Chlorhexidine chips to treat peri-implantitis?

Methods: Peri-implantitis patients with implant pockets of 5 to 8 mm had subgingival implant surface debridement followed by repeated bi-weekly supra gingival plaque debridement and chlorhexidine chip application for 12 weeks.

Results: A total of 290 patients were included: Significant reduction in implant probing depths was measured in the chlorhexidine group ( 1.76 mm) compared to the control group ( 1.54 mm). Relative attachment gain and gingival recession was also larger in the chlorhexidine group. 

Conclusions: Intensive treatment every two weeks comprising of supra gingival plaque removal and chlorhexidine chip application had a greater probing depth reduction compared to plaque removal alone 

For more information please refer to:

J Periodontology 2021 January

Repeated delivery of chlorhexidine chips for the treatment of peri-implantitis: A multicenter, randomized, comparative clinical trial

Machtei E, Romanos G, Kang P, et al.  

Clarithromycin Beneficial with Full Mouth Debridement in Generalized Aggressive Periodontitis?

Methods: Forty patients were randomly assigned to one of two groups: 1) Full Mouth Debridement with Clarithromycin 500mg every 12 hours for 3 days. 2) Full Mouth Debridement with placebo pills.

Results: Both groups were effective for clinical and microbiological parameters. The Clarithromycin group presented with lower mean probing depths for pockets ≥ 7mm at 6 months. The Clarithromycin group also had greater reduction in P. gingivalis DNA counts at 6 months.

Conclusions: Adjunctive use of Clarithromycin with Full Mouth Debridement leads to greater reduction in deep pocketing and reduced P. gingivalis counts at 6 months.

For more information please refer to :

J Periodontol. 2017 Dec;88(12):1244-1252

Clarithromycin as an Adjunct to One-Stage Full-Mouth Ultrasonic Periodontal Debridement in Generalized Aggressive Periodontitis: A Randomized Controlled Clinical Trial.

N Andere, N dos Santos, C Araujo, et al.

Emdogain plus Calcium Phosphate for Two-Wall Defects?


52 patients with at least one non-contained infrabony defect ≥ 3 mm and probing ≥ 3 mm were randomly treated with either Emdogain plus biphasic calcium phosphate or Emdogain alone. The primary outcome was a change in clinical attachment up to 12 months.


Mean clinical attachment gain of 2.38 mm ± 2.17 mm was achieved in the Emdogain plus calcium phosphate group compared to 2.65 ± 2.18 mm when Emdogain was used alone.  There was no statistically significant difference between the two treatment groups.


The treatment of non-contained infrabony defects with Emdogain combined with calcium phosphate did not yield statistically significant improvement compared to Emdogain used by itself.  Both treatment resulted in significantly better clinical attachment levels at 12 months.

For more information please refer to:

J Periodontol. 2017 May;88(5)

Treatment of Non-Contained Infrabony Defects With Enamel Matrix Derivative Alone or in Combination With Biphasic Calcium Phosphate Bone Graft: A 12-Month Randomized Controlled Clinical Trial

Losada M, González R, Garcia AP, Santos A, Nart J

Good long term results for tissue grafts?


Forty-seven patients with 64 sites with lack of attached gingiva were treated with free gingival grafts and 64 control sites were left untreated.  Patients were recalled every 4 to 6 months.  Gingival recession depth, keratinized tissue width, and probing depth were measured at baseline and extending to the follow up period (18 to 35 years)


At the end of the follow up period, 83% of the 64 treated sites showed recession reduction whereas 48% of the 64 untreated sites experienced increase in recession. Treated sites ended with gingival margin 1.7 mm more coronal and keratinized tissue 3.3 mm wider than untreated sites.


Sites treated with gingival augmentation procedures resulted in coronal displacement of the gingival margin and reduced recession, whereas the contralateral untreated sites showed a tendency for increased recession and a tendency to develop new recession during the 18 to 3 year follow up.

For more information please refer to:

Journal of Periodontology 2009 Sep;80(9):1399-405

Periodontal conditions of sites treated with gingival augmentation surgery compared to untreated contralateral homologous sites: a 10- to 27-year long-term study.

Agudio G1, Nieri M, Rotundo R, Franceschi D, Cortellini P, Pini Prato GP.


Platelet-rich fibrin (PRF) to treat periodontal intrabony defects?


36 intrabony defects in 36 individual patients were treated with either demineralized freeze-dried bone allograft (DFDBA) or platelet-rich fibrin (PRF).  Data was collected at baseline and at 6 month follow up and included radiographic bone fill and changes in clinical attachment levels (CAL).


Both treatment groups had significant gain in clinical attachment levels and bone fill, with no significant difference between groups.  Mean CAL gain for DFDBA was 1.16 ± 1.33 mm and mean radiographic bone fill was 1.14 ± 0.88 mm.  PRF had a mean CAL gain of 1.03 ± 0.86 and mean radiographic bone fill of 1.10 ± 1.01 mm.


Intrabony defects treated with either DFDBA or PRF had a significant gain in CAL as well as bone fill after 6 months of healing and there was no significant difference between the two materials.

For more information please refer to:

Journal of Periodontology, November 2016, Vol. 87, No. 11

Clinical and Radiographic Evaluation of Demineralized Freeze-Dried Bone Allograft Versus Platelet-Rich Fibrin for the Treatment of Periodontal Intrabony Defects in Humans

Jane K. Chadwick, Michael P. Mills,  and Brian L. Mealey