Clinical and microbiological effect of subgingival application of chlorhexidine gel and phatodynamic therapy as an adjunctive to full mouth scaling and root planning in the treatment of periodontitis

Abstract

The aim of this clinical and microbial study is to compare the effectiveness of adjunctive Chlorhexidine gel and photodynamic therapy in the treatment of periodontitis. Method and Material: 24 subjects (14 women and 10 men) suffering from moderate-to-severe chronic periodontitis attended in the study in Department of periodontics of Dental Faculty of Tabriz University of Medical Sciences. Main inclusion criteria are: Presence of at least one site per quadrant exhibiting pocket depth of >= 4 mm with bleeding on probing. Before any nonsurgical treatment, subgingival plaque sampling carried out. one of the teeth in each quadrant with probing depth >4mm was selected for microbial and clinical assessment. Selected teeth in these quadrants were randomized to one of three treatments: chlorhexidine gel, photodynamic therapy and scaling and root planning followed by full mouth scaling and root planing. Clinical parameters of probing depth, clinical attachment level, bleeding on probing, gingival recession were measured at baseline, one month and three month after treatment and microbial analysis by real-time polymerase chain reaction carried out at baseline and 3 month after treatment. Primary outcome is probing depth. Results: Although clinical and microbial parameters decreased significantly in three groups after one and three month , intergroup difference was not statistically significant neither one month nor three month . The only clinical parameter that showed statistically significant intergroup difference was BOP in gel and PDT group compared to SRP (p=0.001) without significant difference between gel and PDT group. Conclusion: Within the limitations of current study, subgingival application of Xanthan Chlorhexidine gel combined with scaling and root planning may reduce bleeding of periodontal pockets. Other clinical and microbiological parameters was not different between two groups. It is suggested to design clinical trials to evaluate effectiveness of this gel in aggressive periodontitis and severe periodontitis modified by systemic factors.