.lastname: González
authors.forename: Mariano
authors.initials: M
authors.lastname: Sanz
mesh_terms: D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D058491:Bacterial Load / Q000187:drug effects; D018441:Biofilms / Q000187:drug effects; D002710:Chlorhexidine / Q000008:administration & dosage / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003773:Dental Plaque / Q000188:drug therapy / Q000382:microbiology; D012534:Dental Scaling / Q000379:methods*; D004337:Drug Carriers; D005500:Follow-Up Studies; D005782:Gels; D005884:Gingival Hemorrhage / Q000188:drug therapy / Q000382:microbiology; D005889:Gingival Recession / Q000188:drug therapy / Q000382:microbiology; D005891:Gingivitis / Q000188:drug therapy / Q000382:microbiology; D006090:Gram-Negative Bacteria / Q000187:drug effects; D006801:Humans; D008875:Middle Aged; D009910:Oral Hygiene / Q000193:education; D017622:Periodontal Attachment Loss / Q000188:drug therapy / Q000382:microbiology; D010514:Periodontal Pocket / Q000188:drug therapy / Q000382:microbiology; D010518:Periodontitis / Q000188:drug therapy* / Q000382:microbiology / Q000628:therapy; D010919:Placebos; D011135:Polysaccharides, Bacterial / Q000737:chemistry*; D016745:Root Planing / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D004337:Drug Carriers; D005782:Gels; D010919:Placebos; D011135:Polysaccharides, Bacterial; D002710:Chlorhexidine; C002563:xanthan gum