Clinical Oral Investigations

, Volume 22, Issue 2, pp 791–800 | Cite as

The effects of a desiccant agent in the treatment of chronic periodontitis: a randomized, controlled clinical trial

  • Gaetano Isola
  • Giovanni MatareseEmail author
  • Ray C. Williams
  • Vincenzo Iorio Siciliano
  • Angela Alibrandi
  • Giancarlo Cordasco
  • Luca Ramaglia
Original Article



Chemotherapeutic agents have been widely used as adjuncts for the treatment of chronic periodontitis (CP). This study investigated and compared a desiccant agent as an adjunct to scaling and root planing (SRP) versus SRP alone for the treatment of CP.

Materials and methods

Thirty-six patients with CP were studied. Using a split-mouth design, the maxillary right and left quadrants were randomly assigned to SRP plus desiccant (Hybenx® EPIEN Medical, Inc. St. Paul, MN, USA) or SRP alone. Patients were examined on a regular basis for clinical, microbiological, and inflammatory mediator changes over a 1-year period. Clinical attachment level (CAL) was the primary outcome variable. In addition, the red complex bacteria and gingival crevicular fluid (GCF) inflammatory mediators were monitored.


Compared to baseline, both treatments demonstrated an improvement in periodontal parameters. Compared to SRP alone, SRP plus desiccant yielded a significant improvement in probing depth (PD) (SRP: 2.23 ± 0.31 mm vs. desiccant: 3.25 ± 0.57 mm, p < 0.05), CAL (SRP: 3.16 ± 0.29 mm vs. desiccant: 4.21 ± 0.34 mm, p < 0.05 mm) and bleeding on probing (BOP) (SRP: 4.56 ± 1.5% vs. desiccant: 34.23 ± 4.2%, p < 0.001) at 12 months. Similarly, in the SRP plus desiccant group, the bacteria of the red complex were significantly reduced (p < 0.05); and the level of inflammatory mediators was significantly reduced (p < 0.003) compared to SRP alone.


SRP plus the desiccant resulted in a greater reduction in clinical, microbial and inflammatory mediators compared to SRP alone.

Clinical relevance

Desiccant, when combined to SRP, was demonstrated as a significant approach to control the levels of certain periodontal pathogens, inflammatory mediators in patients with CP.


Chronic periodontitis Desiccants Local delivery Scaling and root planing Randomized controlled trials Microbiology 



The authors would like to thank Dr. Giampaolo Menegazzi for his technical assistance, Dr. Simona Violi for her clinical assistance, and Dr. Rita Aveni of the University of Messina for her help in searching for literature.

This work has been performed with funding by the Department of Biomedical, Odontostomatological Sciences and Morphological and Functional Images, University of Messina, and confirm that all patients of this study were enrolled at the University of Messina, Italy.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


The work was supported by the Department of Odontostomatology, School of Dentistry, University of Messina, Italy.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The local ethical committee of the University of Messina approved the study protocol (#919-10).

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

784_2017_2154_MOESM1_ESM.doc (220 kb)
ESM 1 (DOC 220 kb)


  1. 1.
    Socransky SS, Haffajee AD (1992) The bacterial etiology of destructive periodontal disease: current concepts. J Periodontol 63:322–331CrossRefPubMedGoogle Scholar
  2. 2.
    Matarese G, Isola G, Anastasi GP, Cutroneo G, Favaloro A, Vita G, Cordasco G, Milardi D, Zizzari VL, Tetè S, Perillo L (2013) Effects of the transforming growth factor beta 1 and vascular endothelial growth factor expressions in the pathogenesis of periodontal disease. Eur J Inflamm 11:479–488CrossRefGoogle Scholar
  3. 3.
    Matarese G, Currò M, Isola G, Caccamo D, Vecchio M, Giunta ML, Ramaglia L, Cordasco G, Williams RC, Ientile R (2015) Transglutaminase 2 up-regulation is associated with RANKL/OPG pathway in cultured HPDL cells and THP-1-differentiated macrophages. Amino Acids 47:2447–2455CrossRefPubMedGoogle Scholar
  4. 4.
    Socransky SS, Haffajee AD (2002) dental biofilms: difficult therapeutic targets. Periodontol 2000 28:12–55CrossRefPubMedGoogle Scholar
  5. 5.
    Teles RP, Haffajee AD, Socransky SS (2006) microbiological goals of periodontal therapy. Periodontol 2000 42:180–218CrossRefPubMedGoogle Scholar
  6. 6.
    Oda S, Nitta H, Setoguchi T, Izumi Y, Ishikawa I (2004) current concepts and advances in manual and power-driven instrumentation. Periodontol 2000 36:45–58CrossRefPubMedGoogle Scholar
  7. 7.
    Tunkel J, Heinecke A, Flemmig TF (2002) A systematic review of efficacy of machine-driven and manual subgingival debridement in the treatment of chronic periodontitis. J Clin Periodontol 29(S3):72–81CrossRefPubMedGoogle Scholar
  8. 8.
    Mombelli A, Schmid B, Rutar A, Lang NP (2000) Persistence patterns of Porphyromonas gingivalis, Prevotella intermedia/nigrescens, and Actinobacillus actinomyetemcomitans after mechanical therapy of periodontal disease. J Periodontol 71:14–21CrossRefPubMedGoogle Scholar
  9. 9.
    Petersilka GJ, Ehmke B (2000) Flemmig TF (2002) antimicrobial effects of mechanical debridement. Periodontol 28:56–71CrossRefGoogle Scholar
  10. 10.
    Lafaurie GI, Mayorga-Fayad I, Torres MF, Castillo DM, Aya MR, Barón A, Hurtado PA (2007) Periodontopathic microorganisms in peripheral blood after scaling and root planing. J Clin Periodontol 34:873–879CrossRefPubMedGoogle Scholar
  11. 11.
    Moreira AL, Novaes AB Jr, Grisi MF, Taba M Jr, Souza SL, Palioto DB, de Oliveira PG, Casati MZ, Casarin RC, Messora MR (2015) Antimicrobial photodynamic therapy as an adjunct to non-surgical treatment of aggressive periodontitis: a split-mouth randomized controlled trial. J Periodontol 86:376–386CrossRefPubMedGoogle Scholar
  12. 12.
    Zandbergen D, Slot DE, Cobb CM, Van der Weijden FA (2013) The clinical effect of scaling and root planing and the concomitant administration of systemic amoxicillin and metronidazole: a systematic review. J Periodontol 84:332–351CrossRefPubMedGoogle Scholar
  13. 13.
    Sgolastra F, Gatto R, Petrucci A, Monaco A (2012) Effectiveness of systemic amoxicillin/metronidazole as adjunctive therapy to scaling and root planing in the treatment of chronic periodontitis: a systematic review and meta-analysis. J Periodontol 83:1257–1269CrossRefPubMedGoogle Scholar
  14. 14.
    Smiley CJ, Tracy SL, Abt E, Michalowicz BS, John MT, Gunsolley J, Cobb CM, Rossmann J, Harrel SK, Forrest JL, Hujoel PP, Noraian KW, Greenwell H, Frantsve-Hawley J, Estrich C, Hanson N (2015) Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. J am Dent Assoc 146:508–524 e5CrossRefPubMedGoogle Scholar
  15. 15.
    Haffajee AD, Socransky SS (1994) microbial etiological agents of destructive periodontal diseases. Periodontol 2000 5:78–111CrossRefPubMedGoogle Scholar
  16. 16.
    Marsh PD (2005) Dental plaque: biological significance of a biofilm and community life-style. J Clin Periodontol 32:7–15CrossRefPubMedGoogle Scholar
  17. 17.
    Rhodus NL, Bereuter J (1998) An evaluation of a chemical cautery agent and an anti-inflammatory ointment for the treatment of recurrent aphthous stomatitis: a pilot study. Quintessence Int 29:769–773PubMedGoogle Scholar
  18. 18.
    Porter SR, Al-Johani K, Fedele S, Moles DR (2009) Randomised controlled trial of the efficacy of HybenX in the symptomatic treatment of recurrent aphthous stomatitis. Oral Dis 15:155–161CrossRefPubMedGoogle Scholar
  19. 19.
    Lombardo G, Signoretto C, Corrocher G, Pardo A, Pighi J, Rovera A, Caccuri F, Nocini PF (2015) A topical desiccant agent in association with ultrasonic debridement in the initial treatment of chronic periodontitis: a clinical and microbiological study. New Microbiol 38:393–407PubMedGoogle Scholar
  20. 20.
    Bracke J, Basara M, Savord E, Dunaway A, Watkins M (2015) Pilot evaluation of a simple adjunctive method for improved removal of oral biofilm during conventional scaling and root planing therapy. J Biol Regul Homeost Agents 29:6–9PubMedGoogle Scholar
  21. 21.
    Armitage GC (1999) Development of a classification system for periodontal diseases and conditions. Ann Periodontol 4:1–6CrossRefPubMedGoogle Scholar
  22. 22.
    Braun A, Dehn C, Krause F, Jepsen S (2008) Short-term clinical effects of adjunctive antimicrobial photodynamic therapy in periodontal treatment: a randomized clinical trial. J Clin Periodontol 35:877–884CrossRefPubMedGoogle Scholar
  23. 23.
    Schulz KF, Altman DG, Moher D, CONSORT Group (2010) CONSORT 2010 statement: updated guidelines for reporting parallel group randomized trials. Ann Intern Med 152:726–732CrossRefPubMedGoogle Scholar
  24. 24.
    O’Leary TJ, Drake RB, Naylor JE (1972) The plaque control record. J Periodontol 43:38CrossRefPubMedGoogle Scholar
  25. 25.
    Socransky SS, Smith C, Martin L, Paster BJ, Dewhirst FE, Levin AE (1994) “Checkerboard” DNA-DNA hybridization. BioTechniques 17:788–792PubMedGoogle Scholar
  26. 26.
    Novaes AB Jr, Schwartz-Filho HO, de Oliveira RR, Feres M, Sato S, Figueiredo LC (2012) Antimicrobial photodynamic therapy in the non-surgical treatment of aggressive periodontitis: microbiological profile. Lasers Med Sci 27:389–395CrossRefPubMedGoogle Scholar
  27. 27.
    Luchesi VH, Pimentel SP, Kolbe MF, Ribeiro FV, Casarin RC, Nociti FH Jr, Sallum EA, Casati MZ (2013) Photodynamic therapy in the treatment of class II furcations: a randomized controlled clinical trial. J Clin Periodontol 40:781–788CrossRefPubMedGoogle Scholar
  28. 28.
    Socransky SS, Haffajee AD, Smith C, Dibart S (1991) Relation of counts of microbial species to clinical status at the sampled site. J Clin Periodontol 18:766–775CrossRefPubMedGoogle Scholar
  29. 29.
    Conover WJ (1999) Practical nonparametric statistics. John Wiley & Sons, Inc, New York: WileyGoogle Scholar
  30. 30.
    Drisko CH (2001) Non surgical periodontal therapy. Periodontol 2000(25):77–88CrossRefGoogle Scholar
  31. 31.
    Lo Giudice G, Lo Giudice R, Matarese G, Isola G, Cicciù M, Terranova A, Palaia G, Romeo U (2015) Evaluation of magnification systems in restorative dentistry. An in-vitro study. Dental Cadmos 83:296–305CrossRefGoogle Scholar
  32. 32.
    Matuliene G, Pjetursson BE, Salvi GE, Schmidlin K, Brägger U, Zwahlen M, Lang NP (2008) Influence of residual pocket on progression of periodontitis and tooth loss: results after 11 years of maintenance. J Clin Periodontol 35:685–695CrossRefPubMedGoogle Scholar
  33. 33.
    Mongardini C, van Steenberghe D, Dekeyser C, Quirynen M (1999) One stage full- versus partial-mouth disinfection in the treatment of chronic adult or generalized early-onset periodontitis. I. Long-term clinical observations. J Periodontol 70:632–645CrossRefPubMedGoogle Scholar
  34. 34.
    Page RC (2004) The microbiological case for adjunctive therapy for periodontitis. J Int Acad Periodontol 6:143–149PubMedGoogle Scholar
  35. 35.
    Vergidis PI, Falagas ME (2008) Multidrug-resistant gram-negative bacterial infections: the emerging treat and potential novel treatment option. Curr Opin Investig Drugs 9:176–183PubMedGoogle Scholar
  36. 36.
    Teles R, Teles F, Frias-Lopez J, Paster B (2000) Haffajee a (2013) lessons learned and unlearned in periodontal microbiology. Periodontol 62:95–162CrossRefGoogle Scholar
  37. 37.
    Lang NP, Group B (2015) Reactor report. Non-surgical periodontal therapy: mechanical debridement, antimicrobial agents and other modalities. J Int Acad Periodontol 17(1 Suppl):31–33PubMedGoogle Scholar
  38. 38.
    Lang NP, Tonetti MS (2003) Periodontal risk assessment (PRA) for patients in supportive periodontal therapy (SPT). Oral Health Prev Dent 1:7–16PubMedGoogle Scholar
  39. 39.
    Pini-Prato G, Magnani C, Rotundo R (2016) Treatment of acute periodontal abscesses using the biofilm decontamination approach: a case report study. Int J Periodontics Restorative Dent 36:55–63CrossRefPubMedGoogle Scholar
  40. 40.
    Dentino A, Lee S, Mailhot J (2000) Hefti AF (2013) principles of periodontology. Periodontol 61:16–53CrossRefGoogle Scholar
  41. 41.
    Arweiler NB, Pietruska M, Pietruski J, Skurska A, Dolińska E, Heumann C, Auschill TM, Sculean A (2014) Six-month results following treatment of aggressive periodontitis with antimicrobial photodynamic therapy or amoxicillin and metronidazole. Clin Oral Investig 18:2129–2135CrossRefPubMedGoogle Scholar
  42. 42.
    Air SP, Meghji S, Wilson M, Reddi K, White P, Henderson B (1996) Bacterially induced bone destruction: mechanisms and misconceptions. Infect Immun 64:2371–2380Google Scholar
  43. 43.
    Currò M, Matarese G, Isola G, Caccamo D, Ventura VP, Cornelius C, Lentini M, Cordasco G, Ientile R (2014) Differential expression of transglutaminase genes in patients with chronic periodontitis. Oral Dis 20:616–623CrossRefPubMedGoogle Scholar
  44. 44.
    Dastoor SF, Travan S, Neiva RF, Rayburn LA, Giannobile WV, Wang HL (2007) Effect of adjunctive azithromycin with periodontal surgery in the treatment of chronic periodontitis in smokers: a pilot study. J Periodontol 78:1887–1896CrossRefPubMedPubMedCentralGoogle Scholar
  45. 45.
    Mascarenhas P, Gapski R, Al-Shammari K, Hill R, Soehren S, Fenno JC, Giannobile WV, Wang HL (2005) Clinical response of azithromycin as an adjunct to non-surgical periodontal therapy in smokers. J Periodontol 76:426–436CrossRefPubMedGoogle Scholar
  46. 46.
    Goutoudi P, Diza E, Arvanitidou M (2004) Effect of periodontal therapy on crevicular fluid interleukin-1beta and interleukin-10 levels in chronic periodontitis. J Dent 32:511–520CrossRefPubMedGoogle Scholar
  47. 47.
    Sarkar S, Wilson M (1993) Lethal photosensitization of bacteria in subgingival plaque from patients with chronic periodontitis. J Periodontal Res 28:204–210CrossRefPubMedGoogle Scholar
  48. 48.
    Graves DT, Cochran D (2003) The contribution of interleukin-1 and tumor necrosis factor to periodontal tissue destruction. J Periodontol 74:391–401CrossRefPubMedGoogle Scholar
  49. 49.
    Cutroneo G, Piancino MG, Ramieri G, Bracco P, Vita G, Isola G, Vermiglio G, Favaloro A, Anastasi G, Trimarchi F (2012) Expression of muscle-specific integrins in masseter muscle fibers during malocclusion disease. Int J Mol Med 30:235–42Google Scholar

Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Gaetano Isola
    • 1
    • 2
  • Giovanni Matarese
    • 1
    Email author
  • Ray C. Williams
    • 3
  • Vincenzo Iorio Siciliano
    • 4
  • Angela Alibrandi
    • 5
  • Giancarlo Cordasco
    • 1
  • Luca Ramaglia
    • 2
  1. 1.Department of Biomedical, Odontostomatological Sciences and of Morphological and Functional Images, Unit of Periodontology, School of DentistryUniversity of MessinaMessinaItaly
  2. 2.Department of Neurosciences, Reproductive and Odontostomatological Sciences, School of MedicineUniversity of Naples “Federico II”NaplesItaly
  3. 3.Department of PeriodontologyUNC School of DentistryChapel HillUSA
  4. 4.Department of PeriodontologyUniversity of CatanzaroCatanzaroItaly
  5. 5.Department of Economics, Unit of Statistics and Mathematical SciencesUniversity of MessinaMessinaItaly

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