Efficacy of Subgingival Application of Xanthan-based Chlorhexidine Gel Adjunctive to Full-mouth Root Planing Assessed by Real-time PCR: A Microbiologic and Clinical Study

Background And Aims: The aim of this clinical investigation was to compare clinical and microbiological effectiveness of adjunctive CHX gel in the treatment of periodontitis.

Materials And Methods: Twenty-four subjects with localized or generalized moderate-to-severe chronic periodontitis underwent scaling and root planing. One tooth in each quadrant with a probing depth of >4 mm was chosen for combined gel and SRP, with contralateral tooth as control (SRP treated site). Clinical assessment was carried out at baseline and 1 and 3 months later; microbial assessment was performed by real-time PCR. Periodontal probing depth (PPD) was considered as primary outcome.

Results: Twenty patients completed the study. Baseline PPDs were 4.90±0.78 and 5.05±0.79 in the SRP and gel groups, respectively (P>0.05), which decreased to 3.67±0.59 and 3.7±0.83 one month after treatment and 3.25±0.65 and 3.38±0.79 three months after treatment. Although values decreased significantly in both groups after one and three months (P=0.001 in the SRP and P=0.001 in the gel group), the inter-group difference was not significant neither at one-month (P=0.47) nor at three-month (P=0.77) intervals. The only clinical parameters exhibiting statistically significant inter-group differences was BOP in both one-month (P=0.004) and three-month (P=0.0001) intervals. All the other clinical measurements showed significant decreases after one and three months in both sites but without inter-group differences.

Conclusion: Subgingival application of xanthan chlorhexidine gel combined with scaling and root planing reduced bleed-ing of periodontal pockets. Clinical trials to evaluate effectiveness of this gel in aggressive and severe periodontitis modified by systemic factors are suggested.