Clinical evaluation of topical subgingival application of biodegradable xanthan based 1.5% Chlorhexidine gel for treatment of periodontal pockets

Background & Objectives: Local delivery of antimicrobials in sustained or controlled delivery systems are used to enhance the effect of non-surgical periodontal therapy; it might be possible to achieve gingival health without the need for invasive techniques with the use of local drug delivery systems. Thus the aim of the present study was to evaluate efficacy of topical subgingival application of xanthan based 1.5% chlorhexidine gel in the treatment of periodontal pockets. Methods: A randomized controlled clinical trial was carried out for a period of 6 months. 60 sites in 10 patients suffering from chronic periodontitis were divided into experimental and control sites. The experimental sites were treated with Scaling & root planing (SRP) in combination with subgingival application of biodegradable Xanthan based 1.5 % chlorhexidine gel. The control sites received SRP & subgingival application of placebo gel. Plaque index (PI) Gingival index (GI), Probing pocket depth (PD), clinical attachment level (CAL) and gingival margin position (GMP) were recorded at baseline, 3 & 6 months. Results: All the treatments showed significant reductions in PI, GI, PPD, CAL at 3 & 6 months when compared to baseline values (p<0.05). At 6 months, experimental group showed significantly greater improvement in all clinical parameters than control group. The difference between PPD reduction between the treatment groups were 3.0 & 2.4 mm at 3 & 6 months, respectively (p<0.001). For CAL these were 3.11 & 2.4 mm, respectively (p<0.001). The mean percentages of probing depth reduction & clinical attachment level gain ≥ 2 mm were greater in the experimental sites than control sites (p<0.001). Interpretation & Conclusion: Overall, both therapies led to significant improvements of the investigated parameters. The adjunctive use of Xanthan based 1.5% chlorhexidine gel showed greater PPD reductions CAL gains compared to combination of SRP & placebo gel.