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162 Pietruska M, et al. · Advances in Medical Sciences · Vol. 51 · 2006 · Suppl.

1 ·

Efficacy of local treatment with chlorhexidine
gluconate drugs on the clinical status
of periodontium in chronic periodontitis patients
Pietruska M1*, Paniczko A1, Waszkiel D2, Pietruski J3, Bernaczyk A4

Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, Poland
Department of Paedodontics, Medical University of Białystok, Poland
Dental Practice, Białystok, Poland
NZOZ Non-public Centre of Health Care, Medical University of Białystok, Poland

Abstract Introduction

Purpose: Chlorhexidine gluconate is a relatively com- Chronic periodontitis (CP) is a common ailment affecting
monly used chemotherapeutic in the treatment of peri- adult humans. Its main aetiological factor is the bacterial plaque
odontitis (P), exhibiting antimicrobial capabilities against accumulating on the tooth surface due to hygienic neglect. The
Gram-negative and Gram-positive bacteria, and fungi. This effective methods, commonly used to eliminate dental plaque,
compound is a component of various preparations for topi- include scaling with root planing and periodontal surgical pro-
cal use in the form of solutions for mouthrinsing or peri-irri- cedures. Obviously, appropriate plaque control following profes-
gation, gels, varnishes, chips and even chewing gums. The sional mechanical cleaning of root surfaces is indispensable for
aim of the study was the clinical evaluation of periodontium the disease inhibition [1-3]. Such a control involving individual
after treatment with one of the drugs containing chlorhexi- hygienic procedures is possible in many patients. However, there
dine gluconate (Corsodyl) as compared to professional tooth are a number of subjects who, for mental or manual reasons, are
cleaning in patients with chronic periodontitis. incapable to comply with the appropriate hygienic standards to
Materal and methods: Forty subjects enrolled in the study maintain the effects of treatment and to prevent the disease
were divided into four groups, 10 in each group, according recurrence. It is in these patients that the use of chemotherapeu-
to the mode of treatment (Corsodyl rinse, Corsodyl gel, Cor- tics in combination with traditional therapy can help prevent the
sodyl gel + surgical dressing, scaling). recolonization of pathogenic bacteria in periodontal pockets.
Results: The greatest differences between baseline and Chlorhexidine gluconate is a safe, recognized and more
follow-up examinations were observed in the group where frequently used chemotherapeutic in the treatment of peri-
surgical dressing was applied in addition to Corsodyl gel and odontitis (P), exhibiting an action against Gram-negative and
in the group treated with scaling. Gram-positive bacteria, and fungi [4,5]. It is a component
Conclusions: Chlorhexidine gluconate should be more of various preparations for topical use, such as solutions for
frequently used as a drug adjunct to classic periodontal mouthrinsing or perio-irrigation, gels, varnishes, local delivery
therapy, especially in the forms allowing its direct applica- systems (PerioChip), and even chewing gums [2,5-9].
tion to the periodontal pockets. The aim of this study was the clinical assessment of the
periodontium after treatment with a chlorhexidine digluconate
preparation (Corsodyl) in comparison to the procedure of pro-
Key words: chlorhexidine gluconate, chronic periodontitis. fessional tooth cleaning in subjects with chronic periodontitis.

Material and methods
* CORRESPONDING AUTHOR: Forty patients with CP, aged 30-65 years (17 women and 23
Department of Periodontal and Oral Mucosa Diseases
Medical University of Białystok men), were enrolled in the study. All the patients underwent
ul. M. Skłodowskiej-Curie 7A scaling and root planing. Then, they were divided into four
15-276 Białystok, Poland groups, 10 in each group, depending on the treatment applied.
tel.: +48 085 748 55 27
Group I included patients who rinsed the oral cavity with 0.2%
Received 07.03.2006 Accepted 13.03.2006 solution of chlorhexidine digluconate for one minute (Corsodyl,

75* 1.49** PI 2.001 2. Group II con.01 p=0. the other two – one month and three differences between baseline and the follow-up examinations months later.9±0.76 3.007 p=0.3±0. by 0. The greatest Kline) applied to periodontal pockets at one-week intervals.14 p=0.8±1.58 1. we achieved a significant improvement Assuming that the efficacy of the therapy can be related to in the clinical parameters in all the groups.6±0.27.3±0.3±0.04 p=0. In the current study. Numerical ment of the following parameters: data (mean.0±0. being 1. where In group III. PI was most reduced the disease advancement. Efficacy of local treatment with chlorhexidine gluconate drugs on the clinical status of periodontium in chronic periodontitis patients 163 Table 1. SBI and sisted of patients treated with 1% Corsodyl gel (GlaxoSmith. where the mean difference between the baseline and separately for the pocket depths <5 mm and 5 mm.45** SBI 2.24** Pocket depth 3.6±1. the GI reduction was In all the groups.01 p=0. – SBI (Sulcus Bleeding Index) accrding to Mühlemann and Sonn [11] – GI (Gingival Index) accrding to Löe and Silness [12] Discussion – periodontal pocket depth (in mm) – clinical attachment level (in mm). It should be emphasized that for after the first. and in order to delimit drug leaking from periodontal pockets and its the control group. In groups III and IV.0±0. II for the pockets <5 mm.03 7. major performed before scaling.38** 1. 1-4.03 p=0. Assessment of clinical parameters after application of Corsodyl fluid with regard to periodontal pocket depth Group I (< 5 mm) Group II ( 5 mm) Parameter Examination Examination I II III I II III 1.0±. Clinical examinations were based on the assess. No significant changes were observed after three months in to gradual dissolving.009 p=0.0003 6. the treatment was the same as in group II. In our study. the use of chlorhexidine solu- tion decreases GI by 18%.05 were considered gel by 1.53** 1. Results According to Lang et al. Mouth rinsing with compare changes in the parameters at time intervals in the 0. who showed in this parameter were noted in the Corsodyl group.01 p=0.77 after mouth rinsing.54** 5.2 [13]. but in apart from Corsodyl gel surgical dressing was applied.2 and 1. Other authors have the SPSS 8. Our results well as compared to the baseline.0±0. Pocket depths after treatment were mark- dissolving in the saliva. [13]. difference in these parameters was observed in group III.3±0.0000 1.0000 1. Chlorhexidine used for mouth statistically significant. GI were also significantly reduced after treatment.66 p=0. PI was significantly reduced after 3 months more pronounced. no pharmacological the attachment level in group I after Corsodyl fluid and in group treatment was instituted. The Wilcoxon pairs test was used to shown a similar degree of PI reduction.7±1.4±0. The other two took place one month and three months depth (0.0 PL packet.27 2. respective groups. The differences were had place a week after scaling. The most substantial differences correspond to those reported by Vinholis et al.65.66* 0.36* 1.5±0. respectively).5 after gel . the clinical parameters were assessed in group I.8±1.17 2.69 p=0.0±0.29* 5.7 for those 5 mm. being 44%-57% on average. directly before application of the more pronounced in group III and depended on the pocket drug. the first examination was most of the clinical parameters examined in the study. adhesive surgical dressing Reso-Pack edly reduced in groups I.58 2.8±1. [5]. The preliminary examination in the first three groups significatly decreased on examination 3. this parameter (Meyer Haake) was used to seal the teeth and the surrounding decreased significantly for the pockets 5 mm.73* 6.0±1.001 p=0.49** 2.3±1. In group IV (control).9±0. this parameter changed Clinical examinations were carried out three times by the markedly for the pockets deeper or equal to 5 mm in patients same person with the use of a periodontal probe PCP 11 (LM treated with gel.2% chlorhexidine solution can reduce this parameter by 1.1±0.3±0.4±0.53 2. for pocket depths <5 mm and 1. but not for <5 soft tissues and was kept in the mouth for several hours subject mm.8±0.45** GI 2.04 p=0.003 p=0. rinsing by subjects who do not perform any other hygienic pro- cedures causes a two-fold reduction in plaque accumulation as compared to the placebo-using subjects [14]. referred to the pockets deeper or equal to 5 mm.9 and 2. in the remaining The results were subjected to statistical analysis using groups being 1. examination 3 (after three months) was 1. Differences with p 0.0000 p=0. while scaling by 1.6 a reduction in GI by 0.66 p=0. ** – statistically significant difference between examination I and III GlaxoSmithKline) twice a day for three weeks.3±0.5* 2. 1. the attachment level was Dental).1±1. However.58* 0.8±0.55.3±1.001 * – statistically significant difference between examination I and II. In group II.90* 1.80** Clinical attachment level 3.7±0.88 p=0. respectively. III and IV. In the control group.04 p=0.36 5. standard deviation and p value) have been pre- – PI (Plaque Index) accrding to Silness and Löe [10] sented in Tab.

005 p=0.005 p=0.008 p=0.2±0.17 p=0.58 6.4±1.97 1.01 p=0. As demonstrated in change by 0.8±0.9±0.86** SBI 3.005 p=0. et al.66 5.74* 0.26 7.01 p=0.63* 0.59 p=0. mouth rinsing with chlorhexidine solution allows the marginal gingiva to prevent the gel leaking from the pockets.0000 3.15* 1.67* 1.0001 p=0.9±0.18* 6.72* 3.53 p=0.48 6.0±0.5±0.95 2.05 on average in the fluid and gel groups.50 p=0.4±0.9±0.5±0.0000 * – statistically significant difference between examination I and II.0000 p=0.01 p=0.73** GI 2.164 Pietruska M.5±0.31* 3.60* 1.1±0.52** 1.0000 p=0.52** 1. human and animal studies.97 3.7±0.0000 p=0.5±0.01 p=0.69 p=0.72** PI 2.99 1.9±0.42** Pocket depth 3.0002 3. [17] which .23 2.0000 p=0.2±1.02 p=0.1±0.0000 p=0.4-0.0±0.51 p=0.79* 4.01 p=0.0±2.05* 5.2±1.67** 1.58 p=0.007 p=0.4±1.5±1.87** SBI 3.6±0.2±1.8±1.3±0.97* 0.04 p=0.007 p=0.0±0.85* 1.75 6. pocket depth reduction by approximately 0.47* 0.005 p=0.0±0.1±0. ** – statistically significant difference between examination I and III Table 4.2±0.0002 * – statistically significant difference between examination I and II.53* 1.1 in the scaling group.52 2.80** 5.31** GI 1.9±0.01 p=0.5±1.74** PI 2.0000 3. at the analogous PI levels.40* 1.90 p=0.0000 p=0.0±1.15-17].5±0.3±0.005 p=0.0000 2.8±0.17** 6.1±0.0000 p=0.0000 p=0.88 p=0.0±0.78* 1.9±0.95 and 1. ** – statistically significant difference between examination I and III application and by 0.4±0.2±0.0000 p=0.5±0.9±1.03 p=0.95* 5.0000 3.6±1.15) in the group where Corsodyl compared to the control without pharmacotherapy [5.8±0.0±0.79** 1.72 p=0.81 p=0.5±0.11 3.91 p=0.74** 1.50** GI 2.7±0.2±0. was considerably reduced in chlorhexidine-treated subjects as nounced drop in GI (mean 1.0000 1.04 p=0. Assessment of clinical parameters after application of Corsodyl gel with regard to periodontal pocket depth Group I (<5 mm) Group II ( 5 mm) Parameter Examination Examination I II III I II III 0.81** Pocket depth 3.005 p=0.53 2.0000 1.1±1.1±1.82* 4.4±0.7±0.1±1.76* 0.4±0.04 p=0.005 p=0.0000 4.48** 5.4±0.8±0.0000 1. We found this parameter to This group had also markedly reduced SBI.8±0.83* 6.7±1.9±0.6±0.7±0.40 2.007 p=0.0000 2.8±1. gel application was followed by the use of surgical dressing onto Moreover.0±1.57 5.7±1.3±0.5 mm.58* 1.007 p=0.0000 p=0.6±0.47* 2.92 2.81** Clinical attachment level 3.1±0.4±1.0000 p=0. bleeding and by 1.28** 6.33 6.0±0.99** 1.97* 0.52* 0. ** – statistically significant difference between examination I and III Table 3.1±1.4±0.5±0.4±0.0±1. Table 2.97 p=0.005 p=0. Assessment of clinical parameters in the control group with regard to periodontal pocket dept Group I (<5 mm) Group II ( 5 mm) Parameter Examination Examination I II III I II III 1. We observed the most pro.9±0.0±0.85** 2.56** SBI 2.0000 p=0.57 6.005 p=0.79* 0.6±0.9 after scaling.79* 1. Assessment of clinical parameters after application of Corsodyl gel + surgical dressing with regard to periodontal pocket depth Group I (<5 mm) Group II ( 5 mm) Parameter Examination Examination I II III I II III 1.0015 p=0.99** 1.5±1.007 p=0.0000 * – statistically significant difference between examination I and II.4±1.41* 3.5±0.41** PI 1.6±1.72** Clinical attachment level 4.9±1.30** Clinical attachment level 4.99** 1.8±0.9±0.0±0.0000 3.22 p=0.3±1.006 p=0.01 p=0.0000 p=0.5±0.84* 0.00** Pocket depth 4.9±0.0000 1.1±0.72* 3.

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