2013 Volume 56 Issue 4 Pages 344-352
Purpose: Periodontopathic bacteria and inflammation in a residual periodontal pocket after periodontal therapy increase the risk for further progression of periodontitis. A tooth cleaning gel containing antibacterial and anti-inflammatory agents would be effective to inhibit such progression. The tooth cleaning gel 'Jellcoat F' contains 0.05% chlorhexidine hydrochloride as an antibacterial and β-glycyrrhetinic acid as an anti-inflammatory. We evaluated the effects of Jellcoat F on residual periodontal pockets with clinical, microbiological and biochemical analyses. Methods: The present study had a randomized, controlled, double-blinded design. Systemically healthy patients with ≥20 teeth were enrolled if they had at least two teeth with residual pockets of 6-7 mm depth after at least a month from the completion of active periodontal therapy containing scaling and root planing. Twenty patients were randomly assigned to the test group who used Jellcoat F or the control group who used placebo. Gingival index (GI), plaque index (Pl I), probing pocket depth and bleeding on probing were recorded. In each patient, gingival crevicular fluid (GCF) was collected from one of the teeth with residual pockets, and subgingival plaque from the other. The levels of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in GCF and Porphyromonas gingivalis, Prevotella intermedia, Tannerella forsythia and Treponema denticola in subgingival plaque were determined. After the collections, residual pockets were filled with Jellcoat F or placebo. Patients were instructed to brush their teeth with Jellcoat F or placebo and also apply the gel with a retainer for 10 minutes before sleeping. After 4 weeks, the same examinations were performed. Results: No adverse event was observed. At the baseline, no difference was observed between the test and control groups in age, sex, number of teeth, levels of periodontopathic bacteria, AST and ALT. Comparing the baseline and 4 weeks, only GI and Pl I were significantly decreased in the test group. No other change was found in both test and control groups. Changes of measurements during the 4 weeks were not statistically different between the groups. The effect of Jellcoat F to improve GI remained significant after being adjusted for age and sex. Conclusion: Application of Jellcoat F for 4 weeks on residual pockets after periodontal therapy with teeth brushing and a retainer did not significantly change the levels of periodontopathic bacteria in subgingival plaque, AST and ALT in GCF However, it might suggest the reduction of clinically evaluated supragingival plaque and gingival inflammation.
