title: Treatment of peri-implantitis using multiple applications of chlorhexidine chips: a double-blind, randomized multi-centre clinical trial.
abstract: BACKGROUND
  Universal strategies for managing peri-implantitis are yet to be adopted. The aim of this study is to examine a protocol of intensive application of chlorhexidine containing chips in sites with peri-implantitis.
  
  
  METHODS
  This multi-centre, randomized, double-blind, parallel, two-arm clinical trial included 60 patients (77 implants) with probing depth (PD) 6-10 mm and bone loss ≥2 mm around 1-2 implants. One to two weeks following SRP, baseline measurements were made followed by implants' debridement. Patients were randomized to receive matrix chips (MatrixC) or chlorhexidine Chips (PerioC). Measurements and chips placement were repeated at weeks 2, 4, 6, 8, 12 and 18. At 6 months, patients returned for final examination.
  
  
  RESULTS
  Probing depth reduction was greater in the PerioC (2.19 ± 0.24 mm) compared with MatrixC (1.59 ± 0.23 mm), p = 0.07. Seventy percentage of the implants in the PerioC and 54% in the MatrixC had PD reduction ≥ 2 mm. Likewise, 40% of the sites (PerioC) and 24% (MatrixC) had PD reduction ≥ 3 mm. Clinical attachment level gains for both groups were significant; however, the changes in the PerioC group were significantly greater than in MatrixC [2.21 ± 0.23 mm. and 1.56 ± 0.25 mm respectively, p = 0.05]. Bleeding on probing was reduced by half in both groups.
  
  
  CONCLUSIONS
  Frequent placement of PerioC and MatrixC together with implants debridement resulted in a substantial improvement in sites with peri-implantitis. Further studies will be required to fully appreciate the mechanism of this treatment.
authors.affiliation: Department of Periodontology, School of Graduate Dentistry, Rambam HCC, Technion - Israeli Institute of Technology, Haifa, Israel. machtei@rambam.health.gov.il
authors.forename: Eli E
authors.initials: EE
authors.lastname: Machtei
authors.forename: Shai
authors.initials: S
authors.lastname: Frankenthal
authors.forename: Guy
authors.initials: G
authors.lastname: Levi
authors.forename: Rina
authors.initials: R
authors.lastname: Elimelech
authors.forename: Eyal
authors.initials: E
authors.lastname: Shoshani
authors.forename: Olivia
authors.initials: O
authors.lastname: Rosenfeld
authors.forename: Nirit
authors.initials: N
authors.lastname: Tagger-Green
authors.forename: Benjamin
authors.initials: B
authors.lastname: Shlomi
mesh_terms: D000328:Adult; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D002710:Chlorhexidine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D003774:Dental Plaque Index; D004311:Double-Blind Method; D005260:Female; D005780:Gelatin; D006801:Humans; D016013:Likelihood Functions; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D057873:Peri-Implantitis / Q000188:drug therapy*; D057747:Periodontal Debridement; D010512:Periodontal Index; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000891:Anti-Infective Agents, Local; D005780:Gelatin; C010882:chlorhexidine gluconate; D002710:Chlorhexidine