Introduction: Scaling and root planing (SRP) reduces periodontal inflammation but complete removal of bacterial deposits and toxins is not always feasible. Thus, adjunctive therapeutic strategies like use of local delivery of chlorhexidine (CHX) chip and laser therapy have evolved.
Objective: To compare effectiveness of locally delivered CHX chip with diode laser in treatment of periodontitis.
Methods: The non-randomised trial was done in Department of Periodontics at Peoples Dental College and Hospital (PDCH) from August 2019 to July 2020 after ethical clearance from Nepal Health Research Council. Study population was patients with chronic periodontitis with bilateral periodontal pockets in contralateral hemiarches exhibiting periodontal probing depth (PPD) of ≥5-7 mm attending PDCH. Written informed consent was obtained from all participants. Baseline parameters were recorded one week after full mouth SRP. In group A CHX chip was placed and in group B diode laser treatment was done. The parameters: Oral Hygiene Index-Simplified, Plaque Index, Gingival Index, PPD, and Clinical Attachment Level (CAL) were recorded at one month, three months, and six months.
Results: Fifteen patients were analysed. Comparison showed that PPD scores at one month and three months were significantly lower in Group A compared to Group B. Comparison of CAL scores at baseline of both the groups were same. At subsequent visits, CAL for Group A was lower than Group B, but mean difference was not statistically significant.
Conclusions: Both groups showed significant improvements compared with baseline. However, the difference in improvement of the PPD and CAL between groups was not significant.
Qadri T, Javed F, Johannsen G, Gustafsson A. Role of diode lasers (800–980 nm) as adjuncts to scaling and root planing in the treatment of chronic periodontitis: A systematic review. Photomed Laser Surg. 2015;33(11):568-75.
Aoki A, Sasaki KM, Watanabe H, Ishikawa I. Lasers in nonsurgical periodontal therapy. Periodontol 2000. 2004;36(1):59-97.
Birang R, Yaghini J, Adibrad M, Kiany S, Mohammadi Z, Birang E, et al. The effects of diode laser (980 nm wavelength) and chlorhexidine gel in the treatment of chronic periodontitis. Lasers Med Sci. 2011;2(4).
Soskolne W, Chajek T, Flashner M. An in vivo study of the chlorhexidine release profile of the PerioChipTM in the gingival crevicular fluid, plasma and urine. J Clin Periodontol 1998;25(12):1017-21.
Killoy WJ. The use of locally-delivered chlorhexidine in the treatment of periodontitis. Clinical results. J Clin Periodontol. 1998;25(11):953-8.
Dukić W, Bago I, Aurer A, Roguljić M. Clinical effectiveness of diode laser therapy as an adjunct to non-surgical periodontal treatment: A randomised clinical study. J Periodontol. 2013;84(8):1111-7.
Bansal V, Gupta R, Dahiya P, Kumar M, Samlok JK. A clinico-microbiologic study comparing the efficacy of locally delivered chlorhexidine chip and diode laser as an adjunct to non-surgical periodontal therapy. J Oral Biol Craniofac Res. 2019;9(1):67-72.
Lesaffre E, Philstrom B, Needleman I, Worthington H. The design and analysis of split-mouth studies: what statisticians and clinicians should know. Stat Med. 2009;28(28):3470-82.
Jeffcoat MK, Bray KS, Ciancio SG. Adjunctive use of a subgingival controlled-release chlorhexidine chip reduces probing depth and improves attachment level compared with scaling and root planing alone. J Periodontol. 1998;69(9):989-97.
Azmak N, Atilla G, Luoto H, Sorsa T. The effect of subgingival controlled-release delivery of chlorhexidine chip onclinical parameters and matrix metalloproteinase-8 levels in gingival crevicular fluid. J Periodontol. 2002;73(6):608-15.
Balagopal S, Arjunkumar R. Chlorhexidine: The gold standard antiplaque agent. J Pharm Sci. 2013;5(12):270.
Sridhar V, Wali GG, Shyla H. Evaluation of the perioperative use of 0.2% chlorhexidine gluconate for the prevention of alveolar osteitis after the extraction of impacted mandibular third molars: A clinical study. J Maxillofac Oral Surg. 2011;10(2):101-11.
Raffetto N. Lasers for initial periodontal therapy. Dent Clin North Am. 2004;48(4):923-vii.
Moskow BS. The response of the gingival sulcus to instrumentation: A histological investigation. 2. Gingival curettage. J Periodontol. 1964;35(2):112-26.
Kon S, Novaes AB, Ruben M, Goldman H. Visualization of microvascularisation of the healing periodontal wound II. Curettage. J Periodontal 1969;40(2):96-105.
Divya P, Nandakumar K. Local drug delivery—Periocol in periodontics. Trends Biomater Artif Organs. 2006;19(2):74-80.
Caruso U, Nastri L, Piccolomini R, d’Ercole S, Mazza C, Guida L, et al. Use of diode laser 980 nm as adjunctive therapy in the treatment of chronic periodontitis. A randomised controlled clinical trial. New Microbiol. 2008;31(4):513-8.
Mızrak T, Güncü GN, Çağlayan F, Balcı TA, Aktar GS, İpek F, et al. Effect of a controlled-release chlorhexidine chip on clinical and microbiological parameters and prostaglandin E2 levels in gingival crevicular fluid. J Periodontol. 2006;77(3):437-43.
Soskolne W, Heasman P, Stabholz A. Sustained local delivery of chlorhexidine in the treatment of periodontitis: A multi-center study. J Periodontol. 1997;68(1):32-8.
Heasman P, Heasman L, Stacey F, McCracken G. Local delivery of chlorhexidine gluconate (PerioChipTM) in periodontal maintenance patients. J Clin Periodontol. 2001;28(1):90-5.
Rodrigues IFG, Machion L, Casati MZ. Clinical evaluation of the use of locally delivered chlorhexidine in periodontal maintenance therapy. J Periodontol. 2007;78(4):624-8.
Grover V, Kapoor A, Malhotra R, Battu VS, Bhatia A, Sachdeva S, et al. To assess the effectiveness of a chlorhexidine chip in the treatment of chronic periodontitis: A clinical and radiographic study. J Indian Soc Periodontol. 2011;15(2):139.
Paolantonio M, D'Angelo M, Grassi RF. Clinical and microbiologic effects of subgingival controlled-release delivery of chlorhexidine chip in the treatment of periodontitis: a multicentre study. J Periodontol. 2008;79(2):271-82.
Lin J, Bi L, Wang L. Gingival curettage study comparing a laser treatment to hand instruments. Lasers Med Sci. 2011;26(1):7-11.
Crispino A, Figliuzzi MM, Iovane C. Effectiveness of a diode laser in addition to non-surgical periodontal therapy: Study of intervention. Ann Stomatol (Roma). 2015;6(1):15.
Grisi DC, Salvador SL, Figueiredo LC, Souza SL, Novaes Jr AB, Grisi MF. Effect of a controlled-release chlorhexidine chip on clinical and microbiological parameters of periodontal syndrome. J Clinical Periodontol. 2002;29(10):875-81.