A Novel Approach Using Natural 1% (W/W) Chitosan as a Local Drug Delivery System in the Management of Non-Surgical...

Chitosan is a natural polymer found in abundance in nature. It has antimicrobial and anti-inflammatory properties and is biodegradable and biocompatible in nature. It has been used in various forms as an anti-microbial agent in oral care. However, to date, chitosan has not been investigated as a form of local drug delivery (LDD)in the management of non-surgical periodontal treatment (NSPT). Therefore, we aim to investigate the efficacy of natural 1% (w/w) resorbable chitosan membrane as an adjunct to scaling and root planing (SRP) in non-surgical management of chronic periodontitis.

Ten patients with pocket probing depth (PPD) of ≥ 5 mm were categorized randomly into two treatment groups: test group (SRP plus 1% chitosan membrane) and control group (SRP), in a split-mouth study. The clinical parameters recorded were pocket probing depth (PPD), gingival index (GI) and bleeding on probing (BOP) at baseline before SRP and after 4 weeks. Statistical analysis was performed using Student's t-test, Pearson's chi-squared test, the Wilcoxon signed rank test and the Mann-Whitney U test; statistical significance was set at a p value ≤ 0.05.

The test group showed significant improvement in all clinical parameters as compared to the control group. The mean difference between the outcomes of the test and the control groups for PPD was 1.4 mm. Mean ± standard deviation (SD) for GI was 0.20 ± 0.42 at 4 weeks in the test group. All sites (100%) showed a score of '0' for BOP in the test group at 4 weeks. The results were statistically significant.

Within the limitations of this study, it can be concluded that chitosan membranes as a form of LDD could be used as an adjunct to NSPT.