Treatment of Residual Pockets in Stage III and IV Periodontitis Using an Oscillating Chitosan Device With or Without a Chitosan Gel—A Randomised Parallel‐Arms Clinical Trial

AIM: To compare non-surgical subgingival re-instrumentation with an oscillating chitosan brush (OCB), with and without a novel chitosan hydrogel (LGX), in residual or recurrent pockets in step 3 or 4 of stage III-IV periodontitis patients. MATERIALS AND METHODS: Patients presenting with residual 5-8 mm probing pocket depth (PPD) and modified bleeding on probing (mBOP) scores of 2 or 3 at 3-8 teeth were randomly assigned to treatment with either an OCB alone or OCB combined with LGX gel. Treatment was repeated at 3 months. Examinations took place at baseline (BL) and at 1 (Tp1), 3 (Tp2) and 6 months (Tp3) thereafter. Primary outcomes comprised changes in PPD, mBOP and pocket closure (PC). RESULTS: Thirty-eight patients were included in the analysis. Both treatments resulted in significant PPD and mBOP reductions at all follow-ups. However, sites treated with adjunctive LGX resulted in significantly greater PPD reductions and higher rates of PC compared to OCB alone (Tp2: PPD reductions 1.55 vs. 1.04, p < 0.001; PC: 67.1% vs. 46.4%, p < 0.001; Tp3: PPD reductions 1.73 vs. 1.33, p = 0.001; PC: 76.8% vs. 60.8%, p < 0.01). CONCLUSION: Adjunctive LGX gel application enhanced the efficacy of repeated subgingival re-instrumentation with OCB, reducing the need for additional step 3 interventions. TRIAL REGISTRATION: ClinicalTrials.gov identification number: NCT05773911, first submitted: 2022-09-15 (https://clinicaltrials.gov/study/NCT05773911).