Long-Term Clinical Effects of a Chlorhexidine Varnish Implemented Treatment Strategy for Chronic Periodontitis

• Autores: Tim De Rouck, Mehran Moradi Sabzevar, Jan Cosyn, Iris Wyn
• Localización: Journal of periodontology, ISSN 0022-3492, Vol. 77, Nº. 3, 2006, págs. 406-415
• Idioma: inglés
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• Resumen

  • Long-Term Clinical Effects of a Chlorhexidine Varnish Implemented Treatment Strategy for Chronic Periodontitis Jan Cosyn,* Iris Wyn,* Tim De Rouck,† and Mehran Moradi Sabzevar* *Department of Periodontology, School of Dental Medicine, Free University of Brussels, Brussels, Belgium.

    †Department of Restorative Dentistry, School of Dental Medicine, Free University of Brussels.

    Correspondence: Dr. Jan Cosyn, Department of Periodontology, School of Dental Medicine, Free University of Brussels, Laarbeeklaan 103, B-1090 Brussels, Belgium. Fax: 32-2-4774902; e-mail: jan.cosyn@vub.ac.be.

    Background: Scaling and root planing in combination with oral hygiene monitoring are still considered the therapeutic standards for periodontitis. Although this treatment concept customarily results in satisfactory clinical improvements, treatment outcome may become less favorable predominantly when full access to periodontal defects is compromised, thereby leaving accretions behind. The purpose of this study was to investigate, over a 9-month period, the clinical benefits of a treatment strategy for chronic periodontitis based on a combination of sequential scaling and root planing and subgingival chlorhexidine varnish administration.

    Methods: This randomized controlled, single blind, parallel trial included 26 volunteers with chronic periodontitis. The control group received oral hygiene instructions and was scaled and root planed in two sessions. The test group received the same instructions and treatment; however, all pockets were additionally disinfected using a highly concentrated chlorhexidine varnish. Clinical response parameters were recorded at baseline and at 1, 3, 6, and 9 months. The impact of the initial strategy on the decision-making process for supplementary therapy at 9 months was investigated based on treatment decisions made by five independent clinicians.

    Results: Both treatment strategies showed significant reductions in probing depth and gains in clinical attachment at study termination in comparison with baseline (P <0.001). However, combination therapy resulted in a significant additional pocket reduction of 0.62 mm (P <0.001). Initially deep pockets (≥7 mm) around multirooted teeth seemed to benefit most from the combination strategy, resulting in an additive pocket reduction of 1.06 mm (P = 0.009) and a clinical attachment gain of 0.54 mm (P = 0.048) in comparison to scaling and root planing alone. A trend toward a reduction of surgical treatment needs following the varnish-implemented strategy was found (P = 0.076).

    Conclusion: These findings suggest that the outcome of initial periodontal therapy may benefit from the adjunctive subgingival administration of a highly concentrated chlorhexidine varnish.

    KEYWORDS: Chlorhexidine, clinical study, periodontitis, root planing, scaling, varnish Cited by Jorge Perdigão, Alessandra Reis and Alessandro D. Loguercio. (2013) Dentin Adhesion and MMPs: A Comprehensive Review. Journal of Esthetic and Restorative Dentistry, n/a-n/a.

    Online publication date: 1-Mar-2013.

    CrossRef J Cosyn, SR Miremadi, MM Sabzevar and H De Bruyn. (2013) Clinical effects of an essential oil solution used as a coolant during ultrasonic root debridement. International Journal of Dental Hygiene 11:10.1111/idh.2013.11.issue-1, 62-68.

    Online publication date: 1-Feb-2013.

    CrossRef Vishal Anand, Vivek Govila, Minkle Gulati, Bhargavi Anand, Rajesh Jhingaran and Pavitra Rastogi. (2012) Chlorhexidine–thymol varnish as an adjunct to scaling and root planing: A clinical observation. Journal of Oral Biology and Craniofacial Research 2, 83-89.

    Online publication date: 1-May-2012.

    CrossRef Duck-Su Kim, Jongryul Kim, Kyoung-Kyu Choi and Sun-Young Kim. (2011) The influence of chlorhexidine on the remineralization of demineralized dentine. Journal of Dentistry 39, 855-862.

    Online publication date: 1-Dec-2011.

    CrossRef Harpreet Singh, Pooja Kapoor, GK Meshram and MM Warhadpande. (2011) Evaluation of substantivity of chlorhexidine to human dentin and its application in adhesive dentistry—an in vitro analysis. Indian Journal of Dentistry 2, 8-10.

    Online publication date: 1-Jun-2011.

    CrossRef Marcela R. Carrilho, Ricardo M. Carvalho, Ethan N. Sousa, José Nicolau, Lorenzo Breschi, Annalisa Mazzoni, Leo Tjäderhane, Franklin R. Tay, Kelli Agee and David H. Pashley. (2010) Substantivity of chlorhexidine to human dentin. Dental Materials 26, 779-785.

    Online publication date: 1-Aug-2010.

    CrossRef Jan Cosyn and Mehran Moradi Sabzevar. (2007) Subgingival Chlorhexidine Varnish Administration as an Adjunct to Same-Day Full-Mouth Root Planing. II. Microbiological Observations. Journal of Periodontology 78:3, 438-445.

    Online publication date: 1-Mar-2007.

    Abstract | Full Text | PDF (225 KB) | PDF Plus (222 KB) Jan Cosyn, Iris Wyn, Tim De Rouck and Mehran Moradi Sabzevar. (2007) Subgingival Chlorhexidine Varnish Administration as an Adjunct to Same-Day Full-Mouth Root Planing. I. Clinical Observations. Journal of Periodontology 78:3, 430-437.

    Online publication date: 1-Mar-2007.

    Abstract | Full Text | PDF (336 KB) | PDF Plus (231 KB) Jan Cosyn, Iris Wyn, Tim De Rouck and Mehran Moradi Sabzevar. (2006) Clinical Benefits of Subgingival Chlorhexidine Varnish Application as an Adjunct to Same-Day Full-Mouth Root Planing: A Pilot Study. Journal of Periodontology 77:6, 1074-1079.

    Online publication date: 1-Jun-2006.