{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T23:00:52Z","timestamp":1787785252011,"version":"build-2784847793"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,11,11]],"date-time":"2020-11-11T00:00:00Z","timestamp":1605052800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aap.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Periodontology"],"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Peri\u2010implantitis is a challenging condition to manage and is frequently treated using non\u2010surgical debridement. The local delivery of antimicrobial agents has demonstrated benefit in mild to moderate cases of peri\u2010implantitis. This study compared the safety and efficacy of chlorhexidine gluconate 2.5\u00a0mg chip (CHX chips) as an adjunctive treatment to subgingival debridement in patients afflicted with peri\u2010implantitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A multicenter, randomized, single\u2010blind, two\u2010arm, parallel Phase\u20103 study was conducted. Peri\u2010implantitis patients with implant pocket depths (IPD) of 5\u20108\u00a0mm underwent subgingival implant surface debridement followed by repeated bi\u2010weekly supragingival plaque removal and chlorhexidine chips application (ChxC group) for 12\u00a0weeks, or similar therapy but without application of ChxC (control group). All patients were followed for 24\u00a0weeks. Plaque and gingival indices were measured at every visit whereas IPD, recession, and bleeding on probing were assessed at 8, 12, 16, 24\u00a0week.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 290 patients were included: 146 in the ChxC group and 144 in the control. At 24\u00a0weeks, a significant reduction in IPD (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.01) was measured in the ChxC group (1.76 \u00b1 1.13\u00a0mm) compared with the control group (1.54 \u00b1 1.13\u00a0mm). IPD reduction of \u22652\u00a0mm was found in 59% and 47.2% of the implants in the ChxC and control groups, respectively (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.03). Changes in gingival recession (0.29 \u00b1 0.68\u00a0mm versus 0.15 \u00b1 0.55\u00a0mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.015) and relative attachment gain (1.47 \u00b1 1.32\u00a0mm and 1.39 \u00b1 1.27\u00a0mm,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.0017) were significantly larger in the ChxC group. Patients in the ChxC group that were\u00a0&lt;\u00a065 years exhibited significantly better responses (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.02); likewise, non\u2010smokers had similarly better response (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.02). Both protocols were well tolerated, and no severe treatment\u2010related adverse events were recorded throughout the study.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with peri\u2010implantitis that were treated with an intensive treatment protocol of bi\u2010weekly supragingival plaque removal and local application of chlorhexidine chips had greater mean IPD reduction and greater percentile of sites with IPD reduction of \u22652\u00a0mm as compared with bi\u2010weekly supra\u2010gingival plaque removal.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jper.20-0353","type":"journal-article","created":{"date-parts":[[2020,10,28]],"date-time":"2020-10-28T05:52:45Z","timestamp":1603864365000},"page":"11-20","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Repeated delivery of chlorhexidine chips for the treatment of peri\u2010implantitis: A multicenter, randomized, comparative clinical trial"],"prefix":"10.1002","volume":"92","author":[{"given":"Eli E.","family":"Machtei","sequence":"first","affiliation":[{"name":"Department of Periodontology School of Graduate Dentistry Faculty of Medicine Technion (I.I.T.) Rambam health care campus  Haifa Israel"},{"name":"Division of Periodontology Department of Oral Medicine Infection and Immunity Harvard School of Dental Medicine Harvard University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Romanos","sequence":"additional","affiliation":[{"name":"Department of Periodontology School of Dental Medicine  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Kang","sequence":"additional","affiliation":[{"name":"Division of Periodontics Section of Oral Diagnostic and Rehabilitation Sciences College of Dental Medicine Columbia University  New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suncica","family":"Travan","sequence":"additional","affiliation":[{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Schmidt","sequence":"additional","affiliation":[{"name":"Department of Periodontics Justus\u2010Liebig University  Giessen &amp; Avadent Bad Homburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Papathanasiou","sequence":"additional","affiliation":[{"name":"Department of Periodontology Tufts University School of Dental Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Tatarakis","sequence":"additional","affiliation":[{"name":"Center for Oral Clinical Research Barts &amp; The Royal London School of Medicine and Dentistry Institute of Dentistry Queen Mary University of London (QMUL)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moshik","family":"Tandlich","sequence":"additional","affiliation":[{"name":"Department of Periodontology the Hebrew University\u2010Hadassah Faculty of Dental Medicine  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leila H.","family":"Liberman","sequence":"additional","affiliation":[{"name":"Central Texas Veterans Health Care System  Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Horwitz","sequence":"additional","affiliation":[{"name":"Department of Periodontology School of Graduate Dentistry Faculty of Medicine Technion (I.I.T.) Rambam health care campus  Haifa Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seyed Hossein","family":"Bassir","sequence":"additional","affiliation":[{"name":"Department of Periodontology School of Dental Medicine  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivas","family":"Myneni","sequence":"additional","affiliation":[{"name":"Department of Periodontology School of Dental Medicine  Stony Brook New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harlan J.","family":"Shiau","sequence":"additional","affiliation":[{"name":"Department of Advanced Oral Sciences and Therapeutics School of Dentistry University of Maryland  Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lior","family":"Shapira","sequence":"additional","affiliation":[{"name":"Department of Periodontology the Hebrew University\u2010Hadassah Faculty of Dental Medicine  Jerusalem Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikos","family":"Donos","sequence":"additional","affiliation":[{"name":"Center for Oral Clinical Research Barts &amp; The Royal London School of Medicine and Dentistry Institute of Dentistry Queen Mary University of London (QMUL)  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athena","family":"Papas","sequence":"additional","affiliation":[{"name":"Division of Oral Medicine Tufts University School of Dental Medicine  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joerg","family":"Meyle","sequence":"additional","affiliation":[{"name":"Department of Periodontics Justus\u2010Liebig University  Giessen &amp; Avadent Bad Homburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7102-9746","authenticated-orcid":false,"given":"William V.","family":"Giannobile","sequence":"additional","affiliation":[{"name":"Division of Periodontology Department of Oral Medicine Infection and Immunity Harvard School of Dental Medicine Harvard University  Boston Massachusetts USA"},{"name":"Department of Periodontics and Oral Medicine University of Michigan School of Dentistry  Ann Arbor Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6538-3618","authenticated-orcid":false,"given":"Panos N.","family":"Papapanou","sequence":"additional","affiliation":[{"name":"Division of Periodontics Section of Oral Diagnostic and Rehabilitation Sciences College of Dental Medicine Columbia University  New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Periodontology Department of Oral Medicine Infection and Immunity Harvard School of Dental Medicine Harvard University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,11,11]]},"reference":[{"issue":"5","key":"e_1_2_8_2_1","first-page":"S21","article-title":"Treatment of peri\u2010implantitis: what interventions are effective? 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