Stannous fluoride and subgingival chlorhexidine irrigation in the control of plaque and chronic periodontitis

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Abstract
The possible benefits of stannous fluoride dentifrice (SnF2) and once daily chlorhexidine (CH) in the control of chronic periodontitis were investigated following a single course of scaling and root planing. Fourteen adult patients with pockets 4 mm or deeper received a thorough scaling and root planing, followed by instruction in the irrigation of those pockets with CH. They were given either SnF2-containing or a placebo dentifrice, and a new multituft toothbrush, but no instruction in routine oral hygiene. Plaque index (PII), sulcus bleeding index (SBI) and pocket depth were recorded prior to scaling on day 0. The same parameters and gingival shrinkage were recorded at weeks 1, 2, 4, 8 and 12. CH irrigation was discontinued at day 28. Both groups showed highly significant improvements in all parameters except gingival shrinkage after 28 days. P1I was significantly less at all stages in the SnF2 group. It reached baseline values by day 56 in the placebo and day 84 in the SnF2 group. Periodontitis as assessed by SBI remained reduced significantly below baseline values in both groups. At this time there was no significant difference between the groups as regards SBI. A single course of thorough scaling and rooting planing followed by once daily subgingival irrigation with CH for 1 mo., produced a reduction in periodontitis still apparent 2 mo. after cessation of irrigation. This regime allows a 3-mo. interval between oral hygiene visits. SnF2-containing dentifrice had a plaque control effect additional to that produced by the regime, but had no effect on periodontitis as assessed by SBI.