Two kinds of periodontal therapy: long-term results on the reduction of oral malodor

Objectives: The purpose of this study was to evaluate during 18 months, two kinds of periodontal treatments concerning the reduction of malodor, while periodontal pockets are sites of volatile sulfur compounds (VSC) production. Methods: Twenty patients with chronic periodontitis and probing depths >5.0mm at least 4 teeth were randomly divided in two groups: Control (GI) - scaling and root planning alone (SRP) and Test (GII) - combined use of SRP and subgingival placed drug delivery system containing 2.5mg chlorhexidine. Clinical parameters (Plaque Index-PlI, Probing Depth-PD, Bleeding on Probing-BOP) were recorded at baseline, 3, 6, 9 and 18 months after periodontal treatments. Samples for BANA Test were taken from dorsal surface of the tongue and periodontal pockets (subgingival plaque) and analyzed for the presence of periodontopathic microorganisms: P.gingivalis, B.forsythus and/or T.denticola. The concentration of VSC in the human mouth was determined by a portable sulfide monitor (Halimeter). Results: Both groups presented significant improvements (p<0.05) in all parameters analyzed over the study period (PD - Wilcoxon Test, and PlI, BOP, BANA - Chi-square Test). There were statistically significant differences between the GI and GII for BOP (34.6% and 51.6%, respectively) and positive subgingival samples for BANA Test (57.7% and 80.6%, respectively) at 18 months, which were reduced in the control group. The levels of VSC in the Group I were reduced (Wilcoxon Test, p<0.05) after all considered periods: 295.4ppb (baseline) to 130.1ppb (18 months). In the Group II, the difference was observed at 6 months: 320.8ppb (baseline) to 148.8ppb (6 months), and the VSC levels showed higher than Group I at 6, 9 and 18 months (210.5ppb). Conclusions: The two evaluated periodontal treatments were efficient to show improvements in the clinical and microbiological parameters, and the use of chlorhexidine chip didn't offer additional benefit to reduce halitosis.