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Long-term clinical effects of a chlorhexidine varnish implemented treatment strategy for chronic periodontitis

(2006) JOURNAL OF PERIODONTOLOGY. 77(3). p.406-415
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Abstract
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
clinical study, chlorhexidine, periodontitis, root planing, scaling, varnish, SUBGINGIVAL ANTIMICROBIAL IRRIGATION, CHRONIC ADULT PERIODONTITIS, BACTERIAL INVASION, MUTANS STREPTOCOCCI, DENTAL PLAQUE, RADICULAR DENTIN, ATTACHMENT LEVEL, SINGLE EPISODE, PROBING DEPTH, DEEP POCKETS

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Citation

Please use this url to cite or link to this publication:

MLA
Cosyn, Jan et al. “Long-term Clinical Effects of a Chlorhexidine Varnish Implemented Treatment Strategy for Chronic Periodontitis.” JOURNAL OF PERIODONTOLOGY 77.3 (2006): 406–415. Print.
APA
Cosyn, J., Wyn, I., De Rouck, T., & Sabzevar, M. M. (2006). Long-term clinical effects of a chlorhexidine varnish implemented treatment strategy for chronic periodontitis. JOURNAL OF PERIODONTOLOGY, 77(3), 406–415.
Chicago author-date
Cosyn, Jan, Iris Wyn, Tim De Rouck, and Mehran Moradi Sabzevar. 2006. “Long-term Clinical Effects of a Chlorhexidine Varnish Implemented Treatment Strategy for Chronic Periodontitis.” Journal of Periodontology 77 (3): 406–415.
Chicago author-date (all authors)
Cosyn, Jan, Iris Wyn, Tim De Rouck, and Mehran Moradi Sabzevar. 2006. “Long-term Clinical Effects of a Chlorhexidine Varnish Implemented Treatment Strategy for Chronic Periodontitis.” Journal of Periodontology 77 (3): 406–415.
Vancouver
1.
Cosyn J, Wyn I, De Rouck T, Sabzevar MM. Long-term clinical effects of a chlorhexidine varnish implemented treatment strategy for chronic periodontitis. JOURNAL OF PERIODONTOLOGY. 2006;77(3):406–15.
IEEE
[1]
J. Cosyn, I. Wyn, T. De Rouck, and M. M. Sabzevar, “Long-term clinical effects of a chlorhexidine varnish implemented treatment strategy for chronic periodontitis,” JOURNAL OF PERIODONTOLOGY, vol. 77, no. 3, pp. 406–415, 2006.
@article{855212,
  abstract     = {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.},
  author       = {Cosyn, Jan and Wyn, Iris and De Rouck, Tim and Sabzevar, Mehran Moradi},
  issn         = {0022-3492},
  journal      = {JOURNAL OF PERIODONTOLOGY},
  keywords     = {clinical study,chlorhexidine,periodontitis,root planing,scaling,varnish,SUBGINGIVAL ANTIMICROBIAL IRRIGATION,CHRONIC ADULT PERIODONTITIS,BACTERIAL INVASION,MUTANS STREPTOCOCCI,DENTAL PLAQUE,RADICULAR DENTIN,ATTACHMENT LEVEL,SINGLE EPISODE,PROBING DEPTH,DEEP POCKETS},
  language     = {eng},
  number       = {3},
  pages        = {406--415},
  title        = {Long-term clinical effects of a chlorhexidine varnish implemented treatment strategy for chronic periodontitis},
  url          = {http://dx.doi.org/10.1902/jop.2006.050144},
  volume       = {77},
  year         = {2006},
}

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