Research Article Volume 25 Issue 4 - 2026

Comparative Clinical Evaluation of Local Drug Delivery System of Tetracycline Fiber, Hyaluronan Gel and Chlorhexidine Gel, as Adjunct to Scaling and Root Planing with Scaling and Root Planing Alone in the Treatment of Chronic Periodontitis

Komal S Sharma1*, Chetan Sharma2 and Sudhanshu Agrawal1*

1Reader and Professor, Department of Periodontology, Chandra Dental College and Hospital, Safedabad, Barabanki, Uttar Pradesh, India
2Reader, Department of Oral Pathology, Chandra Dental College and Hospital, Safedabad, Barabanki, Uttar Pradesh, India

*Corresponding Author: Komal S Sharma and Sudhanshu Agrawal, Reader and Professor, Department of Periodontology, Chandra Den- tal College and Hospital, Safedabad, Barabanki, Uttar Pradesh, India.
Received: March 10, 2026; Published: April 22, 2026



Aim: The aim of this study was to evaluate the effects of hyaluronan (HA) and chlorhexidine (CHX) gels as adjunct to scaling and root planing (SRP) in the treatment of chronic periodontitis.

Materials and Methods: 40 patients within the age group of 25 - 55 year participated in the study were randomly equally divided into four groups. Complete SRP and subgingival debridement were performed within all the patients. For control (Group IV) patients, SRP was the only treatment modality given; for group I, II and III patients, at least 10 teeth with 4 ‑ 8 mm probing pocket depth (PPD) were selected for subgingival application of Tetracycline fiber, HA gel and CHX gel, respectively. Clinical periodontal parameter such as gingival index, PPD, and clinical attachment level (CAL) were recorded at baseline and 3 months, whereas plaque index was recorded at baseline, 1 month, and 3 months.

Results: In all the four groups, a significant reduction in PPD and gain in CAL were observed between baseline and 3 months follow-up (P < 0.05); however, at 3 months, PPD was decreased more in group II. In group III pocket depth decreased less than group I but it is not significant. Group IV shows fewer changes in pocket depth than group I, II and group III, but the difference was non‑significant, and group IV (control) showed less changes in PPD and CAL than all experimental groups.

Keywords: Chlorhexidine; Chronic Periodontitis; Hyaluronan

  1. Cosyn J and Wyn I. “A systematic review on the effects of the chlorhexidine chip when used as an adjunct to scaling and root planing in the treatment of chronic periodontitis”. Journal of Periodontology 2 (2006): 257-264.
  2. Paolantonio M., et al. “Clinical, microbiologic, and biochemical effects of subgingival administration of a Xanthan-based chlorhexidine gel in the treatment of periodontitis: A randomized multicenter trial”. Journal of Periodontology9 (2009): 1479-1492.
  3. Johannsen A., et al. “Local delivery of hyaluronan as an adjunct to scaling and root planing in the treatment of chronic periodontitis”. Journal of Periodontology9 (2009): 1493-1497.
  4. Ide M., et al. “The short-term effects of treatment of chronic periodontitis on circulating levels of endotoxin, C-reactive protein, tumor necrosis factor-alpha, and interleukin-6”. Journal of Periodontology3 (2004): 420-428.
  5. Spolsky VW. “Epidemiology of gingival and periodontal diseases”. In: Carranza FA, Newman MG, editors. Clinical Periodontology. 8th Bangalore: Prism Books Pvt Ltd (1996): 65.
  6. Checchi and Pelliccioni. “Hand versus ultra sonic instrumentation in the removal of endotoxins from root surface in vitro”. Journal of Periodontology6 (1988): 398-402.
  7. Drisko C., et al. “Sonic and ultrasonic scalers in periodontics”. Journal of Periodontology11 (2000): 1792-1801.
  8. Tonetti MS. “Local delivery of tetracycline: from concept to clinical application”. Journal of Clinical Periodontology11.2 (1998): 969-997.
  9. Pagnacco A., et al. “Double-blind clinical trial Vs. placebo of a new sodium-hyaluronate-based gingival gel”. Attualita Terapeutica Internazionale4 (1997).
  10. Jentsch H., et al. “Treatment of gingivitis with hyaluronan”. Journal of Clinical Periodontology2 (2003): 159-164.
  11. Pistorius A., et al. “The clinical application of hyaluronic acid in gingivitis therapy”. Quintessence International 7-8 (2005): 531-538.
  12. John W Rapley., et al. “Serum levels of tetracycline during treatment with tetracycline-containing fibers”. Journal of Periodontology10 (1992): 817-820.
  13. Paolantonio M., et al. “Clinical, microbiologic, and biochemical effects of subgingival administration of a Xanthan-based chlorhexidine gel in the treatment of periodontitis: a randomized multicenter trial”. Journal of Periodontology9 (2009): 1479-1492.

Komal S Sharma and Sudhanshu Agrawal., et al. “Comparative Clinical Evaluation of Local Drug Delivery System of Tetracycline Fiber, Hyaluronan Gel and Chlorhexidine Gel, as Adjunct to Scaling and Root Planing with Scaling and Root Planing Alone in the Treatment of Chronic Periodontitis”. EC Dental Science 25.4 (2026): 01-10.