Evaluation of Efficacy of Chlorhexidine Intracanal Medicament on the Periodontal Healing of Concomitant Endodontic-Periodontal Lesions Without Communication: An Interventional Study

Background: Treatment of concomitant endodontic-periodontal lesions remains a challenge in clinical practice and requires effective endodontic and regenerative periodontal therapy. Among other factors, cross seeding and recolonization of flora may affect the outcome of periodontal therapy. Intracanal medicaments have been shown to exert antimicrobial activity on the external root surface, and local delivery of antimicrobials has been suggested to be a complementary approach in the management of periodontitis. Therefore, the objective of this study is to determine the influence of chlorhexidine (CHX) intracanal medicament on the clinical outcomes of therapy. Methods: Thirty-one patients were divided into two treatment groups: 1) open flap debridement (OFD) in endodontically treated teeth (control); and 2) OFD in endodontically treated teeth with CHX placed in the coronal space (test). The clinical variables evaluated were probing depth (PD), clinical attachment level (CAL), and percentage of sites with PD >= 5 mm. Reevaluation was performed at 3 and 6 months post-surgery. Results: Both treatments resulted in improvement in all the clinical variables evaluated. Postoperative measurements from test and control groups showed reductions in mean PD of 2.22 +/- 1.27 and 0.91 +/- 0.81 mm, mean CAL gains of 2.16 +/- 1.12 and 0.60 +/- 0.93 mm, and 43.33% +/- 31.37% and 17.71% +/- 14.23% reduction in sites with PD >= 5 mm. Significantly more PD reduction, CAL gain, and percentage reduction in sites with PD >= 5 mm were observed in the test group at 6 months (P <0.05). Conclusion: CHX may be used as an effective intracanal medicament for promoting periodontal healing in concomitant endodontic-periodontal lesions.