Local delivery of chlorhexidine gluconate (PerioChip) in periodontal maintenance patients

The aim of this randomised, split-mouth, single-blind study was to determine the efficacy of controlled-release delivery of chlorhexidine gluconate 2.5 mg (PerioChip) in patients with residual bleeding pockets (>5 mm) at least 3 months following oral hygiene and root debridement phase therapy.

26 patients (non-smokers) were screened and potential study sites identified. Clinical parameters recorded at baseline and all subsequent visits were plaque index (PI), pocket probing depth (PPD), bleeding index (BI) and clinical attachment level (CAL). All study sites were debrided using ultrasonic instrumentation. PerioChips (PC) were placed in the selected sites of two quadrants (left or right) whilst identified sites in the remaining quadrants were left without adjunctive antimicrobial treatment. Clinical measurements were made at follow-up visits after 1, 3 and 6 months. Mean changes from baseline in PPD, BI and CAL were calculated with the patient as the experimental unit and comparability between the treatments was determined using t-tests.

At baseline there were no significant differences between PC and control sites for mean PI, PD, BI or CAL. The mean (SE) reductions in PPD for PC and control treatments were: 0.47 (0.1), 0.46 (0.1); 0.76 (0.1), 0.55 (0.1); 0.78 (0.1), 0.45 (0.1) for months 1, 3 and 6 respectively. Only at month 6 did the difference between treatments approach statistical significance (p=0.06). Mean (SE) reductions in CAL over the same periods were: 0.17 (0.1), 0.04 (0.08); 0.38 (0.1), 0.21 (0.1); 0.43 (0.1), 0.15 (0.09) p=0.048. Mean (SE) reduction in BI between PC and control treatments only reached statistical significance at 6 months: 1.08 (0.1), 0.59 (0.1) p=0.05.

These data suggest that PerioChip is beneficial for patients on maintenance therapy although the benefit is not apparent until 6 months after placement.