Adjunctive effect of the colloidal silver ions solution in the treatment of chronic periodontal disease: a preliminary clinical study

  • Vladan M. Kovačević University of Defence, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic for Dental Diseases, Belgrade, Serbia
  • Dragana R. Daković University of Defence, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic for Dental Diseases, Belgrade, Serbia
  • Dubravko R Bokonjić Military Medical Academy, National Poison Control Center, Belgrade, Serbia
Keywords: periodontal diseases;, periodontal index;, chlorhexidine;, silver.

Abstract


Background/Aim. Bacteria play the most important role in the development of periodontitis and chlorhexidine (CHX) is a “gold standard” in its treatment. Silver ions are also strong antiseptics, being used in dentistry for a long time. Therefore, the aim of this study was to compare the efficacy of CHX and colloidal silver ions solution (SSI) in the treatment of patients with chronic periodontitis. The additional aim was to ascertain silver ions, tolerability and efficacy comparing to CHX. Methods. Twenty-nine exami­nees of both sexes (the average age 50.6) participated in this study and were divided into two groups. The patients in the first group (n = 15) suffering from a generalized moderate chronic periodontitis, after scaling and root planning (SRP), were treated by rinsing of periodontal pockets with 0.2% solution of CHX. The patients of the second group (n = 14), in addition to the treatment of periodontal pockets, were treated with a 5 mg/mL colloidal SSI. Results. During the periodontal treatment, the mean values of all clinical pa­rameters (except clinical attachment loss – CAL), in the both groups of patients were statistically significantly lower (p < 0.001) in relation to the initial values. The greater re­duction of periodontal bleeching on probing (BOP) depth after one month was found in the SSI treated group (0.97 mm) in relation to the CHX group (0.65 mm). The local ap­plication of CHX and SSI led to statistically significant re­duction of gingival parameters (gingival index – GI and BOP) in the groups after the treatment (GI for 0.65 and 0.87; BOP for 0.31 and 0.33, respectively). Conclusion. The results of our study showed that colloidal SSI was at least equally effective in the treatment of patients with periodontal disease as the solution of CHX. Additionally, the SSI is simple for use which speaks in favor of its more exten­sive use in dentistry including chronic periodontal disease.

Author Biographies

Vladan M. Kovačević, University of Defence, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic for Dental Diseases, Belgrade, Serbia

specijalista parodontologije i oralne medicine, vanredni profesor

Dragana R. Daković, University of Defence, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia; Military Medical Academy, Clinic for Dental Diseases, Belgrade, Serbia

redovni profesor u penziji

References

References

Lui J, Corbet EF, Jin L. Combined photodynamic and low-level laser therapies as an adjunct to nonsurgical treatment of chronic periodontitis. J Periodont Res 2011; 46(1): 89–96.

Anitha V, Rajesh P, Shanmugam M, Priya BM, Prabhu S, Shivaku-mar V. Comparative evaluation of natural curcumin and syn-thetic chlorhexidine in the management of chronic periodonti-tis as a local drug delivery: A clinical and microbiological study. Indian J Dent Res 2015; 26: 53–6.

Pattnaik S, Anand N, Chandrasekaran SC, Chandrashekar L, Ma-ha¬lakshmi K, Satpathy A. Clinical and antimicrobial efficacy of a controlled-release device containing chlorhexidine in the treatment of chronic periodontitis. Eur J Clin Microbiol In-fect Dis 2015; 34(10): 2103–10.

Genovesi A, Barone A, Toti P, Covani U. The efficacy of 0.12% chlorhexidine versus 0.12% chlorhexidine plus hyaluronic acid mouthwash on healing submerged single implant insertion ar-eas: A short-term randomized controlled clinical trial. Int J Dent Hyg 2017; 15(1): 65–72.

Dimitrijević B. Çlinical pariodontology. Belgrade: Zavod za udžbenike i nastavna sredstva; 2011. (Serbian)

Sigusch BW, Engelbrecht M, Völpel A, Holletschke A, Pfister W, Schütze J. Full-mouth antimicrobial photodynamic therapy in Fusobacterium nucleatum-infected periodontitis patients. J Pe¬riodontol 2010; 81(7): 975–81.

Hanes PJ, Purvis JP. Local anti-infective therapy: Pharmacolog-i¬cal agents. A systematic review. Ann Periodontol 2003; 8(1): 79–98.

Berchier CE, Slot DE, van der Weijden GA. The efficacy of 0.12% chlorhexidine mouthrinse compared with 0.2% on plaque ac¬cumulation and periodontal parameters: A systematic review. J Clin Periodontol 2010; 37(9): 829–39.

AHFS. Skin and mucous membrane agents: American Hospi-tal Formulary Service ( AHFS) Drug information. Bethesda, USA: American Society of Health-System Pharmacits; 2011.

Lindhe J, Lang NP, Karring T. Clinical Periodontology and Im-plant Dentistry. 5th ed. Copenaghen, Denmark: Blackwell Munksgaard; 2008.

Medaiah S, Srinivas M, Melath A, Girish S, Polepalle T, Dasari AB. Chlorhexidine chip in the treatment of chronic periodon-titis: A clinical study. J Clin Diagn Res 2014; 8(6): ZC22–5.

Matesanz-Pérez P, García-Gargallo M, Figuero E, Bascones-Martínez A, Sanz M, Herrera D. A systematic review on the ef-fects of lo¬cal antimicrobials as adjuncts to subgingival deb-ridement, compared with subgingival debridement alone, in the treat¬ment of chronic periodontitis. J Clin Periodontol 2013; 40(3): 227–41.

Jeong SH, Hwang YH, Yi SC. Antibacterial properties of pad-ded PP/PE nonwovens incorporating nano-sized silver col-loids. J Mater Sci 2005; 40(20): 5413–8.

McCann M, Curran R, Ben-Shoshan M, Mckee V, Tahir AA, Dev-e¬reux M, et al. Silver (I) complexes of 9-anthracenecarboxylic acid and imidazoles: Synthesis, structure and antimicrobial ac-tivity. Dalton Trans 2012;41(21)

Rotenoy KR. Pain. In: Porter SR, editor. The Merck Manual of di¬agnosis and treatment. 19th ed. Witherhouse, NJ: Merck Sharp & Dohme Corp; 2011. p. 1620–3.

Alidaee MR, Taheri A, Mansoori P, Ghodsi SZ. Silver nitrate cau¬tery in aphthous stomatitis: A randomized controlled trial. Br J Dermatol 2005; 153(3): 521–5.

Spacciapoli P, Buxton D, Rothstein D, Friden P. Antimicrobial ac-tiv¬ity of silver nitrate against periodontal pathogens. J Perio-dontal Res 2001; 36(2): 108–13.

Straub AM, Suvan J, Lang NP, Mombelli A, Braman V, Massaro J, et al. Phase 1 evaluation of a local delivery device releasing sil¬ver ions in periodontal pockets: Safety, pharmacokinetics and bioavailability. J Periodontal Res 2001; 36(3): 187–93.

Shacoori ZT, Chandad F, Rebillard A, Cillard J. Silver-Zeolite com¬bined to polyphenol-rich extracts of Ascophyllum nodo-sum: Potential Active Role in Prevention in Periodontal Dis-eases. PLoS ONE 2014; 9(10): e105475.

Shahab A, Haghighati F, Baeeri M, Jamalifar H, Abdollahi M. A clinical, microbiological and immunological comparison be-tween subgingival irrigation with DentolTM and chlorhexidine in advanced periodontitis. Arch Med Sci 2011; 7(1): 154–60.

Krück C, Eick S, Knöfler GU, Purschwitz RE, Jentsch HF. Clinical and microbiologic results 12 months after scaling and root planing with different irrigation solutions in patients with moderate chronic periodontitis: A pilot randomized trial. J Pe-riodontol 2012; 83(3): 312–20.

Cobb CM. Clinical significance of non-surgical periodontal ther¬apy: An evidence-based perspective of scaling and root planing. J Clin Periodontol 2002; 29(Suppl 2): 6–16.

Rashed HT. Evaluation of the effect of hydrogen peroxide as mouthwash in comparison with chlorhexidine in chronic pe-riodontitis patients: A clinical study. J Int Soc Prev Commu-nity Dent 2016; 6(3): 206–12.

Reise M, Gottschaldt M, Matz C, Volpel A, Jandt KD, Schubert US, et al. Antibacterial effect of silver (I) carbohydrate com-plexes on oral pathogenic key species in vitro. BMC Oral Health 2016; 16: 42.

Lu Z, Rong K, Li J, Yang H, Chen R. Size-dependent antibacte-rial activities of silver nanoparticles against oral anaerobic pathogenic bacteria. J Mater Sci Mater Med 2013; 24(6): 1465–71.

Yilmaz HG, Bayindir H. Clinical evaluation of chlorhexidine and essential oils for adjunctive effects in ultrasonic instru-mentation of furcation involvements: A randomized con-trolled clinical trial. Int J Dent Hygiene 2012; 10(2): 113–7.

Bidar M, Naderinasab M, Talati A, Ghazvini K, Asgari S, Hadi-zadeh B, et al. The effects of different concentrations of chlor-hexidine gluconate on the antimicrobial properties of mineral trioxide aggregate ond calcium enrich mixture. Dent Res J (Is-fahan) 2012; 9(4): 466–71.

Singh H, Kapoor P, Dhillon J, Kaur M. Evaluation of three dif-fer¬ent concentrations of Chlorhexidine for their substantivity to human dentin. Indian J Dent 2014; 5(4): 199–201.

Wen L, Wang RE, Finger M, Lang NP. Evaluation of the an-tigin¬givitis effect of a chlorhexidine mouthwash with or with-out an discoloration system compared to placebo during ex-perimental gingivitis. J Investig Clin Dentist 2014; 5(1): 15–22.

Sağlam M, Arslan U, Buket BŞ, Hakki SS. Boric acid irrigation as an adjunct to mechanical periodontal therapy in patients with chronic periodontitis: A randomized clinical trial. J Peri-o¬dontol 2013; 84(9): 1297–308.

Chang YC, Huang FM, Tai KW, Chou MY. The effect of sodi-um hypochlorite and chlorhexidine on cultured human perio-dontal ligament cells. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001; 92(4): 446–50.

Feng QL, Wu J, Chen GQ, Cui FZ, Kim TN, Kim JO. A mecha-nis¬tic study of the antibacterial effect of silver ions on Esche-richia coli and Staphylococcus aureus. J Biomed Mater Res 2000; 52(4): 662–8.

Pucher JJ, Daniel JC. The effect of chlorhexidine digluconate on human fibroblasts in vitro. J Perodontol 1992; 63(6): 526–32.

Jain A, Bhaskar DJ, Gupta D, Agali C, Gupta V, Gupta RK, et al. Comparative evaluation of honey, chlorhexidine gluconate 0, 2% and combination of xylitol and chlorhexidine mouth-wash (0.2%) on the clinical level of dental plaque: A 30 days ran¬domized control trial. Perspect Clin Res 2015; 6(1): 53–7.

Published
2021/01/13
Section
Short Report