Treatment of peri-implantitis using multiple applications of chlorhexidine chips: a double-blind, randomized multi-centre clinical trial

J Clin Periodontol. 2012 Dec;39(12):1198-205. doi: 10.1111/jcpe.12006. Epub 2012 Sep 30.

Abstract

Background: Universal strategies for managing peri-implantitis are yet to be adopted. The aim of this study is to examine a protocol of intensive application of chlorhexidine containing chips in sites with peri-implantitis.

Materials and methods: This multi-centre, randomized, double-blind, parallel, two-arm clinical trial included 60 patients (77 implants) with probing depth (PD) 6-10 mm and bone loss ≥2 mm around 1-2 implants. One to two weeks following SRP, baseline measurements were made followed by implants' debridement. Patients were randomized to receive matrix chips (MatrixC) or chlorhexidine Chips (PerioC). Measurements and chips placement were repeated at weeks 2, 4, 6, 8, 12 and 18. At 6 months, patients returned for final examination.

Results: Probing depth reduction was greater in the PerioC (2.19 ± 0.24 mm) compared with MatrixC (1.59 ± 0.23 mm), p = 0.07. Seventy percentage of the implants in the PerioC and 54% in the MatrixC had PD reduction ≥ 2 mm. Likewise, 40% of the sites (PerioC) and 24% (MatrixC) had PD reduction ≥ 3 mm. Clinical attachment level gains for both groups were significant; however, the changes in the PerioC group were significantly greater than in MatrixC [2.21 ± 0.23 mm. and 1.56 ± 0.25 mm respectively, p = 0.05]. Bleeding on probing was reduced by half in both groups.

Conclusion: Frequent placement of PerioC and MatrixC together with implants debridement resulted in a substantial improvement in sites with peri-implantitis. Further studies will be required to fully appreciate the mechanism of this treatment.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Anti-Infective Agents, Local / administration & dosage
  • Anti-Infective Agents, Local / therapeutic use*
  • Chlorhexidine / administration & dosage
  • Chlorhexidine / analogs & derivatives*
  • Chlorhexidine / therapeutic use
  • Dental Plaque Index
  • Double-Blind Method
  • Female
  • Gelatin
  • Humans
  • Likelihood Functions
  • Linear Models
  • Male
  • Middle Aged
  • Peri-Implantitis / drug therapy*
  • Periodontal Debridement
  • Periodontal Index
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Infective Agents, Local
  • Gelatin
  • chlorhexidine gluconate
  • Chlorhexidine