Evaluation of the Efficacy of Subgingival Irrigation in Patients with Moderate to Severe Chronic Periodontitis for Whom Periodontal Flap Surgery Is Otherwise Indicated
Jain R, Chaturvedi R, Pandit N, Grover V, Lyle DM, Jain A. J Indian Soc Periodontol 2020; 24(4):348–353.
Study conducted at the Institute of Dental Services, Panjab University, Chandigarh, India.
Objective
To compare the efficacy of using a water flosser with 0.06% chlorhexidine (CHX) and a Pik Pocket™ tip versus rinsing with 0.12% CHX mouthwash in patients with moderate to severe chronic periodontitis who have postponed or declined surgical intervention.
Methodology
Forty subjects were enrolled in this three-month randomised controlled clinical trial.
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Group A: Irrigated with 0.06% CHX twice daily after brushing using a water flosser with a Pik Pocket™ tip.
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Group B: Rinsed with 15 ml of 0.12% CHX twice daily after brushing.
All subjects received phase I treatment, including scaling, root planing, and oral hygiene instruction using a standard manual toothbrush and toothpaste.
Clinical parameters measured at baseline, 2, 4, and 12 weeks included the Gingival Index (GI), Oral Hygiene Index-Simplified (OHI-S), and Bleeding on Probing (BOP). Pocket depth (PD) and clinical attachment level (CAL) were recorded at six sites per tooth. The Lobene Index was used to assess CHX staining intensity and area for each subject.
Results
Thirty-six subjects completed the study. Both groups showed significant improvement in GI, OHI-S, and BOP from baseline to 12 weeks, with no significant difference between them.
However, Group A (0.06% CHX irrigation) achieved significantly greater reductions in pocket depth and clinical attachment level than Group B (0.12% CHX mouthrinse).
Group A also demonstrated significantly less lingual staining than Group B (p = 0.014).
Conclusion
Using the Waterpik™ Water Flosser with 0.06% CHX and the Pik Pocket™ tip twice daily provides significantly greater improvements in periodontal pocket depth and clinical attachment levels than rinsing with CHX mouthwash, while also reducing staining.