A PerioChip is a gelatin platelet containing the active ingredient chlorhexidine. The chip is used to reduce germs in gingival pockets on teeth damaged by periodontitis (inflammation of the periodontium), where it exerts its depot effect, effectively helping to contain periodontitis. The antiseptic chlorhexidine (synonyms: chlorhexidine digluconate, chlorhexidine bis (D-gluconate), CHX) has been used in mouth rinses, gels and varnishes for 30 years and remains the dental gold standard when it comes to treating bacterial infections in the oral cavity without antibiotics. The great advantage of the 4 x 5 mm PerioChip is its form of application: on the one hand, its chlorhexidine concentration of 36% is considerably higher than in rinses or gels with a maximum of 2%, and on the other hand, it dissolves slowly and completely over the course of seven to ten days, whereby the chlorhexidine is released into the sulcus fluid (fluid in the gingival pocket) in a sufficiently high concentration over a long period of time, where it can have a direct local effect on the periodontopathogenic pathogens (those causing dental inflammation). Studies have shown that new colonization of gingival pockets treated with PerioChip can thus be suppressed for up to twelve weeks. This is the basis for the recommendation to repeat the treatment of vulnerable pockets every three months. In conjunction with improved oral hygiene at home, regular dental recall (follow-up visits) and professional dental cleaning (PZR), the following long-term therapy successes can be demonstrated:
- Decreased probing depth of treated gingival pockets / improved clinical attachment – After the inflammatory process has subsided, tissue pressure increases due to collagen deposition, and the measuring probe no longer penetrates as deeply into the sulcus (groove between tooth and gum). The distance of the probe tip measured from the enamel-cement interface to the deepest point of the gingival pocket decreases due to improved adhesion of the structures of the periodontium to the tooth surface.
- Reduction of bleeding tendency
- Germ reduction
- Bone regeneration
Indications (areas of application)
- Residual pockets (pathological gingival pockets remaining after therapy for periodontitis).
- After detection of periodontopathogenic (dental bed inflammation-causing) germs with corresponding pocket findings.
- As a pre-treatment of further periodontal therapy – e.g. to reduce the risk of bacteremia (risk of washing germs into the bloodstream) associated with scaling and root planing (mechanical cleaning and smoothing of the tooth root surfaces) or periodontal surgery.
- To support a classic periodontal treatment
- To contain the recolonization of periodontally pre-damaged gingival pockets.
Contraindications
- Hypersensitivity to chlorhexidine
Before the procedure
Radiographs allow in advance of treatment to assess the extent of periodontal damage (to the periodontium) and plan further therapy. To this end, indices assessing pocket depths and bleeding tendencies provide other important clinical findings. In addition, work must be done to improve oral hygiene technique, without which it will be impossible to control periodontitis in the long term.
The procedure
The gingival pocket to be treated is lightly cleared of saliva with the air blower. The chip, which is packed in a moisture-protected individual blister, is picked up with the tweezers and inserted slowly and carefully with the rounded side down to the pocket fundus (bottom of the pocket) so as not to cause pain with the initially still hard edge. For the period of one to two minutes, it may be necessary to apply slight counterpressure with the forceps to prevent the chip from being pushed back out of the sulcus (groove between the gum and tooth) by the tension of the gingiva.
After the procedure
In the area of the PerioChip, flossing or interdental brushing (brushing between teeth) should be done judiciously within the week following application. The success of the therapy is checked at short-term dental follow-up visits. A check-up at 3-month intervals ensures timely repetition of the chip application in order to stabilize the treatment result in the long term.
Possible complications
- Premature loss of the PerioChip – e.g. due to careless handling of dental floss or interdental brushes.
- Feeling of pressure to pressure pain in the first 24 hours due to swelling of the gelatin.
