Comparative Evaluation of Locally Applied Chlorhexidine 1% Gel and Citrus sinensis Peel Extract Gel as an Adjunct to Nonsurgical Periodontal Therapy in Localized Periodontitis Treatment: A Clinico-Microbiological Study.

Background: Periodontal disease is polymicrobial in nature and to control the infection we need to target the inflammatory component. Nonsurgical periodontal therapy is used for mechanical debridement. Use of agents along with nonsurgical periodontal therapy is gaining momentum. Locally delivered agents like antibiotics and herbal products are used in nonsurgical and surgical periodontal therapy. Phytotherapy offers antioxidant, antimicrobial action and has less chances of drug resistance. Objective: This study design compared locally delivered chlorhexidine (CHX) 1% gel and Citrus sinensis peel extract (CSPE) gel in the management localized periodontitis as an adjuvant treatment to scaling and root planing (SRP). Material and Method: Forty-six subjects diagnosed with Grade II/III localized periodontitis were randomly assigned into two groups. After thorough SRP, CSPE gel placement was done in the test group and 1% CHX gel in the control group. Clinical parameters measured were probing pocket depth (PPD), clinical attachment level (CAL) and microbiological analysis (bacterial culture from pocket sample) was done prior to SRP and at 60 days. Results: Both the 1% CHX and CSPE gel provide comparable outcome (p ≥ 0.05) in improvement of PPD, CAL and bacterial colony count. Statistically significant results were obtained in terms of PPD; p = 0.044 (test group) and p = 0037 (control group). CAL showed statistically significant results in test group with p = 0.044. Inter group and Intra group comparison of plaque index showed no statistical difference. Colony forming units (CFU) between the two groups (p = 0.001) was found statistically significant. Conclusion: Locally delivered herbal CSPE gel can be an effective, economical,and antibacterial gel as an adjunctive treatment of periodontitis.